Meta-analysis on the treatment of adenoid hypertrophy in children with integrated traditional Chinese and western medicine

Objective: To evaluate the effect of combined Chinese and western medicine on children withadenoidal hypertrophy. Methods: System comprehensive retrieve hownet (CNKI), a database of ten thousand China (WanFang), Chinese biomedical database (CBM), weipu database (VIP), PubMed, Embase and Cochrane library database, retrieval time from March 1, 2009 to December 31, 2019, the use of "Cochrane bias risk assessment tools to have included in the quality of literature evaluation, and to use the literature on into RevMan 5.3 software for Meta quantitative analysis. A total of 10 references were included in this study, and a total of 464 clinical cases were included in the total sample size for meta-analysis, including 242 in the experimental group and 222 in the control group. Results: The statistical data show that the total effective rate of combined traditional Chinese and western medicine for the treatment of adenoid hypertrophy in children is higher than that of western medicine alone (OR = 4.27, 95% CI: 2.50, 7.13, P <0.00001) The effect of nasal congestion caused by adenoid hypertrophy in children is better than that of western medicine alone (MD =-0.64, 95% CI [-0.94, -0.35], P <0.0001);the effect of improving snoring symptoms in children Better than using western medicine alone, the difference is statistically significant (MD =-0.66, 95% CI [-1.11, -0.21], P <0.01);the effect of reducing the relative ratio of adenoid and posterior nostril is better than that of pure The difference was statistically significant when treated with Chinese or Western medicine (MD =-0.18, 95% CI [-0.24, -0.12], P <0.00001). Conclusion: Based on the existing data and methods, traditional Chinese medicine combined with western medicine has a reliable effect on adenoid hypertrophy in children. It is superior to western medicine alone in terms of treatment efficiency and improvement of clinical symptoms, without serious adverse reactions.

Assessment of Intranasal Steroid ,Effect in Management of Adenoid Hypertrophy in Children between 2-11 Years Old

Adenoid hypertrophy associated with high morbidity in children. However, in severe cases surgery recommended, some medical treatments are effective too. This study is based on effect of nasal steroid spray, mometasone, in decreasing upper airway obstruction and other symptoms of adenoid hypertrophy. In a clinical trial study 51 children with adenoid hypertrophy divided in two groups： 2-4 years old and 5-11 years old. Each patient receive nasal momethasone （one puff each nostril twice a day） for 3 months and their symptoms evaluated before treatment, 3 months after treatment initiation and 3 months after stop it with questionnaire and lateral neck radiography. Decreasing in all symptoms score and upper airway obstruction was statistically significant in both groups 3 months after treatment and its effect maybe stable for next 3 months. Nasal momethasone spray is effective in decreasing adenoid size and severity of symptoms of adenoid hypertrophy and this response is more obvious in 2-4 years old children.

变应原筛查在儿童腺样体肥大中的研究

目的讨论变应原筛查在腺样体肥大患儿中的结果及临床意义。方法选取我院住院治疗的200例腺样体肥大患儿为腺样体肥大组,40例不伴腺样体肥大患儿为对照组,检测血清变应原筛查,对结果进行不同组间比较。结果腺样体肥大组总过敏原阳性率、食入性过敏原阳性率、吸入性过敏原阳性率均高于对照组(χ^2=8.048、8.000、6.938,P均<0.05);腺样体肥大组中总过敏原阳性率随年龄增长呈下降趋势(χ^2=13.132,P<0.05))。总过敏原阳性项数、食入性过敏原阳性项数、吸入性过敏原阳性项数腺样体肥大组均高于对照组(Z=2.925、2.631、2.362,P均<0.05);腺样体肥大组中总过敏原阳性项数中位数以3~6岁组最高(Z=2.582,P<0.05),食入性过敏原中牛奶、鸡蛋白、牛/羊肉组合均高于对照组。结论过敏原刺激是腺样体肥大的病因之一,患儿发病年龄越小,过敏易感性程度越高,其中牛奶、鸡蛋白、牛/羊肉组合类食入性过敏原刺激作用不容小觑。

Clinical observation of Zhen'ai needling method in Nei Jing(Classic of Internal Medicine)for children with allergic rhinitis accompanied by adenoid hypertrophy

Objective:To observe the clinical efficacy of Zhen'ai needling method in Nei Jing(Classic of Internal Medicine)for children with allergic rhinitis(AR)accompanied by adenoid hypertrophy(AH).Methods:A total of 74 children who met the screening criteria were divided into a Zhen'ai group and a control group by the random number table method,with 37 cases in each group.The control group was treated with acupuncture at Zusanli(ST 36),Hegu(LI 4),Yingxiang(LI 20),Juliao(ST 3),Yintang(GV 29),Shangxing(GV 23)and Baihui(GV 20).The Zhen'ai group added points of Zhen'ai needling method{Shanglianquan[Extra,located at 1 cun above Lianquan(CV 23)],Tianrong(SI 17)and Lieque(LU 7)}in addition to the points in the control group.The needles were retained for 30 min.The treatment was performed twice a week.The total nasal symptom score(TNSS),sino-nasal outcome test-20(SNOT-20)and symptom scale for AH(SSAH)were assessed before and after 10 treatments.The clinical efficacy of the two groups was compared after treatment.Results:During the treatment,5 cases dropped out in the control group and 2 cases in the Zhen'ai group.After treatment,the total effective rate of the Zhen'ai group was 94.3%,versus 93.8%in the control group.There was no significant difference between the two groups(P>0.05).The markedly effective rate of the Zhen'ai group was 42.9%,versus 12.5%in the control group,and the difference was statistically significant(P<0.05).After treatment,there were significant intra-group differences in the scores of TNSS,SNOT-20 and SSAH in both groups(all P<0.05);the scores of SNOT-20 and SSAH in the Zhen'ai group were lower than those in the control group,and the differences between the groups were statistically significant(both P<0.05).Conclusion:Both conventional acupuncture and conventional acupuncture plus Zhen'ai needling method can improve clinical symptoms of children with AR accompanied by AH;and conventional acupuncture plus Zhen'ai needling method has a better effect than conventional acupuncture in improving AH symptoms.

Therapeutic efficacy observation of Tuina manipulation for pediatric adenoid hypertrophy

Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)manipulation for pediatric adenoid hypertrophy(AH).Methods A total of 60 children with AH were randomized into an observation group and a medication group,with 30 cases in each group.The observation group was treated with pediatric Tuina treatment,and the medication group was treated with 0.05%mometasone furoate nasal spray.The changes of main clinical symptom score,quality of life(QOL)score and X-ray nasopharynx lateral film were observed,and the clinical efficacy was evaluated.Results The total effective rate of the observation group was 90.0%,and that of the medication group was 66.7%.The difference between the two groups was statistically significant(P<0.05).After treatment,the A/N value[ratio of adenoid thickness(A)and nasopharyngeal cavity width(N)]of posterior nasopharyngeal lateral film did not show significant change in either group(P>0.05).After treatment,the clinical symptom scores in both groups decreased,and the intra-group differences were statistically significant(P<0.001),but there was no statistical difference between the two groups(P>0.05).After treatment,the QOL scores of children in both groups decreased,and the intra-group differences were statistically significant(P<0.001),and the difference between the two groups was statistically significant(P<0.001).Conclusion Tuina manipulation is effective in treating pediatric AH,and produces a better effect in improving traditional Chinese medicine symptoms and QOL than 0.05%mometasone furoate nasal spray.