Objective

2

To compare the clinical effect and safety of integrated traditional Chinese and western medicine versus western medicine alone in the treatment of children's community-acquired pneumonia （CAP）.

Methods

2

A prospective cohort study was conducted in 13 domestic tertiary first-class pediatric hospitals and the pediatirc department of affiliated hospitals of the university of traditional Chinese medicine （TCM）. Children with CAP were included， and were naturally divided into western medicine group and integrated traditional Chinese and western medicine group according to the treatment they were given. The propensity score matching （PSM） method was used to calculate the scores of baseline variables and confounding factors that were statistically significant between the two groups， and were matched with 1∶1 nearest neighbor matching. A total of 424 cases were successfully matched， with 212 cases in each group. Repeated measures analysis of variance， Kaplan-Meier survival analysis， Log Rank test and other methods were used to analyze and compare the overall recovery rate of disease， the decreasing trend of disease score， the disappearance rate and disappearance time of symptoms or syndrome， hospitalization cost and length of stay between groups.

Results

2

The utilization rate of integrated traditional Chinese and western medicine in large hospitals in domestic China was 77.4%. Western medicine institutions mostly used Chinese patent medicines when applying integrated treatment， accounting for 74.3% of the total. The 7-day recovery rate of the integrated treatment group was 54.72%， significantly higher than 44.34% of the western medicine group （

P

＜0.05）， but there was no difference in the decreasing trend of disease score within 14 days between the groups （

P

＞0.05）. There was significant difference between groups in the disappearance rate and disappearance time of cough， expectoration， and auscultation rales on the 7th day （

P

＜0.05）， which was in favor of the integrated group. The disappearance rate of auscultation wet rales was higher and the disappearance time was shorter in the integrated group， while the disappearance rate the disappearance time of expectoration were better in the western medicine group. There was no significant difference in length of stay between the two groups （

P

＞0.05）. The integrated group had lower rate of adverse reactions （

P

＜0.05）， and lower hospitalization cost （

P

＜0.05）.

Conclusions

2

The integrated traditional Chinese and western medicine can improve the symptoms of pulmonary wet rales in children with CAP more quickly and effectively， and is superior to western medicine alone in terms of the safety and cost.