Objective

2

To explore the relationship between traditional Chinese medicine （TCM） syndrome types and the clinical characteristics of severe

Mycoplasma pneumoniae

pneumonia （SMPP） in children.

Methods

2

A total of 408 children with SMPP who were hospitalized in the Department of Traditional Chinese Medicine at Beijing Children's Hospital， affiliated with Capital Medical University， from September 2019 to November 2023， were included in the study. TCM syndrome typing was conducted， and the characteristics of clinical manifestations and indicators of each syndrome type were observed.

Results

2

The most common TCM syndrome in children with SMPP was phlegm-heat obstructing lung syndrome， followed by toxin-heat obstructing lung syndrome， with high fever being the predominant symptom. Healthy

qi

deficiency and pathogen lingering syndrome and lung and spleen

qi

deficiency syndrome had a longer duration of illness， with moderate fever being more common. Toxin-heat obstructing lung syndrome was associated with mixed infections and pulmonary atelectasis， and had the highest incidence of necrotizing pneumonia （NP）. Pleural effusions were most common in phlegm-heat obstructing lung syndrome， which was also associated with a higher incidence of obstructive bronchitis and plastic bronchitis （PB）. Obstruc

tive bronchitis was most commonly seen in healthy

qi

deficiency and pathogen lingering syndrome. Myocardial damage and hepatic damage were more prevalent in toxin-heat obstructing lung syndrome and phlegm-heat obstructing lung syndrome. Infectious reaction rash was mainly concentrated in toxin-heat obstructing lung syndrome. The index values of ferritin， absolute neutrophil count， ALT， AST， CRP， LDH， α-HBDH， and D-D showed a significant gradient： toxin-heat obstructing lung syndrome

>

phlegm-heat obstructing lung syndrome

>

healthy

qi

deficiency and pathogen lingering syndrome

>

lung and spleen

qi

deficiency syndrome （

P

<

0.05）.

Conclusion

2

There is a certain correlation between TCM syndrome types and the clinical features of SMPP. Toxin-heat obstructing lung syndrome presents the most severe clinical manifestations， characterized by significantly elevated myocardial enzymes， liver enzymes， and inflammatory markers， requiring vigilance for the occurrence of pulmonary atelectasis and NP. Toxin-heat obstructing lung syndrome， phlegm-heat obstructing lung syndrome， and healthy

qi

deficiency and pathogen lingering syndrome are often associated with a hypercoagulable state， which is correlated with elevated D-D levels. Phlegm-heat obstructing lung syndrome is associated with the formation of PB.