Observation on the Efficacy of Self-formulated Huatan Chushi Zhuyu Decoction in the Treatment of Adenoid Hypertrophy in Children and Literature Research on Traditional Chinese Medicine Treatment

To observe the clinical efficacy of the self-formulated Huatan Chushi Zhuyu Decoction (HCZ Decoction) combined with basic Western medical treatment in children with moderate to severe adenoid hypertrophy (AH) accompanied by allergic rhinitis (AR), and to explore the theoretical basis by referring to traditional Chinese medicine (TCM) literature. A retrospective analysis was conducted. A total of 64 children with moderate to severe AH admitted to the outpatient department from January 2022 to December 2024 were included and divided into the decoction group (43 cases) and the non-decoction group (41 cases) according to the treatment regimen. The non-decoction group was treated with mometasone furoate nasal spray (100 μg/d) + montelukast (4-5 mg/d) for 2 weeks, combined with cetirizine (5-10 mg/d) for anti-allergy. On this basis, the decoction group was additionally given the HCZ Decoction (including tangerine peel, Poria cocos, Pinellia ternata, licorice, Arisaema cum Bile, peach kernel, Spina Gleditsiae, etc.), one dose per day, taken after breakfast and dinner, with a treatment course of 2 weeks. Baseline data such as age, gender, and BMI of the children in the two groups were collected. The differences in nasal symptom scale, pediatric sleep disorder scale, polysomnography (PSG) parameters, and the degree of AH before and after treatment were compared. The t-test and chi-square test were performed using SPSS 27.0 statistical software, with a significance level of P < 0.05. Chinese databases such as CNKI and Wanfang (from 2014 to 2024) were systematically searched. Using the Citespace 6.3 literature processing tool, the hotspots and clustering information of keywords, institutions, and co-authors related to the TCM treatment of AH in Chinese literature were analyzed. There were no statistical differences in general data and clinical baseline data between the two groups (P > 0.05), indicating comparability. The scores of various items in both the decoction group and the non-decoction group decreased after treatment, confirming the effectiveness of the treatment. The total score of OSA-18 was at the moderate to severe level, and there were differences in the total score and the changes of various scores between the decoction group and the non-decoction group, with the scores of the decoction group being lower. There was a difference in the change score of the total nasal symptom score (TNSS) between the two groups, mainly manifested in nasal obstruction and sneezing. There were no differences in the changes of OAHI and LSaO2 scores between the two groups. The literature study showed that the core therapeutic methods of TCM treatment for AH are "resolving phlegm, removing dampness, and promoting blood circulation to remove blood stasis", which highly coincides with the compatibility of the self-formulated decoction. The HCZ Decoction combined with basic Western medical treatment can significantly improve the nasal symptoms and sleep quality of children with moderate to severe AH accompanied by AR. Its curative effect may be achieved by regulating the local inflammatory response rather than reducing the volume of the adenoids. TCM literature supports that ‘the intermingling of phlegm, blood stasis, and dampness’ is the core pathogenesis of AH. This decoction provides a safe and effective non-surgical treatment option for clinical practice.