Association between gastrointestinal heat retention syndrome and respiratory tract infections in children: A prospective cohort study

Abstract

Abstract Objective To explore the relationship between gastrointestinal heat retention syndrome and the incidence of pneumonia and recurrent respiratory tract infections (RRTIs) in children. Methods A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital. Children without respiratory tract infections (RTIs) were consecutively recruited according to the selection criteria. A semi-structured questionnaire was used to record traditional Chinese medicine (TCM) symptoms and demographic and physiological characteristics. Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity. The participants were followed up for 12 months. Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months. Episodes of pneumonia and RTIs were recorded in detail. Results A total of 420 children were included. Of participants, 370 (88.10%) were followed up for 12 months. The mean number of RTI episodes per participant was 5.37 (95% CI: 5.14 to 5.60). In total, 186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the non-gastrointestinal heat retention syndrome group completed the 12-month follow-up period. The baseline of both groups was comparable. The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27 (95% CI: 1.01 to 1.59) times that in children without gastrointestinal heat retention syndrome. Logistic regression analysis revealed that abnormally increased appetite with frequent hunger, foul breath, dry stools, and dark red or purple fingerprints were positively correlated with the incidence of pneumonia. Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI. Conclusions Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children. Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.