Study On The Correlation Between The Characteristics Of Patients With Moderate And Severe Acne And TCM Syndrome Types

Objective: moderate to severe acne can easily damage the patient’s appearance,cause greater psychological pressure,and cause certain troubles in work and life.Collect age,gender,type of skin lesions,and preliminary assessment of their psychological status,explore the relationship between the TCM syndrome types and the characteristics and psychological status of patients with moderate to severe acne,in order to provide a certain reference for clinical diagnosis and treatment and psychological counseling.Methods: in this study,240 patients with moderate to severe acne who visited the Dermatology Clinic of the Affiliated Hospital of Tianjin Academy of TCM from February2020 to February 2021 were surveyed by the Questionnaire on the Characteristics of the Incidence of Moderate and Severe Acne and the SCL-90 Scale to Collect data such as gender,disease course,BMI,mental health status,and TCM syndrome types.Use Excel2019 software to establish a database,and use SPSS26.0 software for statistical data and description processing.Chi-square test is used for statistical description of categorical variables,independent sample t-test and one-way analysis of variance are used for statistical description of continuous variables.Cross-tabulation analysis is used after multiple-choice questions are selected for multiple response analysis.Differences are statistically significant with P<0.05.Results:1.General information and the distribution of TCM syndrome types: 240 patients with moderate to severe acne,the number of patients with phlegm and blood stasis coagulation syndrome is the largest,a total of 84 patients,accounting for 35%;followed by gastrointestinal damp-heat syndrome,a total of 74 patients,accounting for 30.8%;Chong-Ren disorders syndrome there were 69 patients with disorder syndrome,accounting for 28.7%;the least patients with lung meridian wind-heat syndrome,only 13 patients,accounting for 5.4%.Most patients with moderate to severe acne are aged between 20 and 30 years old.There are175 patients,accounting for 72.9%.Those between 30 and 40 years old are the least,only 16 People,accounting for 6.7%.After Chi-square test,age grouping is correlated with TCM syndrome type.The number of gastrointestinal damp-heat syndrome,phlegm stasis coagulation syndrome,Chong-ren disorder syndrome,and lung meridian wind-heat syndrome in the 20-30 age group was significantly higher than other age groups,among which gastrointestinal damp-heat syndrome accounted for the highest proportion;Chong-ren disorder syndrome was 20～30 years old.In this survey,there are 83 men and 157 women,and the ratio of male to female is about 1:1.89.According to the results of the Chi-square test,there are statistically significant differences in the distribution of different genders and TCM syndrome types.There are more male patients than female patients in the syndrome of phlegm and blood stasis coagulation,and the remaining syndrome types are more female patients.In this study,27.5% of patients were underweight,49.2% were normal weight,20% were obese,and 3.3% were obese.According to the Chi-square test,the BMI has significant differences in the distribution of TCM syndromes.The lung meridian wind-heat syndrome has the largest number of underweight patients;the more obese and obese patients have the syndrome of phlegm and blood stasis coagulation.2.Living habits and the distribution of TCM syndrome types: Statistics on the dietary preferences of patients with moderate to severe acne.From the multiple response analysis,it can be seen that the fried food was selected the most,with a total of 174 people,accounting for 39.0%;followed by the sweets,with a total of 158 people choosing,accounting for 35.0%;78 people chose the spicy category;only 36 people chose the light and healthy category,accounting for 8.0%.The results of cross-tabulation analysis of diet preference response and TCM syndromes show that preference for sweets and fried foods is more common in gastrointestinal damp-heat syndrome and phlegm stasis coagulation syndrome,spicy food is more common in lung meridian wind-heat syndrome,and patients with Chong-Ren disorders prefer more Light and healthy diet.In this survey,154 patients were drinking,accounting for64.2%.According to the Chi-square test,drinking behavior affects the distribution of TCM syndromes,and it is statistically significant.Drinking patients are more common in gastrointestinal damp-heat syndrome,phlegm stasis coagulation syndrome,and Chong Ren disorder syndrome.Phlegm stasis coagulation syndrome accounts for the largest proportion,followed by gastrointestinal Damp-heat syndrome and Chong Ren disorder syndrome.The statistical results of this survey show that 64.0% of patients have staying up late behavior.According to the Chi-square test,the difference in the distribution of staying up late behavior in TCM syndromes is not statistically significant.Analyze the association between defecation frequency and TCM syndromes in patients with moderate to severe acne.After Chi-square test,there is no statistical significance.Regardless of TCM syndrome,the number of people who take it once every 2-3 days is larger,and it accounts for the proportion of phlegm and blood stasis coagulation syndrome highest.3.Analysis of relevant data of moderate to severe acne skin lesions and TCM syndrome types: In this survey,59.2% of the patients self-reported a family history of acne.Chi-square test results showed that the family history of acne was not statistically related to TCM syndrome types,regardless of whether the survey subjects had acne Family history,among which the medical syndrome type is the phlegm stasis coagulation syndrome,which accounts for the largest proportion,and the lung meridian wind-heat syndrome accounts for the smallest proportion.In this survey,oily and mixed skin types are the main skin types of patients with moderate to severe acne,accounting for 39.2% and 32.5% respectively.There is no statistical correlation between skin types and TCM syndromes,but phlegm and blood stasis coagulation syndrome is the most obvious in oily and mixed skin types.According to the statistics of the distribution of the patient’s skin lesions,after multiple response analysis,the chin,mandible,and cheeks were selected by more people,accounting for 21.3%,18.0%,and 13.5%,respectively.The skin lesions on the forehead and neck were less selected,respectively.Only accounted for 7.4% and 7.8%.Analyze the correlation between the distribution of skin lesions and TCM syndromes by cross-tabulation.The results show that the chest is more common in the lung meridian wind-heat syndrome,and the nose,cheeks,mandible,and chin are more common in the gastrointestinal damp-heat syndrome,phlegm and blood stasis.Coagulation syndrome,the neck is more likely to occur in phlegm and blood stasis coagulation,Chong-Ren disorder.In this survey,there were 65 people with Western medicine skin lesions classified as level II,122 people at level III,and 53 people at level IV,accounting for 27.1%,50.8%,and 22.1% of the total.After Chi-square test,different skin lesion grades are associated with TCM syndrome types.The majority of grade Ⅱ Chong-Ren disorders are syndrome of gastrointestinal damp-heat syndrome and phlegm stasis coagulation syndrome in grade Ⅲ,and phlegm stasis coagulation syndrome of grade Ⅳ is mainly.Analyzing the course of the patient’s disease,only 18 people have been ill within 1 year,164 have been ill for 1-5 years,and 58 have been ill for more than 5 years.According to the Chi-square test,the length of the disease is statistically significant in the different distributions of TCM syndromes.The illness time is less than 1 year,mainly with lung meridian wind heat syndrome;between 1-5 years,there are more people with the gastrointestinal damp-heat syndrome and phlegm stasis coagulation syndrome;there are more people with phlegm stasis coagulation syndrome and Chong-Ren disorder syndrome who have been sick for more than 5 years,and the proportion of Chong-ren disorder is higher.4.Analysis of psychological status and TCM syndrome types of patients with moderate to severe acne: the total scores,total average scores,and 10 factor scores of 240 moderate to severe acne patients in this survey were compared with the scores of the normal SCL-90 scale of Chinese normal population by independent sample t-test,except for the scores of psychiatric factors,the scores of the remaining factors in this survey are all higher than the norm of the Chinese normal population,and they are statistically significant.The proportion of factors with moderate severity of psychological symptoms,ranked in the top six from high to low,are anxiety(66.7%),depression(54.6%),obsessive-compulsive symptoms(45.4%),others(44.6%),and interpersonal relationships.Sensitivity(21.7%),paranoia(8.8%),with severe severity only obsessive-compulsive symptoms(0.8%),anxiety(0.4%),and depression(0.4%).Statistics of the SCL-90 scale scores of different Western medicine skin lesion severity grades.After analysis of variance,somatization and terror factor scores have statistical differences in the distribution of different skin lesion severity.Somatization and terror factors have the highest scores in the severity of grade Ⅳ skin lesions,followed by grade Ⅲ and grade Ⅱ.Analyze the scores of different TCM syndrome types on the SCL-90 scale,which can be obtained from the analysis of variance,Somatization,interpersonal sensitivity,depression,anxiety and terror factor scores have statistical differences in the distribution of TCM syndrome types.The somatization factor scored the highest in Chong-ren disorder syndrome,and descended into phlegm stasis syndrome,gastrointestinal damp-heat syndrome,lung meridian wind-heat syndrome;the highest score for interpersonal relationship sensitivity is Chong-Ren disorder syndrome,and the lowest is lung meridian wind-heat syndrome;depression and anxiety factors have the highest scores in Chong-ren disorder syndrome,followed by phlegm stasis coagulation syndrome,gastrointestinal damp-heat syndrome,and Chong-ren disorder syndrome;the highest score for the fear factor was in the lung meridian wind-heat syndrome,followed by the phlegm stasis coagulation syndrome,and the difference in scores was relatively small in the gastrointestinal damp-heat syndrome and Chong-Ren disorder syndrome.Conclusion:1.Moderate to severe acne usually occurs between 20 and 30 years old,most of which are female patients,and the course of the disease is mostly 1 to 5 years.2.The proportion of TCM syndromes of moderate to severe acne is in the order of phlegm stasis coagulation syndrome>gastrointestinal damp-heat syndrome>Chongren disorder syndrome>Lung meridian wind-heat syndrome.3.The distribution of TCM syndromes of moderate to severe acne is related to age,gender,course of disease,BMI,diet preference,drinking,distribution of skin lesions,Western medicine skin lesion classification,and factors related to somatization,interpersonal sensitivity,depression,anxiety and horror mental health conditions.4.In the SCL-90 scale for patients with moderate to severe acne,except for psychotic factors,the scores of the remaining factors in this study are all higher than the domestic norm.Anxiety,depression,and obsessive-compulsive symptoms are the main factors affecting their mental health.5.Patients with moderate to severe acne of Chong-Ren disorder are more likely to have negative psychological conditions.