| Objective:To analyze the clinical features of Alopecia Areata(AA)in children,and to improve the understanding,diagnosis and treatment of Alopecia Areata in children by dermatologists.Methods: The clinical data of 310 children with alopecia areata who visited the Department of Traditional Chinese Medicine and Dermatology of a hospital from June 2020 to June 2022 were retrospectively analyzed,including gender,age,age of onset of first alopecia areata,family history of alopecia areata,combined diseases,Hair loss severity score,test results,TCM syndrome classification,clinical efficacy,treatment cycle and recurrence.Group according to different age groups,and compare whether there are statistical differences in gender and severity;group according to severity,and compare whether there are statistical differences in gender,laboratory tests,and combined diseases;according to different TCM syndrome types Grouped,and compared whether there were statistical differences among them in severity,gender,season of onset,laboratory tests,clinical efficacy,treatment cycle,and recurrence rate;in addition,healthy children who visited the Children’s Health Department at the same time were selected as controls,to compare the results of laboratory tests between children with alopecia areata and healthy children.Finally,Logistic multivariate analysis was used to analyze the risk factors of moderate and severe alopecia areata.Results:1.310 children with alopecia areata,with an average onset age of 6.65±3.06 years;165 males,with an average onset age of6.52±3.28 years;145 females,with an average onset age of 6.80±2.78 years.Among the 310 children,only 11 cases reported a family history of alopecia areata,of which 8 cases were first-degree family history,2 cases were twins,and 3 cases were second-degree family history and third-degree family history.2.According to different age groups,there were 30 cases of infants,83 cases of preschool age,178 cases of school age,and 19 cases of adolescence.The difference between male and female in different age groups was statistically significant(P<0.05).3.Grouped according to severity,divided into two groups:mild,moderate and severe,including 253 cases of mild alopecia areata,accounting for 81.61%;15 cases of moderate alopecia areata,accounting for 4.84%;42 cases of severe alopecia areata,accounting for 13.55%;The ratio of moderate to severe is 4.44:1.In moderate and severe patients,the proportions of decreased 25-hydroxyvitamin D,abnormal Ig E levels,elevated TGAb and/or TPOAb,atopic dermatitis,and hyperthyroidism were higher than mild patients,and the difference was statistically significant(P<0.05).The proportion of people with decreased serum calcium,decreased serum iron,decreased serum zinc,abnormal FT3,abnormal FT4,abnormal TSH,accompanied by allergic rhinitis,urticaria,vitiligo,lichen planus,arthritis,precocious puberty,and superficial gastritis was There was no statistically significant difference between the two groups(P > 0.05).4.The proportion of children with alopecia areata with decreased serum iron,serum zinc,serum 25-hydroxyvitamin D,abnormal Ig E levels,and increased TGAb and/or TPOAb was higher than that of healthy children,and the difference was statistically significant(P<0.05).There was no significant difference in the number of decreased serum calcium,abnormal FT3,abnormal FT4,and abnormal TSH between the two groups(P>0.05).5.TCM syndrome differentiation was performed on all children with alopecia areata.There were 88 children with blood heat generating wind syndrome,143 children with spleen deficiency and damp accumulation syndrome,34 children with kidney essence deficiency syndrome,and 45 children with Qi and blood deficiency syndrome.There were statistical differences among different syndrome types in severity distribution,gender distribution,and onset season(P<0.05).The proportion of children with mild blood heat generating wind syndrome was higher than that of moderate and severe children,the proportion of children with moderate and severe syndrome of spleen deficiency and damp accumulation was higher than that of mild children,and the difference was statistically significant(P < 0.05).There was no significant difference in the proportion of children with mild,moderate,and severe syndromes between the two groups of syndromes of insufficiency of essence and qi and blood(P>0.05).The proportion of children with spleen deficiency and damp accumulation syndrome with abnormal Ig E was higher than that of children with other syndrome types,and the proportion of children with Qi and blood deficiency syndrome with decreased serum zinc was higher than that of children with other syndrome types,and the difference was statistically significant(P<0.05).The total cure rate of 310 children after treatment was 81.29%,among which the effective rate of blood heat generating wind syndrome was 94.31%,the effective rate of spleen deficiency and damp accumulation syndrome was 76.91%,the effective rate of kidney essence deficiency syndrome was 58.82%,and the effective rate of Qi and blood deficiency syndrome was 86.07%.The Chi-square test showed that there was a statistically significant difference in the effective rate of treatment among different syndrome types(P<0.05).155 cases of cured patients were followed up by telephone half a year later,and 43 cases relapsed,with a total recurrence rate of 27.74%.Among them,there were 5 cases of recurrence of blood heat generating wind syndrome,the recurrence rate was 8.06%;26 cases of recurrence of spleen deficiency and damp accumulation syndrome,the recurrence rate of 48.15%;5recurrences of kidney essence deficiency syndrome,the recurrence rate of 45.45%;For example,the recurrence rate was 25%,and the recurrence rate among different syndrome types was statistically different(P<0.05).6.Through multi-factor logistic regression analysis,it was found that onset in early childhood,decreased serum 25-hydroxyvitamin D,abnormal Ig E,accompanying atopic dermatitis,and traditional Chinese medicine syndrome of spleen deficiency and damp accumulation had statistical significance for the occurrence of moderate to severe alopecia areata((P<0.05).Conclusion:1.Childhood onset,decreased serum 25-hydroxyvitamin D,abnormal Ig E,atopic dermatitis,and TCM syndrome of spleen deficiency and damp accumulation are risk factors for moderate to severe alopecia areata.2.The TCM syndrome type of alopecia areata has changed compared with the past,and the syndrome of spleen deficiency and damp accumulation has become the main syndrome type of alopecia areata in children.3.In clinical practice,children with alopecia areata with blood heat generating wind syndrome have the mildest disease,good curative effect,less recurrence,and good prognosis;while spleen deficiency and damp accumulation syndrome and kidney essence deficiency syndrome are severe,with poor clinical curative effect,high recurrence rate,and poor prognosis. 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