| Objective: Through the retrospective analysis 200 cases of patients with blood heat intrinsic white-bi clinical data,to the patient’s general information,clinical manifestation,laboratory indexes such as clinical data,diagnosis and treatment were retrospectively analyzed,thereby increasing awareness of blood heat intrinsic white bi,for the treatment of blood heat intrinsic white bi provide better thinking and evidence-based clinical basis.Materials and Methods: Data of 8 kinds of inpatients diagnosed as interleukin-8 types of blood fever and 8 kinds of interleukin-8 kinds of dermatology were collected in the dermatology electronic medical record system of The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2018 to December 2021.The collected clinical data(including general data,clinical manifestations,laboratory tests,comorbidities,treatment methods and efficacy)were reviewed,and statistical analysis was performed using SPSS26.0 and MInitab2021.Results:1.General data: A total of 200 cases were collected,including 128 males and 72 females,with males significantly more than females(P <0.05);The minimum age was 14 years,the maximum age was 94 years,the average age was 51.99±16.12 years;The age of patients was positively correlated with PASI score before treatment(P <0.05).The average age of first onset was 40.00±16.77 years.There were 69 patients(34.5%)with definite causes,and 36patients(18%)with upper respiratory tract infection.There were 54 cases(27%)in spring,61cases(30.5%)in summer,37 cases(18.5%)in autumn,and 48 cases(24%)in winter.The shortest course was 15 days and the longest was more than 60 years,with an average of12.06±13.37 years.There was no significant correlation between PASI score and course of disease before treatment(P >0.05).125 patients had one or more diseases,including dyslipidemia(85 cases,42.5%)and hypertension(44 cases,22%).Infectious history of 7cases(3.5%);19 cases(9.5%)had a family history of psoriasis.The shortest and longest hospitalization days were 7 days and 24 days,with an average of 13.66±2.52 days.2.Clinical manifestations:Skin lesions: scattered in different sizes of erythema,papules,and the rash was mostly bright red and covered with silver-white scales.Hair on the scalp could be compressed into bundles due to thick scaling(98 cases,49%),and finger deck could be pitted(5 cases,2.5%).Skin lesions: There were two or more sites of skin lesions in all patients.The proportion of skin lesions in lower limbs(185 cases,92.5%),upper limbs(140cases,70%),scalp(136 cases,68%),back(112 cases,56%),chest(85 cases,42.5%),face(84cases,42%),neck(42 cases,21%),external ear(38 cases,19%),abdomen(20 cases,10%),nail(5 cases,2.5%).Self-conscious symptoms: all patients had pruritus of varying degrees,and 6 patients(3%)had obvious pain in partial rash.3.Laboratory examination: 79 cases(39.5%)had abnormal blood routine,including 38 cases of neutrophil increase and 18 cases of neutrophil decrease;Monocyte elevation in 12 cases;Lymphocyte increase in 28 cases,eosinophil increase in 25 cases;Basophil increase in 24cases;C-reactive protein increased in 34 cases);46 cases had abnormal liver function(23%),including 29 cases with decreased white bulb ratio,10 cases with increased alkaline phosphatase,28 cases with increased alanine aminotransferase,8 cases with increased aspartate aminotransferase,30 cases with increased gamma-glutamyltransferase,and 8 cases with decreased total protein).45 cases(22.5%)had abnormal renal function,among which uric acid,creatinine and urea nitrogen increased in 2 cases and uric acid increased in 43 cases.110 cases(55%)had abnormal immune function,of which 72 cases had abnormal immunoglobulin A.Abnormal immunoglobulin G in 32 cases;Abnormal immunoglobulin M in 23 cases;Abnormal cluster differentiation antigen in 19 patients);A total of 85 cases(42.5%)had dyslipidemia,including 48 cases with increased triglyceride and 45 cases with increased total cholesterol.4.Treatment: TCM treatment: According to the statistics of the first prescription taken internally after admission with the first-party-statistics,119 TCM medicines were involved,among which heat clearing medicine was the most common(1562 times,53.6%),four qi was the most common(1967 times,67.5%),five ingredients were the most common(1573 times,53.9%),and meridian returning was the most common(1738 times,59.6%).Three drug combinations were obtained by cluster analysis of high-frequency drugs: Drug group 1:Honeysuckle,Forsythia forsythia,Glycyrrhiza root,Cortex moutan,radix paeoniae,Hedyotis diffusa,Radix Schistodicae,Caulis spatholobi,Sophorae japonica,Black plum,Rehmannia glutinosa,Chinese flowering lotus,Radix Sophorae,Radix Sophorae;Group 2: Radix scrophulariae,Milk thistle,Poria tuckahoe,Angelica sinensis,Salvia miltiorrhiza;Drug group3: Rhizoma atractylodes,coix seed,stir-fried Atractylodes atractylodes with bran,Poria cocos,Tribulus terrus,Schizonepeta schizonepeta;All 200 cases were treated by TCM external treatment,of which the most drug external treatment was psoriasis lotion(140 cases,70%),and the most non-drug external treatment was ear point pressing(125 cases,62.5%).Western medicine treatment: oral administration of ezetirizine tablets(50 cases,25%)was the most common antihistamine,and oral administration of spleen aminopeptide freeze-dried powder(126 cases,63%)was the most common immunomodulate drugs.Compound glycyrrhizin injection(188 cases,94%)was the most anti-inflammatory drug.Compound Qingyou ointment(138 cases,69%)was the most common type of glucocorticoids.Most of the non-glucocorticoids were tacrolimus ointment(20 cases,10%).5.Treatment effect:The average PASI score before treatment was 29.41±8.59,and the average PASI score after treatment was 11.60±4.35,with extremely significant statistical difference(P<0.01).The average syndrome score before treatment was 20.99±2.37,and the average syndrome score after treatment was 12.03±2.39,with extremely significant statistical difference before and after treatment(P <0.01).Western medicine curative effect evaluation:cured: 2 cases,obvious effect: 100 cases,effective 97 cases,ineffective: 1 case;The total effective rate is 99.5%.Evaluation of TCM curative effect: cured 1 case,marked effect 64 cases,effective 127 cases,ineffective 8 cases,total effective rate is 96%.Conclusion:1.In this study,the male patients were significantly more than the female patients;before treatment,the Pasi score was positively correlated with age;summer was the most frequent season for this disease.2.Upper respiratory tract infection was the main predisposing factor in this study.3.In this study,the herbal decoction was mainly taken orally by heat-clearing drugs,with the most cold nature,the most sweet taste,and the most Meridians into the liver.The drug combination obtained by cluster analysis mainly centers on long-nosed-pit-viper pill,Simiao Yong’an decoction and Shenling Baizhu powder,which can be used as reference in clinical medicine.4.In this study,the efficacy of integrated traditional Chinese and Western medicine in treating blood-heat intrinsic type of bai-bi is accurate. |
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