| Purpose:By retrospectively analyzing the clinical data of 219 cases of wet sore with damp-heat accumulation syndrome,the characteristics and treatment methods of this disease were summarized in order to provide more effective basis and reference for further optimization of clinical treatment scheme of wet sore with damp-heat accumulation syndrome.Material and method:Collect the clinical data of wet sore patients with damp-heat accumulation syndrome hospitalized in dermatology department of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 1,2020 to December 31,2022.Screen through inclusion criteria and exclusion criteria,input the general information,clinical manifestations,related laboratory examination indexes,EASI score and itch score before and after treatment,hospitalization days of treatment drugs and other items into Excel table and use SPSS 26.0 software to make statistical analysis and draw relevant conclusions.Results:1.General information: 219 cases of wet sore with damp-heat accumulation syndrome were included in this study,among which 123 cases were male and 96 cases were female,the ratio of male to female was 1.28: 1(P>0.05).The maximum hospitalization age was 88 years old,the minimum was 13 years old,and the average was 61.89±15.42 years old.Most of the patients were 60-74 years old(P<0.05).The age of first onset was 2 years old and 87 years old with an average of 58.22 ± 16.74 years old,mainly from 60 to 74 years old(P<0.05).There were 50 cases(22.83%)in spring,57 cases(26.03%)in summer,63 cases(28.77%)in autumn and 49 cases(22.37%)in winter(P>0.05).45 cases(20.55%)had inducing factors or aggravating factors,which were mainly diet factors.44 cases(20.09%)were systematic treated with glucocortex before admission.55 cases(25.46%)had previous allergic history,among which the most patients(46 cases,21.00%)had previous drug allergic history.The shortest course of disease was 3 days and the longest was more than 30 years,with an average of 3.72±5.79 years.The shortest time of hospitalization was 7 days,the longest was 21 days,and the average time was 12.21±2.53 days.Among 161 patients(73.52%),66 patients(30.14%)were complicated with at least one disease and other skin diseases.2.Clinical manifestations: The main lesions involved the trunk(212 cases,96.80%),the upper limbs(207 cases,94.52%)and the lower limbs(202 cases,92.24%).The top ten lesions were papules(219 cases,100%),erythema(216 cases,98.63%),scratches(174 cases,79.45%),scab(158 cases,72.14%),exudation(95 cases,43.38%),hypertrophy(92 cases,42.01%),desquamation(76 cases,34.70%),scab(72 cases,32.88%),swelling(59 cases,26.94%),flushing(56 cases,25.57%).219 cases of wet sore with damp-heat accumulation syndrome had different degrees of pruritus.3.Laboratory examination: In blood routine examination,white blood cell count increased in 14 cases,neutrophil count increased in 13 cases,lymphocyte count increased in 15 cases,and eosinophil count increased in 78 cases.There were 72 cases of total protein,3 cases of albumin,66 cases of elevated globulin,16 cases of elevated alanine aminotransferase,and 9cases of elevated aspartate aminotransferase in liver function tests.In renal function tests,uric acid increased in 27 cases and creatinine increased in 11 cases.There were 121 cases(55.25%)with abnormal myocardial enzyme spectrum.Venous blood glucose increased in 40 cases(18.26%).C-reactive protein increased in 33 cases(15.07%).There were 215 cases(98.17%)with abnormal immune function.Among the 156 food intolerance tests,79 cases had at least one food allergy(50.64%),and the top three positive rates were eggs(51 cases,32.69%),wheat(22 cases,14.10%),milk(13 cases,8.33%).Among the 178 cases of special allergen examination,36 cases(20.22%)were allergic to at least one allergen,and the positive rate of allergens in the inhalation group ranked first three for dust mite(10 cases,5.62%),cat epithelial(9 cases,5.06%),common ragweed(9 cases,5.06%).The higher allergen positive rates in the ingestion group were eggs(7 cases,3.93%),crabs(3 cases,1.69%),and milk(3 cases,1.69%).There were 110 cases(50.23%)of serum total Ig E >100 ul.4.Factors influencing the severity of skin lesions: According to EASI score,they were divided into mild group and moderate-severe group.The two groups of the general information,clinical manifestations and related laboratory examination indexes were analyzed by single factor.The results showed that there was significant difference in gender,previous oral tripterygium wilfordii preparation,head,hands,feet,EOS count in peripheral blood,serum albumin,serum lactate dehydrogenase,serum hydroxybutyrate dehydrogenase,serum Ig M,serum C3,serum C-reactive protein and serum total Ig E between two groups(P<0.05).Binary logistic regression showed that high EOS count in peripheral blood(OR=2.129,95%CI:1.013-4.475,P=0.046)was a risk factor of the severity of skin lesions and high serum albumin level(OR=0.88,95%CI:0.801-0.973,P=0.012)was a protective factor of the severity of skin lesions.5.Treatment: TCM treatment: 210 cases of 219 patients of wet sore with damp-heat accumulation syndrome were treated with oral Chinese medicine decoction.210 prescriptions used for the first time involved 141 traditional Chinese medicines,which appeared 3358 times in total,and the average frequency of each traditional Chinese medicine was 23.81 times.There were 31 drugs with frequency greater than 23 times as high frequency drugs and the top10 drugs were Renmanniae radix,Moutan cortex,Glycyrrhizae radix et rhizome,Saposhnikoviae radix,Alismatis rhizoma,Schizonepetae herba,Scutellariae radix,Tribuli fructus,Sophorae flavescentis radix,Silybi fructus.The medicinal flavor was mainly cold and warm.The medicinal properties were mainly bitter,sweet and pungent.The main meridian attribution was in liver,lung,spleen and heart.The efficacy was classified into 18 categories,among which the most were heat-clearing drugs,followed by exterior syndrome-relieving drugs and deficiency-tonifying drugs.Heat-clearing drugs were mainly heat-clearing and dampness-eliminating drugs.Cluster analysis showed that 31 high-frequency drugs could be divided into three categories.Group C1 included Renmanniae radix,Moutan cortex,Forsythiae fructus,Lonicerae japonicae flos,Scutellariae radix,Bupleuri radix,Angelicae sinensis radix,Glycyrrhizae radix et rhizome,Alismatis rhizoma,Gardeniae fructus,Schizonepetae herba,Sal viae miltiorrhizae radix et rhizoma,Silybi fructus,and Paeoniae radix rubra.Group C2 included Atractylodis macrocephalae rhizoma,Poria,Entadae semen,Tribuli fructus,Dictamni corte,Citri reticulatae pericarpium,Hedysari radix,and Cortex Dictamni.Group C3 included Coicis semen,Phellodendri amurensis cortex,Sophorae flavescentis radix,Atractylodis rhizom,Andrographis herba,Scrophulariae radix,Uncariae ramulus cum uncis,Kochiae fructus,and Coriolus.Tripterygium wilfordii preparations were commonly used in oral Chinese patent medicines(27 cases,12.33%).In the external treatment of traditional Chinese medicine,wet compress of traditional Chinese medicine(52 cases,23.74%)was the most common method for external treatment of drugs,and method of bloodletting at the tip of ear was commonly used in non-drug external treatment(143cases,65.30%).Western medicine treatment: The common intravenous drugs were compound glycyrrhizin injection(200 cases,91.32%).The common antihistamines were oloratadine tablets(171 cases,78.08%),and Spleen aminopeptide lyophilized powder(194 cases,88.58%)was commonly used in the immunomodulator.For topical medicine,compound boric acid solution wet compress(204 cases,93.15%)were used.Red light irradiation was the main physical therapy(99 cases,45.21%).6.Clinical curative effect: Among 219 patients,5 cases were cured(2.28%),141 cases were markedly effective(64.38%),52 cases were effective(23.74%)and 21 cases were ineffective(9.59%).The total effective rate was 90.41%.Conclusion:1.In this study,the wet sore with damp-heat accumulation syndrom was more common in 60-74 years old.2.In this study,the elevation of EOS count in peripheral blood and the decrease of serum albumin can increase the risk of serious skin lesions.3.In this study,the top 10 drugs were Renmanniae radix,Moutan cortex,Glycyrrhizae radix et rhizome,Saposhnikoviae radix,Alismatis rhizoma,Schizonepetae herba,Scutellariae radix,Tribuli fructus,Sophorae flavescentis radix,Silybi fructus.The medicinal flavor was mainly cold and warm.The medicinal properties were mainly bitter,sweet and pungent.The main meridian attribution was in liver,lung,spleen and heart.The main efficacy classification of drug was heat-clearing drugs,followed by exterior syndrome relieving drugs and deficiency tonifying drugs.4.In this study,the potential new prescriptions obtained by clustering mainly focus on classical prescriptions such as Longdan Xiegan Decoction and Ermiao Powder,with the method of dispelling wind,relieving exterior syndrome and tonifying deficiency at the same time.This provided a certain reference for clinical practice.5.In this study,Chinese and Western medicine were effective in treating with wet sore damp-heat accumulation syndrome. |
PDF Full Text Request