| Objective:Study I:To understand the encountered groups’knowledge about the acne and to unde rstand the cognitive status of acne and the reasons of cognitive differences among peo ple who encounter acne,and to provide basis for health education of acne.Study II:In the form of a questionnaire survey,collect the clinical data of patients w ith post-acne to explore the clinical characteristics of post-acne,the distribution charact eristics of TCM syndrome differentiation and the correlation between them for the clin ical prevention of acne and to offer detailed control measures and diagnosis basis.Materials and methods:Clinical Study I:A questionnaire survey was conducted among patients and their families in the Affiliat ed Hospital of Liaoning University of Traditional Chinese Medicine from September 2021 to September 2022.The questionnaire contents included general conditions,whethe r the acne was perceived as a disease,cognition of factors related to the acne.A tota l of 3072 patients were screened and analyzed by SPSS 26.0 statistical software.The statistical data were expressed by the number of sample and component ratio,andχ~2 t est was used for comparison between the groups.Factors that affect the cognition of t he patients were analyzed by logistics regression method,and P<0.05 was considered statistically significant.Clinical Study II:Post-adolescent acne patients admitted to the dermatology clinic of the Affiliated Hosp ital of Liaoning University of Traditional Chinese Medicine from September 2021 to S eptember 2022 were collected.The general condition,living habits,eating habits and f emale menstruation of the patients were collected in the form of questionnaires,and s yndrome differentiation analysis of TCM was conducted based on the symptoms of th e patients,and 300 patients were screened.300 cases without acne were collected as control group at 1:1 ratio of sex and age.The information of the two groups was inp ut into Excel tables respectively,and statistical analysis was conducted by using SPSS26.0 statistical software.The count data was expressed as constituent ratio(%).Chi-sq uare test was used for the comparison between unordered groups,and rank sum test was used for the comparison between ordered groups(P<0.05)was statistically signific ant.In order to further study the relationship between living habits,eating habits,fem ale menstruation and acne,the Chi-square test was used for univariate analysis of eac h variable,and then the univariate factors with statistical significance(P<0.05)were in cluded into the binary logistics regression analysis model for further screening.The te st criteria were as follows:P<0.05 and OR>1means high risk factors for acne.P<0.05and OR<1 means protective factors for acne,and P>0.05 and OR>1 were perceived as suspiciously dangerous factors for acne.Results:Clinical Study I:1.A total of 3072 people were involved in this survey,among whom 650 women(21.2%)and 578 men(18.8%)had a history of acne or were suffering from acne,P=0.747>0.05,and the difference was not statistically significant.The majority of people w ere 21-30 years old(35.4%),the largest number of people with education background were high school,technical secondary school,junior college 1452 people(47.3%)and un dergraduate 1002 people(32.6%).2.Cognition of acne2.1The degree and ways of cognition:1730(56.0%)of the respondents had no knowl edge about the acne,followed by 1185(39.0%)with relative cognition of acne,only157(5.0%)of them had a good knowledge about acne.Ways of cognition:(78.5%)w ere aware of acne through the Internet(public account,Weibo,wechat),accounting for the largest proportion,hospital consultation accounted for the least proportion(24.7%).2.2Whether acne was a disease:gender,whether there was a history of acne,(P>0.05)were not statistically significant.There were significant differences at the cognition of acne in accordance with age,education background and major,and the differences had statistical significance(P=0.000<0.05).2.3Whether the acne was related to heredity:The acne was related to genetic factors ac cording to21-30 years old,postgraduate education,medical science and acne history,a nd there was statistical significance between acne and heredity(P<0.05).2.4Negative impact:Women perceived that acne affected their personal image(54.8%),social interaction(52.6%),and they were more subject to anxiety and inferiority(56.5%)and other negative emotions than men.Apart from the anxiety and inferiority,other negative emotions were statistically significant(P<0.05).2.5Season:Summer was perceived as the peak acne season(73.0%).2.6Skin type:Oily skin had the highest proportion(45.9%).2.7Age of onset of acne:21-30(59.4%)and under 20(59%)were the highest proport ion.2.8Treatment manners and methods:Those who came to the dermatology department o f the normal hospital accounted for the most(51.7%),followed by those who had the extrusion or purchase of acne products(32.3%).Most of the patients(59.1%)were tre ated by integrated Chinese and western medicine.3.Inducing factors3.1Diet:It’s believed that spicy food and frying(72.4%and 66.0%)would induced or aggravated the acne,followed by those sweet food(48.2%),seafood(46.6%),meat(41.8%),hot fruit(37.5%),milk yogurt(35.5%)and nuts(25.8%),fruits(9.0%),and vegetables(8.4%)accounted for the least.3.2Bad living habits:It’s believed that stay-up-late and alcoholism(73.7%、70.1%)w ere the main causing factors for the acne,followed by smoking(66.9%),constipation(64.5%),drinking too little water(53.7%),screen time(39.9%)and cosmetics(35.9%).3.3Others:Negative emotions(irritability,depression,anxiety)that induced and aggrava ted acne accounted for the most,followed by long-term wearing masks(54.2%),femal e menstruation,gynecological diseases(44.4%,33.2%),UV(37.7%).Clinical Study II:1.The basic situation of acne patients after puberty(1)Gender:There were 94 males(31.3%)and 206 females(68.7%),with a male to female ratio of 1:1.46.(2)Age:The mean age of the 300 patients was 29.64±4.00 years old.The average age for both men and women was 29.(3)Parts with acne:291 cases(97.0%)had acne on their the face,107 cases(35.7%)in the back,79 cases(26.3%)in the neck,and 79 cases(26.3%)in the chest,of which the acne on the cheeks of the face was the most(78.7%),followed by jaw(206 cases)(68.7%)and forehead(138 cases)(46.0%).(4)Acne grade:156 patients(52.0%)had acne gradeⅡ,and the proportion of acne gradeⅢwas the least(13.0%).2.Comparison between acne group and control group2.1General condition(1)Skin type:Compared with the control group(19.3%),(33.0%),oily skin(45.3%),mixed skin(43.3%)were more likely to subject to the acne,it can be seen that acne is more likely to appear on oily skin,followed by mixed skin.(2)Chaeta:The body hair was thick in the acne group(34.7%)and in the control grou p(13.7%),indicating that the body hair of acne patients was thick.(3)Stress:Moderate stress(72.2%)and severe stress(80.0%)in acne patients were sig nificantly higher than those in control group(27.8%)and control group(20.0%).It ca n be seen that acne patients have greater stress.2.2 Living Habits(1)Sleeping time:110 people in acne group(36.7%)and 51 people in control group(17.0%)fell asleep after 24 o’clock,indicating that the sleeping time of the acne group was late.(2)Alcohol consumption:86 occasional drinkers(28.7%)and 78 frequent drinkers(26.0%)in the acne group were higher than 32 occasional drinkers(10.7%)and 19 frequ ent drinkers(6.3%)in the control group,indicating a higher frequency of drinking in post-adolescent acne patients.(3)Daily water intake:83 people(27.7%)in the acne group drank less than 4 cups a day,which was higher than 39 people(13%)in the control group,indicating that the daily water intake in the acne group was relatively low.(4)Smoking:30 patients(10%)smoked more than 10 cigarettes a day in the acne gro up,which was higher than 7 patients that smoked more than 10 cigarettes(2.3%)in t he control group.(5)Electronic screen time:224 patients(74.7%)in the acne group looked at electronic screen time for more than 6 hours,significantly higher than 130 patients(43.3%)in the control group,indicating that the electronic screen time in the acne group was longer.(6)Use of cosmetics:The frequency for using cosmetics in the acne group(60.7%)was higher than that in the control group(48.7%),indicating that patients in the acne group often used cosmetics.2.3 Dietary habit(1)Taste preference:The most proportions of preference for sweet and spicy were 64.0%and60.0%respectively in the acne group.It can be seen that acne patients prefer sweet and spicy taste.(2)Beverage preference:The proportions of milk(51.7%)and coffee(44.0%)in acne group were higher than that in control group(37.0%)and coffee(35.0%).(3)High-fat diet:the proportions of beef and mutton and fried puffs in acne group were(63.0%)and(62.0%),and that in control group were(48.7%)and(30.3%).The proportions of acne group were higher than that in control group,indicating that acne patients preferred beef and mutton and fried puffs.2.4 Menstruation(1)Menstrual cycle:Patients with irregular menstrual cycle:the number of patients in the acne group with late menstrual period(61.9%)and irregular menstruation(61.4%)was higher than that in the control group,indicating that acne patients were more subject to irregular menstrual cycles after puberty.(2)Accompanying symptoms:the number of patients with dysmenorrhea in the acne group(53.9%)and that in the control group(40.3%),it can be seen that acne patients were more subject to dysmenorrhea after puberty.2.5Results of multi-factor comparison:After chi-square univariate screening,the general situation,living habits,eating habits,menstrual cycle and accompanying symptoms of the two groups of patients were included into the logistics regression for the further screen and the results were as follows.(1)General condition:Oily,mixed oily,thick body hair,moderate and severe stress were high-risk factors for the occurance of acne after puberty(P<0.05,OR>1).(2)Living habit:Sleeping after 24am,drinking 4-8 cups of water,occasional or frequent alcohol consumption,watching electronic screen for more than 6 hours a day,and using cosmetics were all high-risk factors for the occrance of acne after puberty(P<0.05,OR>1);Smoking more than10 cigarettes a day was a protective factor for acne(P<0.05,OR<1).(3)The results showed that sweet,spicy,beef and mutton,fried pupped food were the high-risk factors for the occurance of acne after puberty(P<0.05,OR>1),and milk,hot pot and roast meat were the suspicious factors for the occurance of acne after puberty.(P>0.05,OR>1).(4)Menstruation:Late menstruation,irregular menstruation and dysmenorrhea were high-risk factors for the occurance of acne after puberty(P<0.05,OR>1).3.The relationship between TCM classification and various factorsThe survey showed that 83 patients(27.7%)had gastrointestinal dampness-heat syndrome among the five syndrome types.68 patients(22.7%)suffered from Chong Ren syndrome;There were 23 patients(7.7%)with lung wind-heat syndrome,58 patients(19.3%)with liver depression and fire syndrome and 68 patients(22.7%)with blood stasis and spittoon syndrome.Gastrointestinal damp-heat acne is mainly occurred on the mixed skin(49.4%),defecation is performed in 2-3 times a day(37.3%),with a preference for sweet(81.9%)and sinuous food(67.5%);The patients with syndrome of disharmony of Chong and Conception Channel mainly feature female(100.0%),mixed skin type(67.6%),the highest frequent use of cosmetics(86.8%),irregular menstrual cycle and premenstrual,irregular menstruation,often accompanied by dysmenorrhea,and aggravated skin lesions before(4.4%)and after menstruation(57.6%),which is closely related to menstruation(66.2%);The severity of the wind-heat type patients is mainly grade I(78.3%),and the living habits,diet and menstruation have no obvious characteristics.Liver depression and fire type acne accounted for the highest proportion in 2 to 5 days of a bowel movement(39.7%),the frequency of occasional drinking was the highest(41.4%),and menstruation with abnormal emotions(72.5%);Acne of blood blood circulation and spittoon type is more common in men(55.9%),the severity of acne are mainly gradeⅢ(35.3%)andⅣ(29.4%),mostly oily skin(72.1%),frequent drinking frequency is the highest(35.3%),with the highest proportions of preference for carbonated drinks(51.5%),beef and mutton(79.4%),fried puked food accounts for the highest proportion,menstrual cycle is irregular,mainly in the late menstrual period(46.7%).Conclusions:Conclusion of study I:The public had a relative one-sided cognition of acne,so it’s necessary to do well in acne education and expand their awareness.Conclusion of study II:1.Acne was related to living habit,eating habits,menstruation and so on after puberty.2.Factors related with the onset of acne after puberty:(1)General condition:Oily and mixed oily skin,thick body hair,stress were high-risk factors for acne after puberty.(2)Living habit:Stay-up-late,drinking alcohol,deficient daily water intake,irregular bowel movements,excessive use of electronic screens,and use of cosmetics were all high-risk factors for the occurance of acne after puberty.(3)Dietary habit:sweet,spicy,beef and mutton,fried puffed food were high-risk factors for the occurance of acne after puberty;The hot pot and roast meat were suspicious factors.(4)Menstruation:Late menstruation,irregular menstruation and dysmenorrhea were all high-risk factors for the occurance of acne in women after puberty.3.The relationship between syndrome differentiation of TCM and various factors:(1)General condition:Oily and mixed oily skin,thick body hair,stress were high-risk factors for acne after puberty.(2)The patients with syndrome of disharmony of Chong and Conception Channel mainly feature female,mixed skin type,the highest frequent use of cosmetics,irregular menstrual cycle and premenstrual,irregular menstruation,often accompanied by dysmenorrhea,and aggravated skin lesions before and after menstruation,which was closely related to menstruation.(3)The severity of the wind-heat type:patients were mainly grade I,related to oily skin of grade.(4)Liver depression and fire type:its associsted with one defecation every 2-5days an d menstruation with abnormal emotions.(5)Acne of blood blood circulation and spittoon type:It was related to male gradeⅢandⅣskin lesions,oily skin,frequent drinking of carbonated drinks,fried beef a nd mutton and puffed food,imenstrual cycle was mainly in the late menstrual period. |
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