| Objective: To collect the cases of inpatients in the dermatology department of Fengtian Hospital of Traditional Chinese Medicine in Liaoning Province,summarize the general data,clinical manifestations and integrated Chinese and western medicine treatment of patients with liver channel pent-up heat type snake cluster sore,summarize the case characteristics and treatment methods of patients in our hospital,and provide reference for further improving the treatment of liver channel pent-up heat type snake cluster sore with integrated Chinese and western medicine.Material and method: In the way of case review,the cases of patients with liver channel pentup heat type snake cluster sore hospitalized in the dermatology ward of Fengtian Hospital of Traditional Chinese Medicine from January 2017 to December 2022 were collected,recorded and analyzed.Include: general information(name,sex,season of onset,age,past history,etc.);Clinical data(lesion site,lesion shape,first symptoms,tongue,pulse,laboratory examination,etc.);Treatment(TCM decoction,Chinese patent medicine,use of Western medicine and external treatment of traditional Chinese and Western medicine,etc.);Efficacy(skin lesion score before and after treatment,pain score before and after treatment),SPSS26.0 statistical software was used for statistical analysis.Results:1.General information: A total of 138 patients were included in this study,including53 males(38%)and 85 females(62%),with a male to female ratio of 1:1.6,more females than males(P < 0.05).The age of hospitalization ranged from 23 years old to86 years old,and the average age was 59.88±12.91 years old.The distribution of hospitalization age was most concentrated in 60-69 years old(52 cases,37.68%).There were 35 cases(25.36%)in spring,29 cases(21.03%)in summer,41 cases(29.71%)in autumn and 33 cases(23.9%)in winter.There was no statistical difference in this season(P > 0.05).There were 80 patients(58%)with one or more diseases,among which hypertension(42 cases)(30.43%),diabetes(26 cases)(18.84%),coronary heart disease(21 cases)(15.21%)were the most common,and circulatory system(66 cases)(48.20%)and endocrine system(29cases)(21.01%)were the most involved.Most of the patients had no obvious predisposing factor,and the main inducing factor of a small number of patients was emotional disturbance.26 cases(18.9%).2.Clinical manifestations: Lesions: Among the 138 patients,90 cases(65.22%)were found on the left side and 48 cases(34.75%)were found on the right side.There was a statistical difference in the distribution of left and right lesions(P < 0.005).Most lesions involved one or more parts of unilateral limb,among which 76 cases(55.07%)were found to involve two parts of unilateral limb.Two sites on the left side were involved in 50 cases(36.23%).Lesions morphology: All 138 patients showed unilateral distribution of clustered papules,humidus,blisters,tension in the blisters wall,clarified blisters,blisters non-fusion,flushing of the base,partial blisters rupture,accompanied by erosion and exudation,in a banded arrangement.First symptom: the number of patients with both rash and pain was the largest,of which 75 cases(54.34%)had both rash and pain,54 cases(39.13%)had pain first,and 9 cases(6.53%)had rash first.Tongue and pulse: 125 cases(90.58%)of red tongue,72 cases(52.17%)of moss yellow,38 cases(27.54%)of pulse string appeared most frequently3.Laboratory examination: 115 cases(83.33%)had normal white blood cell count,5cases(3.62%)were higher,and 18 cases(13.05%)were lower.The percentage of neutrophil was normal in 98 cases(71.01%),high in 18 cases(13.05)and low in 22cases(15.94%).The percentage of lymphocyte was normal in 36 cases(26.09%),high in 82 cases(59.42%)and low in 20 cases(14.49).The percentage of monocytes was normal in 110 cases(79,71 %),high in 23 cases(16.67%)and low in 5 cases(3.62%).4.Treatment: A total of 113 prescriptions were collected in this study,involving 121 traditional Chinese medicines.The total frequency of use reached 2,013 times,with an average frequency of 16.64.Among them,the top 15 herbs with the highest frequency of use were Radix cymbidiae(109 cases)(5.43%),Rhizoma corydalis(104cases)(5.18%),Psyllium plantageae(104 cases)(5.18%),Radix isatidis(102 cases)(5.08%),Radix isatidis(94 cases)(4.83%),Radix isatidis(82 cases)(4.08%),safflower(81 cases)(4.04%)and Shuanghua 7 3 patients(3.63%),71 patients(3.53%),70 patients(3.48%),70 patients(3.48%),69%(3.43%),68 patients(3.39%),66 patients(3.28%),64 patients(3.18%),61 patients(3.03%)of gardenia;The most frequently appeared drugs were heat-clearing drugs(36.11%),followed by drugs for promoting blood circulation and removing blood stasis(26.68%),drugs for regulating water and dampness(13.56%),drugs for regulating qi(7.3%)and drugs for tonifying deficiency(6.6%).The main channels were liver(20.78%),heart(17.29%),stomach(11.66%)and spleen(10.80%).The majority of the drug properties were cold(60.41%),and the rest were warm(19.50%),flat(17.73%),cool(2.20%)and hot(0.15%).Bitter taste(45.85%)was dominant.84 cases(60.87%)of Reduning in TCM injection.External treatment of traditional Chinese medicine: 123 cases(89.13%)of acupuncture treatment,124 cases(89.85%)of bloodletting treatment,10 cases(7.42%)of traditional Chinese medicine collapse,6 cases(4.34%)of traditional Chinese medicine encapsulation.Western medicine and treatment: 57 patients(41.30%)took famciclovir orally,Jingdian Yanhuning injection 23There were 88 cases(16.67%),88 cases(63.77%)of metocobalamin tablets,30 cases(22.74%)of painkillers,50 cases(36.23%)of canola polysaccharide nucleic acid injection,33 cases(23.91%)of acyclovir cream and 124 cases(89.85%)of infrared radiation.5.Treatment results: Before treatment,26 patients(18.84%),45 patients(32.60%)and 27 patients(19.56%)had skin lesions score of 6,and the average score of skin lesions before treatment was 6.38±1.74.After treatment,the lesion score was mainly concentrated in 0 points 76 cases(55.08%)and 1 points 47 cases(34.05%).After treatment,the overall average score was 0.59±0.67 points,which was significantly decreased before and after treatment(P < 0.05).Before treatment,88 cases(63.77%)had pain score of 7,and 118 cases(85.5%)had pain grade of 4,with an average score of 7.07±0.67.After treatment,90 cases(65.21%)had pain score of 3,and 124 cases(89.85%)had pain grade of 2.The average score of pain score after treatment was2.74 ± 0.73,which significantly decreased before and after treatment(P < 0.05).Among the 138 patients after treatment,6 cases(4.35%)were cured,121 cases(87.68%)were improved,and 11 cases(7.97%)were not cured.The total effective rate was 92.03%.Conclusion:1.The characteristics of the cases in this study showed that females were more than males,and the high incidence was concentrated in the age group of 60-69.Most of the patients had one or more diseases in the past,and most of the patients had no obvious causes of disease,and there was no obvious difference in seasonal distribution.2.The site of the disease in this study was more involved in one or more parts on one side,concentrated in the trunk.3.In this study,15 kinds of high-frequency drugs were obtained,and the principles of using liver channel and heat-suppressing type snake sore were summarized as clearing heat and dampness and detoxifying,promoting blood circulation and collages to relieve pain,soothing liver and regulating qi;Efficacy classification of heat-clearing drugs frequency is the most,the main drug into the liver channel,the drug to cold most,the most concentrated pharmaceutical taste to bitter.4.In this study,the combination of traditional Chinese and western medicine has a good clinical effect in the treatment of liver channel stasis heat type snake string sore. |
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