| Research objective:Through skin CT, observe the RCM characteristics of the different TCM syndrome types of vitiligo, and compare them with the western medicine staging and typing.Research method:This research enlisted a total of 69 cases of patients who conformed to the diagnostic criteria of the TCM and western medicine of vitiligo. The patients'general conditions and the current medical history were recorded, and TCM syndrome diagnoses were first conducted on the vitiligo patients of the 69 listed cases, who were divided into the syndrome of stagnation of Qi due to depression of the liver, the liver and kidney deficiency syndrome and syndrome of syndrome of Qi stagnation and blood stasis; then, based on the criteria of the western medicine staging, typing of vitiligo, their staging and vitiligo types judged; skin CT was used for the observation of the RCM characteristics of the vitiligo skin lesions. Skin lesions were selected on all the patients for photography and CT scans.Research results:1.1 Among the skin lesions of the vitiligo patients and the syndrome of stagnation of Qi due to depression of the liver and the liver and kidney deficiency syndrome, the differences in the typing of such four types as the non-segmental type, distributing type, the generalized type and facial and extremity typing featured no statistical significance (P>0.05)1.2 Comparison of the western medicine staging and TCM syndromes of vitiligo skin lesions:the differences of the patients'skin lesions of the syndrome of stagnation of Qi due to depression of the liver and the liver and kidney deficiency syndrome in the distributions of the three phases of the VIDA staging featured statistical significance (P<0.01), and the differences in the distributions of the results of Wood light exam also featured statistical significance (P<0.01). This indicates that skin lesions of liver depression and Qi stagnation syndrome are mostly in the development stage, while the skin lesions of the liver and kidney deficiency syndrome are mostly in the stationary phase.1.3 Results of RCM observations1.3.1 Results of the analysis of the various TCM syndrome types RCM indexes:1.3.1.1 Analysis on the clarities of the vitiligo edge:among the syndrome of stagnation of Qi due to depression of the liver, there were mostly skin lesions with less clarified vitiligo edges, while in the liver and kidney deficiency syndrome, there were mostly skin lesions with clarified vitiligo edges (P>0.05)1.3.1.2 Analysis of basal layer pigment loss of vitiligo:among the syndrome of stagnation of Qi due to depression of the liver and the liver and kidney deficiency syndrome, the basal layer pigments in most of the skin lesions saw obvious reductions of the basal layer pigments, and in a small number of the basal layers of the skin lesions, no obvious reductions were seen, and under RCM, the structures of the basal cell rings and the pigments on them had excellent restorations, and the colors of the corresponding skins were also excellent.1.3.1.3 Analysis of the appearances of local focuses or total loses in the vitiligo basal layer: among the patients with liver and kidney deficiency syndrome basal layer pigments, there were more patients who has local focuses or total losses, while among the patients with the syndrome of stagnation of Qi due to depression of the liver, there were more patients who has no losses in the basal layer pigments (P<0.01)1.3.1.4 Analysis of the integrity of the basal cell rings:among the patients of the syndrome of stagnation of QI due to depression of the liver, there were more patients who has losses of the basal layer rings, while among the patients with the liver and kidney deficiency syndrome, there were more patients with roughly complete basal layer rings (P<0.01)1.3.1.5 Analysis of the infiltration status of epidermatitis and chorionitis cells:among the patents with the syndrome of stagnation of QI due to depression of the liver, the proportions of the epidermatitis and chorionitis cells in the skin lesions were higher (P<0.01), while the same proportions were smaller among the patients with the liver and kidney deficiency syndrome (P<0.01)1.3.1.6 Analysis of the contents of the normal skin pigments in the surroundings of the vitiligo:among the patients with the syndrome of stagnation of Qi due to depression of the liver, the proportions of skin lesions with the abnormal contents of the abnormal skin pigment contents in the surroundings of the vitiligo were higher, while among the patients with the liver and kidney deficiency syndrome, no higher abnormal proportions of the pigments in the surroundings of the vitiligo (P<0.05)1.3.1.7 Analysis of the chromophage and depositions of the pigment granules in the shallow layers of the dermis:among the patients with the syndrome of stagnation of QI due to depression of the liver, it was observed that there were mostly patients with positive RCM indexes, while there were fewer positive ones among the patients with the liver and kidney deficiency syndrome (P<0.05)1.3.1.8 Analysis of the distribution status of the dendritic melanin cells:among the patients with the syndrome of stagnation of Qi due to depression of the liver, exams revealed fewer ones with the dendritic melanin cells, while there were more among those with the liver and kidney deficiency syndrome (P<0.01)1.3.1.9Analysis of the distributions of the intercellular edema:among the patients with the syndrome of stagnation of Qi due to depression of the liver patients, the proportion of the intercellular edema of the skin lesions was higher, while among the patients with the liver and kidney deficiency syndrome, the proportion was smaller (P<0.01)Research conclusion:Using CT observation, this research observed the RCM manifestations of the different TCM syndrome types of vitiligo, discussed the status of syndrome distributions of the various observation indexes, and conducted correlation analysis on the western medicine staging and RCM indexes of vitiligo.1.In the analysis of the syndrome of stagnation of Qi due to depression of the liver and the liver and kidney deficiency syndrome and the RCM indexes, it was discovered that among the patients with the syndrome of stagnation of QI due to depression of the liver, there were more patients who were in the progressive stage, under RCM, the vitiligo edges usually lacked clarity, and the basal layer pigments saw marked reductions; in the basal layer pigments, no local focuses or total losses, loses of the basal cell rings, infiltrations of the epidermatitis and chorionitis cells, loses of the normal skin pigment loss in the surroundings of the vitiligo, and the depositions of the chromophage and pigment granules in the shallow layers of dermis were seen, and there were fewer distributions of the dendritic melanin cells and there were intercellular edema; among the patients with the liver and kidney deficiency syndrome, there were more who were in the stationary stage, and under RCM, the manifestations that are opposite to the indexes of those with the syndrome of stagnation of Qi due to depression of the liver.2.In the VIDA scoring, Wood light exam staging and RCM indexes, there might be the possibilities in the wrong judgments of the VIDA scoring and Wood light exam. Under RCM, the pigment loss of the basal layer cannot indicate whether the vitiligo has advanced. It was impossible to judge whether the skin lesions have advanced with single reliance on whether losses were see in the basal layer pigments. No infiltrations were seen in the epidermal skin and dermis, no pigment abnormalities were seen in the surroundings of the vitiligo, and no chromophage and pigment granules seen in the shallow layers of the shallow layers of the dermis, and no intercellular edema seen; it was impossible to rule out the possibility of the advancement of the disease condition.. The integration of the manifestations of the various indexes is of extreme importance to the adjuvant diagnosis of the disease condition with skin CT. |
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