寻常型痤疮中医证素及其与皮损特征的相关性分析  

Analysisof the Chinese Medical Symptoms of Acne Vulgaris and their Correlation with the Characteristics of Skin Lesions

作　　者：邓欢欢 段行武[1] 吴治民 张静 李小婷[1,2] 刁若涵 DE Huanhuan;DUAN Xingwu;WU Zhiming(Dongzhimen Hospital,Beijing University of Chinese Medicine Beijing University of Chinese Medicine,Beijing 100700,China;Beijing University of Chinese Medicine Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学,北京100029

出　　处：《四川中医》2023年第11期88-93,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：北京市财政项目(编号:PXM2019_026273_000005)。

摘　　要：目的:探讨寻常型痤疮的中医证素分布规律,从而分析研究痤疮面部皮损特征与中医证素分布的相关性。方法:采用流行病学调查方法,收集2022年1月至2023年1月就诊于北京中医药大学东直门医院皮肤科门诊的134例痤疮患者的基本情况、全身症状及皮损表现等相关资料,建立excel数据库并根据证候权值以提取证素,再通过SPSS26.0对患者一般资料、证素及皮损表现进行数据处理,并运用SPSS Modeler18.0对证素与皮损特征进行关联性分析。结果:(1)证素分布:病位证素(前10位)按照频数由高到低依次为脾、肝、胞宫、肌肤、肾、胃、表、心神、肺、大肠。病性证素(前10位)按照频数由高到低依次为湿、阴虚、气虚、血虚、阳虚、血瘀、气滞、痰热、寒、血热。(2)证素与皮损特征的相关性:(1)皮损类型:丘疹与大肠、阴虚关联性最强;脓疱与胃、湿关联性最强;粉刺与肺、阴虚关联性最强。(2)皮损等级:Ⅱ级与胞宫、肾、阴虚、气滞关联性最强。(3)皮损面部分区:D3+D4(下颌)主要与肝、脾关联性较强,C2+C5(口周外上侧)依次与肾、胃、大肠关联程度较大,B2+B5(脸颊正中)与肾关联程度较强,B1+B6(两颊至耳前)与肝、脾关联程度较强。皮损颜色与病位、病性证素均无强关联性。结论:寻常型痤疮病机复杂多变,证型繁琐不一,通过证素辨证可抓住痤疮病变的关键因素,且中医证素分布与皮损特征存在一定的相关性,证素和皮损辨证的有机结合在痤疮的临床治疗中有着指导意义。Objective:To investigate the distribution of Chinese medical symptoms in acne vulgaris,and then analyze and study the correlation between the characteristics of acne facial lesions and the distribution of symptoms.METHODS:An epidemiological survey was conducted to collect data on the basic conditions,systemic symptoms and skin lesion manifestations of 134 acne patients attending the outpatient clinic of the Department of Dermatology,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine from January 2022 to January 2023,and an excel database was established to extract the evidence elements according to the evidence weights.The data were then processed by SPSS26.0 to analyse the general data,evidence and skin lesions of the patients,and SPSS Modeler18.0 was used to correlate the evidence with the characteristics of the skin lesions.Results:(1)Distribution of evidence elements:The pathogenic evidence elements(top 10)were,in descending order of frequency,spleen,liver,uterus,skin,kidney,stomach,table,heart and soul,lung and large intestine.The pathogenic elements(top 10)are,in descending order of frequency,Dampness,Yin deficiency,Qi deficiency,Blood deficiency,Yang deficiency,Blood stasis,Qi stagnation,Phlegm-heat,Cold,and Blood-heat.(2)Correlation between evidence elements and lesion characteristics:(i)Lesion type:papules were most strongly associated with large intestine and yin deficiency;pustules were most strongly associated with stomach and dampness;acne was most strongly associated with lung and yin deficiency.(Ⅱ)Grade of lesion:Grade II is most strongly associated with the uterus,kidney,yin deficiency and qi stagnation.(iii)Skin lesion facial areas:D3+D4(lower jaw)are mainly more strongly associated with the liver and spleen;C2+C5(upper outer perioral area)are more strongly associated with the kidney,stomach and large intestine in that order;B2+B5(middle of cheeks)are more strongly associated with the kidney;B1+B6(both cheeks to front of ears)are more strongly associated with the liver and s

关 键 词：痤疮 病位证素 病性证素 皮损特征 关联规则 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]