不同中医证型酒渣鼻106例皮肤镜特征分析

Characteristics of dermoscopy in rosacea of different TCM syndromes:a analysis from 106 patients

目的探讨不同中医证型酒渣鼻皮肤镜镜下图像特点及其在中医辨证中的应用价值。方法选取酒渣鼻患者106例,辨证分为肺胃热盛型61例,热毒蕴肤型34例,气滞血瘀型11例。每例患者取2张放大50倍皮肤镜照片,统计各型患者毛囊角栓数量、血管形态(包括球状血管、分枝状血管、线状血管、多角形血管)及血管分布特点(包括簇集分布、散在分布、网状分布)。结果3型毛囊角栓分布情况比较差异无统计学意义(P>0.05)。肺胃热盛型球状血管阳性率高于热毒蕴肤型、气滞血瘀型(P<0.05)。气滞血瘀型多角形血管阳性率高于肺胃热盛型、热毒蕴肤型(P<0.05)。气滞血瘀型血管网状分布阳性率高于肺胃热盛型、热毒蕴肤型(P<0.05)。结论肺胃热盛型酒渣鼻皮肤镜下球状血管多见,气滞血瘀型酒渣鼻皮肤镜下多角形血管、血管网状分布多见。

Objective To observe manifestation of dermatoscopy in rosacea of different TCM syndromes,and explore the characteristics of dermoscopy images and application of dermatoscopy in TCM.Methods Totally 106 patients with rosacea were dialectically selected and divided into Group 1(TCM lung and stomach hyperthermia,n=61),Group 2(TCM heat toxin accumulation skin,n=34),Group 3(TCM qi-stagnancy and blood stasis,n=11).Two dermoscopic images of each patient were magnified 50 times to evaluate the number of follicular plug,vascular morphology(globular vessels,scattered vessels,linear vessels,polygonal vessels),and the characteristics of vascular distribution(cluster distribution,scattering distribution,network distribution).Results No difference was statistically significant in the proportion of follicular plug between groups(P>0.05).Positive rate of globular vessels was higher in Group 1 than in Group 2 and Group 3(P<0.05).Compared with Group1and Group 2,positive rate of polygonal vessels in Group 3 was increased(P<0.05),and positive rate of vascular distribution was increased(P<0.05).Conclusion For patients with rosacea of different TCM syndromes,globular vessels of dermatoscopy are more common in patients with lung and stomach hyperthermia,polygonal vessels and vascular distribution are more common in patients with qi-stagnancy and blood stasis.