特应性皮炎脾虚湿蕴证患者的皮损表现特征分析

Analysis of the Characteristics of Skin Lesions in Patients with Atopic Dermatitis with Spleen Deficiency and Dampness Accumulation Syndrome

目的通过数据挖掘及临床横断面研究结合的方式,探讨特应性皮炎脾虚湿蕴证患者的皮损表现特征。方法现代文献研究方面,检索建库以来至2021年10月31日特应性皮炎脾虚湿蕴证的相关文献,提取并规范皮损特征,对所纳入皮损表现进行频数分析及关联分析;门诊招募于广东省中医院皮肤科就诊的特应性皮炎患者,分为脾虚湿蕴和非脾虚湿蕴2组,填写人口学资料及《特应性皮炎脾虚湿蕴证中医皮损特征采集表》,采用SPSS 27.0软件对数据进行非参数检验和二元Logistic回归分析,比较2组患者的皮损表现差异。结果文献研究共纳入符合要求的文献288篇,其中丘疹、鳞屑、瘙痒、糜烂及渗出等是特应性皮炎脾虚湿蕴证最常见的皮损表现;关联分析提示丘疹、瘙痒、糜烂、渗出、干燥与脾虚湿蕴证的关联性较强。门诊横断面研究共纳入受试者152例,差异分析提示2组患者在粗糙、鳞屑与潮红方面差异有统计学意义(P<0.05),其他皮损表现差异均未见统计学意义(P>0.05);单因素回归结果提示粗糙、鳞屑与潮红会显著影响患者是否为脾虚湿蕴证(P<0.05),而多因素回归结果提示,仅潮红为非脾虚湿蕴证的显著影响因素(P<0.05)。结论特应性皮炎脾虚湿蕴证患者的皮损表现以干燥、鳞屑、肥厚等干性皮损为主,符合亚急性、慢性期皮损表现;临床脾虚湿蕴证患者较少出现渗出、水疱、糜烂等湿性皮损。

Objective To explore the characteristics of skin lesions in patients with spleen deficiency and dampness accumulation syndrome of atopic dermatitis by combination of data mining and clinical cross-sectional study.Methods The relevant modern clinical literature were searched since the establishment of the databases to October 31st,2021.EXCEL 2017 database was established and descriptive analysis of frequency,correlation analysis was conducted.In addition,patients with atopic dermatitis from the dermatology department of Guangdong Hospital of Traditional Chinese Medicine were recruited and divided into two groups.Demographic data and the collection table of skin lesion characteristics were filled in.Non-parameter test and binary logistic regression analysis were analyzed by SPSS 27.0.Results A total of 288 articles were included,the most common manifestations of spleen deficiency syndrome included papule,scales,pruritus,erosion and exudation.The correlation analysis indicated that papules,pruritus,erosion and exudation had strong correlation with spleen deficiency dampness syndrome.A total of 152 patients were included in clinical study.The difference analysis indicated that there were statistical differences between two groups in roughness,scaling and flushing(P<0.05).The results of single factor regression suggested that roughness,scaling and flushing could significantly affect whether patients had spleen deficiency dampness syndrome(P<0.05),and the results of multivariate regression indicated that only flushing was a significant factor of non-spleen deficiency dampness syndrome(P<0.05).Conclusion There were no significant features in skin lesions of atopic dermatitis patients with spleen deficiency dampness syndrome,however,both"dampness"and"dryness"skin lesions features can appear simultaneously.