310例儿童斑秃回顾性临床分析及中医辨证分型的相关性研究

Clinical analysis and Traditional Chinese Medicine syndrome of 310 alopecia areata in children

目的:总结分析儿童斑秃的临床特点及中医证型的相关性,探讨中重度斑秃发生的危险因素。方法:回顾性分析310例斑秃患儿的临床资料,按照脱发严重程度分轻度、中重度两组,比较两组在性别、年龄、实验室检查、合并疾病、中医证型的差异,并采用多因素Logistic回归分析中重度斑秃发生的危险因素。结果:①310例斑秃患儿,平均发病年龄(6.65±3.06)岁。②斑秃患儿的脱发类型以斑片型为主,两组在性别、年龄段分布上有统计学差异(P<0.05)。③血清25羟基维生素D降低、IgE异常、甲状腺抗体阳性、伴随特应性皮炎、伴随甲状腺功能亢进的患者人数比例在两组间具有统计学差异(P<0.05)。④中医辨证为脾虚湿蕴证的患儿143例,血热生风证患儿88例,肾精不足证患儿34例,气血两虚证患儿45例。⑤通过多因素Logistic回归分析,发现幼儿期发病、血清25羟基维生素D降低、IgE异常、伴随特应性皮炎、中医辨证为脾虚湿蕴证对斑秃严重程度的影响具有统计学意义。结论:幼儿期发病、血清25羟基维生素D降低、IgE异常、伴随特应性皮炎、中医辨证为脾虚湿蕴证是中重度斑秃发生的危险因素。

Objective To summarize and analyze the clinical characteristics of children's alopecia areata and the correlation of Traditional Chinese Medicine syndrome types,explore the risk factors of moderate and severe alopecia areata.Methods The clinical data of 310 children with alopecia areata who were retrospectively analyzed.According to the severity of hair loss,they were divided into two groups:mild and moderate.age,laboratory tests,combined diseases,and differences in Traditional Chinese Medicine syndrome types,and the risk factors for moderate to severe alopecia areata were analyzed by Logistic multivariate analysis.Results 1.310 children with alopecia areata,with an average age of onset of(6.65±3.06)years old.2.The main type of hair loss in children with alopecia areata is patchy type,and there are statistical differences in the distribution of gender and age between the two groups(P<0.05).3.There was a statistically significant difference between the two groups in the proportion of patients with decreased serum 25-hydroxyvitamin D,abnormal IgE,thyroid antibody positive,atopic dermatitis,and hyperthyroidism(P<0.05).4.There were 143 children with syndrome of spleen deficiency and damp accumulation,88 children with blood heat generating wind syndrome,34 children with kidney essence deficiency syndrome,and 45 children with Qi and blood deficiency syndrome.5.Through multi-factor Logistic regression analysis,it was found that onset in early childhood,decreased serum 25-hydroxyvitamin D,abnormal IgE,atopic dermatitis,and Traditional Chinese Medicine syndrome of spleen deficiency and damp accumulation have statistically significant effects on the severity of alopecia areata.Conclusion Onset in early childhood,decreased serum 25-hydroxyvitamin D,abnormal IgE,atopic dermatitis,and syndrome of spleen deficiency and damp accumulation are risk factors for moderate to severe alopecia areata.