儿童特应性皮炎中医证型分布及生活质量研究

Research on the distribution of traditional Chinese medicine syndrome types and quality of life in children with atopic dermatitis

目的探讨儿童特应性皮炎(atopic dermatitis,AD)中医证型分布与疾病严重程度、生活质量之间的关系。方法应用AD评分指数(SCORAD)评分表、儿童皮肤病生活质量指数(CDLQI)问卷,对嘉兴市中医医院皮肤科门诊就诊的80例AD患儿进行临床症状评分与问卷调查。结果儿童AD中医证型分布中,湿热蕴结证14例(17.5%)、脾虚湿蕴证39例(48.8%)、血虚风燥证27例(33.7%),不同年龄患儿的中医证型分布不同,差异有统计学意义(P<0.05)。80例AD患儿经SCORAD评分,轻度22例(27.5%)、中度44例(55%)、重度14例(17.5%),病情以轻、中度为主。CDLQI问卷结果显示,对生活质量无影响8例(10%)、轻度影响36例(45%)、中度影响27例(33.8%)、重度影响9例(11.2%)、极重度影响0例,对患儿的生活质量以轻、中度影响为主。湿热蕴结证和脾虚湿蕴证患儿病情明显重于血虚风燥证(P<0.05),湿热蕴结证和脾虚湿蕴证对患儿生活质量的影响程度大于血虚风燥证(P<0.05)。Pearson相关分析提示患儿的CDLQI问卷评分与SCORAD评分呈正相关(r=0.86,P<0.05)。结论儿童AD中医证型与年龄、病情严重程度、生活质量有一定的相关性,为我们临床辨证施治方案的选择提供了依据并指导家庭健康教育。

Objective To explore the relationship between the distribution of traditional Chinese medicine patterns,disease severity,and quality of life in children with atopic dermatitis(AD).Methods The SCORAD scoring scale and CDLQI questionnaire were used to evaluate the clinical symptoms and conduct a questionnaire survey of 80 children with AD who visited the dermatology outpatient department of Jiaxing Traditional Chinese Medicine Hospital.Results In the distribution of traditional Chinese medicine syndrome types in children with AD,there were 14 cases(17.5%)of damp heat pattern,39 cases(48.8%)of spleen deficiency with dampness pattern,and 27 cases(33.7%)of blood deficiency-induced wind dryness pattern.The distribution of traditional Chinese medicine patterns varied among children of different ages,and the differences were statistically significant(P<0.05).80 children with Alzheimer's disease were evaluated by SCORAD,with 22 cases(27.5%)being mild,44 cases(55%)being moderate,and 14 cases(17.5%)being severe.The disease was mainly mild to moderate.The results of the CDLQI questionnaire showed that there were 8 cases(10%)with no impact,36 cases(45%)with mild impact,27 cases(33.8%)with moderate impact,9 cases(11.2%)with severe impact,and 0 cases with extremely severe impact.The quality of life of the affected children was mainly mild to moderate.The severity of the disease in children with damp heat pattern and spleen deficiency with dampness pattern is significantly more severe than that of blood deficiency-induced wind dryness pattern(P<0.05),and the impact on the quality of life of children with damp heat pattern and spleen deficiency with dampness pattern is greater than that of blood deficiency-induced wind dryness pattern(P<0.05).Pearson correlation analysis suggests that the CDLQI questionnaire score of children with AD is positively correlated with SCORAD score(r=0.86,P<0.05).Conclusion Traditional Chinese medicine patterns in children with AD are correlated with age,severity of the disease,and quality of life,providing a basis for the selection of clinical diagnosis and treatment plans and guiding family health education.