北京中医药大学学报2024，Vol.47Issue(10)：1438-1448,11.DOI:10.3969/j.issn.1006-2157.2024.10.014
对1 049例寻常型银屑病患者病程证候、证素演变规律的回顾性研究
A retrospective study on the evolution of TCM syndrome and TCM syndrome elements in the course of disease in 1,049 patients with psoriasis vulgaris
摘要
Abstract
Objective The study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine(TCM)and TCM syndrome elements in different chronic stages of psoriasis vulgaris.Methods A database was constructed using electronic medical records collected from July 2019 to March 2024 from 1,049 patients with psoriasis vulgaris.The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages:initial diagnosis,progressive stage(Week 2-3),progressive stage(Week 4-5),skin lesion improvement stage(Week 6-7),and remission stage.The syndrome elements network was constructed using community detection algorithms,and the association rules between local skin lesion syndrome differentiation and overall syndrome differentiation were displayed using heatmaps.Results(ⅰ)Initial diagnosis.In the syndrome differentiation of local skin lesions,blood heat syndrome was the most common(79.79％);among the disease location of TCM syndrome elements(called"disease location"),liver was the most prevalent(35.62％);and among the pathological factors of TCM syndrome elements(called"pathological factors"),fire(heat)was the most common(75.48％).(ⅱ)Active stage(Week 2-3).In the syndrome differentiation of local skin lesions,blood heat syndrome remained the most prevalent(73.13％);among the disease location,liver was still the most prevalent(31.71％);and among the pathological factors,fire(heat)continued to be the most common(82.11％),while dampness(22.26％)and qi stagnation(8.39％)began to increase.(ⅲ)Active stage(Week 4-5).The syndrome differentiation of local skin lesions was dominated by blood heat syndrome(45.91％)and blood dryness syndrome(37.19％);among disease location,the interior was the most prevalent(15.25％);and among the pathological factors,fire(heat)remained the most common(50.66％),with an increase in yin deficiency(34.26％).(ⅳ)Skin lesion improvement stage(Week 6-7).In the syndrome differentiation of local skin lesions,both blood dryness syndrome(49.44％)and blood stasis syndrome(33.33％)increased;among the disease location,meridians increased most significantly and became the most prevalent(13.44％);and among the pathological factors,blood stasis increased most significantly and became the most prevalent(28.20％).(ⅴ)Remission stage.In the syndrome differentiation of local skin lesions,blood stasis syndrome became the primary(55.69％),while the percentage of blood dryness syndrome decreased(21.16％);meridians(25.71％)and blood stasis(62.34％)remained the most predominant syndrome elements related to disease location or pathological factors.Conclusion The overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency.From the initial diagnosis to the active phase(Week 2-3),heat syndrome dominated;during the active phase(Week 4-5),heat syndrome coexisted with damp syndrome or yin deficiency syndrome;changes in the syndrome element network were the most significant during the lesion improvement phase,with blood stasis gradually increasing and peaking during the remission phase.Blood stasis,dampness,and qi stagnation were pervasive throughout psoriasis vulgaris;qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients.关键词
寻常型银屑病/真实世界研究/演变规律/关联网络/证素/回顾性研究Key words
psoriasis vulgaris/real-world study/evolution rules/association network/elements of syndrome of traditonal Chinese medicine/retrospective study分类
医药卫生引用本文复制引用
王家悦,底婷婷,蒙玉娇,陈朝霞,李萍,周冬梅,白彦萍,段行武,蓝海冰,赵一丁,赵京霞,王燕..对1 049例寻常型银屑病患者病程证候、证素演变规律的回顾性研究[J].北京中医药大学学报,2024,47(10):1438-1448,11.基金项目
国家自然科学基金项目(No.82074435) （No.82074435）
北京市属医院科研培育计划项目(No.PZ2023020) （No.PZ2023020）
首都医科大学科研培育基金(No.PYZ23168) （No.PYZ23168）
2024年度北京市中医药研究所市财政专项资助课题(No.YJS-2024-07) National Natural Science Foundation of China(No.82074435) （No.YJS-2024-07）
