| Object1.Literature research: Based on the traditional Chinese medicine inheritance support system(TCMISS)to build a database,using a variety of data mining methods to study the rules of Chinese medicine fumigation prescription for treating nonneoplastic epithelial disorders of vulva(NNEDV),and provide a new reference for the clinical treatment of NNEDV.Chinese medicine treatment has certain value.2.Clinical study: To evaluate the clinical efficacy in the treatment of NNEDV,,analyze its cubic basis,summarize its clinical treatment experience,and promote the clinical promotion of this side.The application provides evidence.Summarize the investigation and analysis of the relevant factors of the disease and the psychological impact on patients,and provide a clinical basis for the prevention and treatment of this disease in the future.Methods1.Literature research:Through the China Knowledge Network,Weipu,Wanfang database to collect the prescription of NNEDV for Chinese medicine fumigation and washing from January 2012 to November 2018,using TCMISS software to analyze drug patterns and conduct prescription mining.2.Clinical study: 30 patients with NNEDV who were received medical advice and informed consent at the gynaecology clinic of Dongzhimen Hospital from January 2018 to February 2019 were collected.Treatment with Baiban fumigation prescription for 3 courses.Questionnaires were used to collect general conditions and related scales of patients,and to analyze the changes of vulvar lesions before and after each treatment.Results1.Literature research results: This study included 89 prescriptions,138 Chinese medicines,16 Chinese medicines with a drug frequency greater than 15 times,50 combinations of drugs with a frequency greater than 17 times,and 8 cores and 4 core groups excavated.The top five drugs with the highest frequency are Radix Sophora Flavescentis,Fructus Cnidii,Fructus Kochiae,Cortex Phellodendri and Cortex Dictamni.The first three items of high-frequency medicine are “Radix Sophora Flavescentis + Fructus Cnidii”,“CortexPhellodendri + Radix Sophora Flavescentis”,“Radix Sophora Flavescentis+ Fructus Kochiae”,“Fructus Kochiae +Fructus Cnidii”,“Radix Sophora Flavescentis+cortex dictam”.High-frequency drugs and core groups reflect the characteristics of medications based on reinforcing insufficiency and reducing excessiveness.2.Clinical study results:(1)Patients ranged in age from 26 to 70 years,with an average age of 42 years.There are13 people(43.3%)under the age of 35 years old;there are 5 people(16.7%)between 36 and45;and 9(30%)between 46 and 55.There are 3 people(10%)older than 55 years old.(2)Education:masters and above:6(20%),undergraduate students:8(26.67%),college graduates:8(26.67%),high school/secondary schools and below:8(26.67%).The shortest course of disease is 3 months,the longest course is 30 years,and the average course of disease is 7.2 years.(3)Among the relevant factors,the number of staying up late and sedentary factors were20(66.7%)and 22(73.3%)respectively,and 10 people(33.3%)were fond of spicy food.Mental stress and irritability were 21(70%)and 19(63.3%),respectively.Among the working factors,the total number of people in pressure is 10(33.33%).(4)A total of 30 cases were collected,9 cases were cured,17 cases were markedly effective,3 cases were effective,1 case was ineffective,and the total effective rate was 97%.Among them,17 cases of squamous hyperplasia of vulva(VSH),7 cases were cured,9 cases were markedly effective,1 case was effective,and the effective rate was 100%;13 cases of lichen sclerosus of vulva(VLS)were cured.In 2 cases,8 cases were markedly effective,2cases were effective,1 case was ineffective,and the effective rate was 92.3%.There was no significant difference in the therapeutic effect between the two pathological types(P>0.05).(5)The score of itching degree,the score of lesion degree,the score of pigmentation change and the total score of patients with VLS and VSH were lower than those before treatment.The difference in symptom scores before and after treatment was statistically significant(P<0.05).(6)The score of itching degree,the score of lesion degree,the score of pigmentation change and the total score after treatment were lower than those before treatment in each course of treatment.The score of itching degree was statistically significant before and aftertreatment in the first course(P<0.05).There was significant difference in the score of lesion degree in the first and second courses before and after treatment(P<0.05);the score of pigmentation change and total score were statistically significant before and after treatment(P<0.05).(7)According to the severity of disease classification,it was divided into mild group(first degree),moderate group(second degree),and severe group(tired degree and forth degree).The results showed that there was a statistically significant difference in total scores between the mild group and the severe group(P<0.05).There was no significant difference in the total scores between the mild group and the moderate group,the moderate group and the severe group.(P>0.05).(8)There were 10 cases of anxiety,20 cases of no anxiety.The scores of the anxious patients were higher than those without anxiety,there was a statistically significant difference in the score of itching degree,the score of pigmentation change the total score,(P<0.05).and there was no significant difference in the score of lesion degree(P>0.05).There were 13 cases of depression,17 cases of no depression,and scores of depression were higher than those without depression,and in the score of itching degree and the score of lesion degree,the difference was statistically significant(P<0.05).There was no significant difference in the the score of pigmentation change the total score.The results were not statistically significant(P>0.05).(9)Nottingham health poofity(NHP)according to six dimensions,the six scores of anxiety/depression are higher than those without anxiety/depression,including energy,sleep,emotional response,and social activities.The difference was statistically significant(P<0.05),and there was no significant difference in pain and physical activity(P>0.05).Conclusion1.Literature research:The clinical manifestations of NNEDV are different,and multiple syndromes appear at the same time.System evolution has obtained 8 core combinations,mostly for the combination of heat-clearing and dampness,warming yang to dredge collaterals and blood-stasis,and phlegm and anti-itch drugs.Four new prescriptions were obtained,all of which reinforce insufficiency and reduce excessiveness.Treatment of this disease should be based on the four clinics,distinguish between false and real,distinguishbetween primary and secondary contradictions,syndrome differentiation and treatment.2.Clinical research(1)Baiban fumigation prescription has significant clinical effect on the treatment of NNEDV.It has obvious curative effect on the treatment of VSH and VLS pathological types.The itching degree,skin lesions degree and pigmentation changes are obviously improved after treatment.And the patients has no allergies or other adverse reactions during the treatment,which deserves further clinical promotion.(2)The age of onset of this disease is mostly in the perimenopausal period of women,and there is a tendency to younger patients.The cause of the disease may be related to staying up late,sedentary,nervous,emotionally irritable,and stressful work factors.Patients should try to avoid these incentives,improve their lifestyle,and see them soon after the onset of illness.(3)The clinical symptoms of this disease are difficult to linger,which may easily cause anxiety or depression,and these negative emotions may reduce the quality of life of patients,including emotional response,energy and sleep quality. |
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