The Study Of Syndrome Differentiation And Infrared Thermography Of Primary Hyperhidrosis In Guangdong Area

ObjectiveTo explore the characteristics of infrared thermography of different syndrome differentiation types of primary hy perhidrosis(PHH)in Guangdong,and to expand the application field of thermal texture maps system(TTM)in traditional Chinese medicine,and to make certain contributions to the health management,diagnosis and treatment of PHH.MethodsIn a cross-sectional survey,PHH patients and healthy volunteers were screened according to inclusion and exclusion criteria.Clinical syndrome differential diagnosis was performed for the subjects,and the Hyperhidrosis Disease Severity Scale(HDSS)was used for grading.A total of 6 infrared thermal images of subjects in front,side,back,head holding position and hand raising position were collected using TTM.The system’s built-in function is used to measure the temperature on the infrared thermogram by point,record the temperature of each front-mu point(℃)and the average temperature(℃)data of the Du pulse,the triple burner,the anterior and posterior regions of the body,and calculate the relative temperature difference △T(℃).Statistical methods were used to analyze the characteristics of infrared thermogram and its correlation with HDSS score in PHH group.ResultsIn this study,a total of 50 PHH patients who met the criteria were included,and a total of 10 healthy controls were included.There was no statistically significant difference in gender and age distribution between the two groups(P>0.05).According to the syndrome type,PHH group could be divided into 3 cases of insecurity of the lung and the defensive qi,12 cases of liver depression and spleen deficiency,11 cases of spleen deficiency and dampness syndrome,5 cases of deficiency of qi and Yin,6 cases of forced steaming of dampness and heat,7 cases of syndrome of Yin deficiency with effulgent fire,and 6 cases of disharmony between nutrient qi and defensive qi.(1)The characteristics of the infrared thermal image of the PHH group in the front-mu point:the difference test showed that the difference of the relative temperature difference△T between the PHH group and the control group was statistically significant,including left Zhongfu,right Zhongfu,Shimen and Guanyuan points.The relative temperature difference of the four acupoints was higher than that of the control group,indicating that the heat deviation of the related acupoints in PHH patients was higher.The differences between the control group and TCM syndrome differentiation were tested.Results show that compared with the control group,the Riyue of the steaming of dampness and heat group,the Zhongfu of the spleen deficiency and dampness syndrome group,the Zhongfu,Juque,Zhongwan,left Zhangmen and Shimen of the syndrome of Yin deficiency with effulgent fire group,the left Zhongfu,left Jingmen and Shimen of the insecurity of the lung and the defensive qi group,the left Zhongfu and right Jingmen of the deficiency of qi and Yin group,the Zhongfu,right Zhangmen,Jingmen and Guanyuan of the liver depression and spleen deficiency group,relative temperature difference has a statistical difference(P<0.05).(2)The characteristics of the infrared thermal image of the PHH group in the triple burner and the Du pulse:by difference test,the PHH group and the control group had no statistical difference in the relative temperature difference of the triple burner △T(P>0.05),in which the control group the Upper-jiao △T was the highest,the Middle-jiao and Lower-jiao △T decreased,while the PHH group the Lower-jiao △T was the lowest,the lower and Upper-jiao △T increased in turn.There were differences in the distribution of the triple burner temperature among different syndrome differentiation types in PHH group.About the Upper-jiao △T minus the Middle-jiao △T,the control group compared with the syndrome of Yin deficiency with effulgent fire group,the forced steaming of dampness and heat group compared with the syndrome of Yin deficiency with effulgent fire group,the spleen deficiency and dampness syndrome group compared with the deficiency of qi and Yin group,the disharmony between nutrient qi and defensive qi group compared with the deficiency of qi and Yin group,the lung and the defensive qi group compared with the syndrome of Yin deficiency with effulgent fire group,the deficiency of qi and Yin group compared with the syndrome of Yin deficiency with effulgent fire group,the liver depression and spleen deficiency group compared with the syndrome of Yin deficiency with effulgent fire group change the statistical differences(P≤0.05).About the Middle-jiao△T minus Lower-jiao △T,there were statistical differences between the control group and the syndrome of Yin deficiency with effulgent fire group,the disharmony between nutrient qi and defensive qi group and the syndrome of Yin deficiency with effulgent fire group,the deficiency of qi and Yin group and the syndrome of Yin deficiency with effulgent fire group(P≤0.05).Compared with the control group,the Middle-jiao △T of the syndrome of Yin deficiency with effulgent fire group,and the Upper-jiao △T of the disharmony between nutrient qi and defensive qi group had statistical difference(P<0.05).However,t test results showed that there was no statistical significance in the Du pulse between the PHH group and the control group(P>0.05).(3)The relationship between infrared thermogram and HDSS score of the PHH group:Spearman correlation analysis was used to analyze the relationship between the front-mu point △T,the triple burner △T,the Du pulse △T and the HDSS score in PHH group.The results showed that the relative temperature △T of Zhongwan,Tianshu,Middle-jiao and Lower-jiao was negatively correlated with HDSS score(P<0.05),and the relative temperature of the Middle-jiao was significantly negatively correlated with HDSS score(P<0.01).The higher the HDSS score,the more serious the PHH hyperhidrosis,the lower the relative temperature difference of Zhongwan,Tianshu,Middle-jiao and Lower-jiao,and the cooler the local temperature.ConclusionThis study found that the type of PHH in Guangdong population may account for the largest proportion of spleen deficiency syndrome.Statistical analysis showed that the Middle-jiao △T in the PHH group showed a cool deviation compared with the healthy control group,and the relative temperature difference in Zhongfu,Shimen and Guanyuan points showed a heat deviation compared with the control group,indicating that PHH had a certain connection with the Middle-jiao area,Zhongfu,Shimen and Guanyuan points.There was also a statistical difference between the front-mu point △T of different syndrome differentiation and the healthy control group,which has a certain guiding significance for the clinical syndrome differentiation treatment of PHH.HDSS score was negatively correlated with the relative temperature difference of Zhongwan,Tianshu,Middle-jiao and Lower-jiao,suggesting that the severity of PHH hyperhidrosis may be most closely related to the spleen and kidney.