Study On The Characteristics Of TCM Syndrome Elements And Related Factors In Different Grades Of Acne

Objective:The purpose of this study is to use the syndrome differentiation theory to compare the distribution characteristics of TCM disease nature syndrome elements and disease location syndrome elements in different grades of acne,and to analyze the correlation between the severity of acne and gender,age,course of disease,family history,staying up late and acne prone areas.In order to provide a certain reference for acne differentiation and prevention.Methods:In this project,160 acne patients were classified into 4 grades according to the Pillsbury grading method used in the 2019 Chinese acne treatment guidelines.The patients’ basic data,four diagnostic information,lesion images and other condition data were collected through questionnaire inquiry and physical examination,and factors related to the severity of acne condition were analyzed,and the TCM health state identification system was used to calculate the evidence points and analyze the characteristics and differences in the distribution of TCM evidence in the four groups of patients.Results:1.The differences in the distribution of age,gender,family history,and predilection sites(forehead,cheeks,forehead and back)among the four groups of acne patients were statistically significant(P<0.05),and the differences in the distribution of disease duration and whether they stayed up late were not statistically significant(P>0.05).Among them,age was negatively correlated with the severity of acne condition(Spearman r=-0.359,P<0.01),and the intrinsic correlation of its grade characteristics was also present(Kendall’s tau-c=-0.313,P<0.01),which was negatively correlated.2.Acne patients’ pathogenic evidence elements were mainly distributed in the liver,followed by the spleen,kidney,skin,uterus,and stomach;the pathogenic evidence elements were mainly heat,followed by dampness,phlegm,yin deficiency,qi stagnation,and blood stasis.3.Grade Ⅰ acne is mainly located in the liver,followed by the spleen,uterus,and stomach;the pathological elements are mainly heat and dampness,followed by phlegm,yin deficiency,and qi stagnation.Grade Ⅱ acne is mainly located in the liver,followed by the spleen,uterus,and kidney;the pathological elements are mainly heat,followed by dampness,yin deficiency,qi stagnation,and phlegm.Grade Ⅲ acne is mainly located in the liver,followed by the kidney,spleen,skin,and uterus;the pathological elements are mainly heat and dampness,followed by yin deficiency,qi stagnation,phlegm,and yang deficiency.The pathological elements of grade Ⅳ acne are mainly distributed in the skin,liver,followed by the spleen;the pathological elements are mainly heat,phlegm,and dampness,followed by toxicity,yin deficiency,and qi stagnation.4.The distribution of the evidence elements skin and toxin was significantly different in different grades of acne(P=0.000<0.01),and skin and toxin were the same in the grade Ⅰ,grade Ⅱ and gradeⅢ groups,all of which were lighter than the grade Ⅳ group;the distribution of the pathological evidence element phlegm was significantly different in different grades of acne(P=0.021<0.05).5.The two variables of skin evidence element score and acne grade were correlated(Spaerman r=0.410,P<0.01),and the intrinsic correlation of their grade characteristics was also present(Kendall’s tau-b=0.371,P<0.01),which was positively correlated.The two variables of toxin score and acne grade were correlated(Spearman r=0.362,P<0.01),and the intrinsic correlation of their grade characteristics was also present(Kendall’s tau-b=0.333,P<0.01)and positively correlated.6.Acne was more common with deficiency-solid intermixing,and less common with both pure deficiency and pure solid evidence;deficiency-solid intermixing was most common with heat and yin-deficiency intermixing,and solid intermixing was most common with heat and damp intermixing,with no significant difference in the intermixing of deficiency and disease location;the clustering of evidence elements could be roughly divided into 11 categories,with strong generalization and more precise coverage.Conclusion:1.The liver,spleen,kidney,skin,and uterus are the main sites of acne,and heat,dampness,and phlegm intermingling are the characteristics of acne;grade Ⅰ and Ⅱ acne are mainly located in the liver,spleen,and uterus;grade Ⅲ acne is mainly located in the liver,kidney,and spleen;grade Ⅳacne is mainly located in the skin and liver;grade Ⅰ acne is mainly heat,dampness,phlegm,and yin deficiency;grade Ⅱ and Ⅲ acne are mainly heat,dampness,yin deficiency,and qi stagnation;and grade Ⅳ acne is mainly heat,phlegm,dampness,and toxicity.Grade Ⅳ acne is mainly heat,phlegm,dampness,and toxicity.2.Skin,phlegm,and toxin evidence were significant in grade Ⅳ acne,with skin and toxin positively correlated with the severity of acne.3.Acne with mixed evidence of deficiency and reality is dominated by heat and yin deficiency;liver depression and qi stagnation,phlegm and dampness,qi and blood burnt evidence may be the main pathogenesis of acne.4.Grade Ⅳ acne is characterized by adolescent males with a family history of acne and significant skin lesions,which can provide certain reference value for the prevention and treatment of severe acne.