| Purposes: By collecting the medical records of hospitalized patients with phenotypic urticaria in wind fever,discussing pathogenesis factors,laboratory tests and integrated traditional Chinese and Western medicine treatment,exploring new prescription drugs and improving diagnosis and treatment plans,hoping to summarize the TCM characteristic therapy of urticaria in our hospital and provide a reference for clinical differentiation treatment.Materials and methods: This study recorded in detail the clinical data of patients diagnosed with urticaria and wind fever in the dermatology ward of our hospital from January2020 to December 2022,including general information(name,gender,age,course of disease,actual number of days of hospitalization,etc.),seasonal solar terms,etiological triggers,allergy history,laboratory tests,clinical symptoms and signs,tongue veins,traditional Chinese medicine differential treatment,Western medicine treatment and other information.In this way,the clinically related factors of urticaria and wind fever and the characteristic treatment methods of traditional Chinese medicine were analyzed.Results:1.This study included 156 medical records that met the criteria,including 52 male patients(33.33%)and 102 female patients(66.67%);The male-to-female ratio was 1:2;patients with chronic urticaria were recorded aged as young as 11 years,maximum as 73 years,and mean as 50 years.The minimum length of hospital stay is 4 days and the maximum is 30 days,and the average length of hospital stay is 11 days.There were 19 cases(12.2%)in spring,58 cases(37.2%)in summer,44 cases(28.2%)in autumn,and 35 cases(22.4%)in winter.It is more common in summer.The solar term with the highest incidence is the light summer heat.2.Clinical symptoms and signs: top 5 skin manifestations: different degrees of itching(100%),positive skin scratches(98.71%),wheals(95.51%),edema and swelling(35.90%),scratches(21.53%);Noncutaneous manifestations mainly included eyelid or lip or extremity edema(35.89%),dyspnea(24.36%)when the rash was aggravated,chest tightness and palpitations and other precardiac symptoms(14.74%),dysphagia(11.53%),gastrointestinal symptoms(7.05%),chills and fever(5.12%).3.Laboratory tests: Ig E and C-reactive proteins can effectively help the clinical diagnosis and treatment of urticaria.Food intolerances can help patients identify allergens in their daily diet,the top 5 food intolerances: eggs(33.33%),wheat(9.62%),milk(8.97%),soy(7.05%),shrimps,crabs and shellfish(7.05%).4.Western medical treatment: oral drugs: mainly antihistamine drug ebastine tablets 138 cases(88.46%),levocetirizine hydrochloride tablets 95 cases(60.09%),olopatadine hydrochloride tablets 43 cases(27.56%),loratadine tablets 12 cases(7.69%).The leukotriene receptor antagonist montelukast sodium tablets 26 cases(16.67%)were intravenous drugs: the frequency of application of compound glycyrrhizin injection was 94.81%,vitamin C injection was 100%,calcium carbonate injection was 62.82%,and levofloxacin injection was 21.15%.Glucocorticoids were used in 23.72% of patients.5.Traditional Chinese medicine prescriptions: A total of 135 prescriptions were recorded in this study,involving 113 flavors of traditional Chinese medicine,with a total frequency of use of 2099 times.All traditional Chinese medicines were analyzed: the top 5 efficacy distribution were antipyretic drugs(32.21%),anti-epidemiological drugs(23.63%),deficiency tonic drugs(21.39%),liver quenching drugs(4.57%),and water relieving drugs(3.29%).The medicinal taste was bitter(46.45%),sweet(44.78%),spicy(27.06%),light(3.29%),and salty(1.76%).The medicinal properties were cold(26.92%),slightly warm(18.29%),flat(15.34%),warm(12.34%),and slightly cold(12.15%).The correlation analysis of 38 flavors of traditional Chinese medicines used ≥ frequency 10 times yielded 46 association rules,and cluster analysis could cluster 3 categories.Conclusion:1.In this study,the incidence rate of urticaria in women with stroke heat syndrome was significantly higher than that in men.The age of onset of this disease is 40-59 years old,and the majority of patients have a course of disease greater than 6 weeks.Most of them have acute attacks of chronic urticaria,with a peak season of summer and a peak season of heat stroke.2.In this study,serum total Ig E,C-reactive protein,and food intolerance can effectively assist in the clinical diagnosis of this disease and guide treatment.3.In this study,the efficacy of oral Chinese medicine is mainly composed of heat clearing drugs and tonifying drugs.In this study,the commonly used traditional Chinese medicine for urticaria caused by stroke and heat syndrome includes Fangfeng(6.38%),Licorice(6.00%),Raw Rehmannia(5.76%),Atractylodes macrocephala(5.72%),Peony bark(5.57%),Astragalus membranaceus(5.38%),Scutellaria baicalensis(4.95%),Burdock(4.86%),White Fresh bark(4.24%),and Angelica sinensis(5.53%).4.In this study,a potential new formula was summarized: Formula 1 can treat urticaria with wind heat syndrome accompanied by blood heat.Formula 2 is suitable for urticaria with wind heat syndrome and dampness heat accumulation.Formula 3 can be used as the basic formula for treating wind-heat syndrome with excessive wind evil accompanied by liver depression.Common drug combinations include Fangfeng Huangqi,Fangfeng Huangqi Baizhu,Fangfeng Huangqi Licorice,Fangfeng Huangqi Baizhu Licorice.5.In this study,the combination of traditional Chinese medicine decoction with antihistamines,compound glycyrrhizic acid glycoside,and vitamin C has a good therapeutic effect on this disease. |
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