Analysis Of Disease Constitution And Influencing Factors Of Vulvar Pruritus In The Outpatient Department Of Dermatology

Objective1.To explore the disease constitution of patients with vulvar pruritus from the outpatient department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, exclude the disease of Gynaecology and STD. To analyse the TCM syndrome types and the degree of itching of these patients.2. To investigate the influencing factors of the symptom of vulvar pruritus in the outpatient department of Dermatology by using a case-control study. It probably can help Dermatologist to improve the level of diagnosis and treatment associated with vulvar pruritus.MethodsThe study consistd of two parts:first is about the descriptive analysis. To diagnosis the patients with vulvar pruritus from the outpatient department of Dermatology in Nov2012-Aug2013(203cases, exclude the disease of Gynaecology and STD), then collect and record the data (included the degree of itching, other symdroms, name of disease, age, job, habits, etc) of the patients. That is in order to explore the disease constitution and TCM syndrome types of them. The second part is about the case-control study. To collect and record the data of the control group which were without vulvar pruritus randomly in the outpatient department of Dermatology or the physical examination center. It is to compare with the case group for investigating the factors affected the symptom.Established the database with Epidata3.1in computer. Adopt SPSS18.0to perform analysis of database such as descriptive analysis, Chi square test and binary logical regression analysis.Results 1. Disease constitution, TCM syndrome types and the degree of itching of the patients(1)The average duration of patients was30.1month. In203cases,99were non-infectious vulvitis constitute48.7%of all patients, includ acute vulvitis(7,3.4%)and chronic vulvitis(92,45.3%).73pruritus vulvae (35.8%),14alphelasma(6.9%),7Lichen sclerosus(3.4%),5Senile vaginitis (2.5%). And1each in Bowenoid papulosis, VIN Ⅲ, Pagist’disease, Fordyce and Pseudocondyloma of vulvae (0.5%).(2)There were58syndrome of dampness-heat of liver channel (67.44%) and28syndrome of yin deficiency of liver and kidney (32.56%) in vulvitis.27syndrome of dampness-heat diffusing downward (45%),21syndrome of wind and dryness due to blood deficiency (35%),8wind-cold syndrome (13.33%) and4blood heat and wind syndrome (6.67%) in the pruritus vulvae.10each in syndrome of dampness-heat of liver channel (50%)and syndrome of yin deficiency of liver and kidney(50%)in alphelasma and LS. All5were syndrome of yin deficiency of liver and kidney (100%) in Senile vaginitis.1syndrome of dampness-heat of liver channel (33.33%)and2syndrome of yin deficiency of liver and kidney(66.67%) in Bowenoid papulosis, VIN Ⅲ and Pagist’disease. There were71syndrome of dampness-heat of liver channel (40.34%)and45syndrome of yin deficiency of liver and kidney(25.57%) of all.(3)The patients evaluated degree of itching by themselves, the mean score was6.63,5and above account for85.8%of the total.92cases as moderate in self-rated itching grade accounted for52.3%.60cases were severe, accounting for34.1%.2. Factors affected the symptom(1)The mean age of case group was39.30, higher than control group which was34.94(OR=1.547,95%CI=1.015-2.358). Getting old may increase opportunity of causing the symptom.(2)In the group which were under the age of34,univariate logistic re gression analysis showed that associated with the syndrome:suffer from v aginitis again and again(OR=9.246,95%CI=2.612-32.727), the long-term use o f certain drugs (OR=6.172,95%CI=1.692-22.516), introversion and irritabili ty(OR=2.040,95%CI=1.034-4.024), use the liquid to clean the vulva(OR=1.963.95%CI=1.056-3.651), the use of dry-weave sanitary towel (OR=0.524,95%C1=0.268-1.026); influencing factors of another group are:introversion an d irritability (OR=5.428,95%CI=2.389-12.336), relationships with family was neither good nor bad (OR=3.610,95%CI=1.598-8.156), use the liquid to clean the vulva (OR=3.541,95%CI=1.657-7.569), the use of inferior san itary towel (OR=3.257,95%CI=1.566-6.771), panties drying in the shade (OR=2.430,95%CI=1.003-5.883) and ate spicy food(OR=0.488,95%CI=0.257-0.928)(3)The multivariable logistic regression analysis showed that suffer from vaginitis again and again (OR=9. Oil), long-term use of certain drugs (OR=8.234), use the liquid to clean the vulva (OR=2.180) increase the risk of incidence of vulvar pruritus in under the age of34; The factors of another group are introversion and irritability (OR=5.662) and use the liquid to clean the vulva (OR=3.952)Conelusion1. Non-infectious inflammatory genital lesions, vulvar cancer and precancerous lesions constituted the diseases of patients. Most were vulvar inflammation lesions and pruritus vulvae. However, alphelasma and LS can not be ignored.2. TCM syndrome types focus on dampness-heat of liver channel and syndrome of yin deficiency of liver and kidney.3. The risk factors focus on suffer from vaginitis again and again, the long-term use of certain drugs, use the liquid to clean the vulva, introversion and irritability, getting old.4. Since the itching was serious, duration was long, it brought great trouble to the patients, suggesting that clinicians must give attention to the symptom of vulvar pruritus.How to solve the problem will become one of the clinical work which can not be ignored.