Study On Investigating The Traditional Chinese Medicine Syndromes Of Oral Lichen Planus In Chengdu Area

Objective:Through literature research, to investigate TCM syndrome distribution of oral lichen planus,and to create the OLP syndrome investigation form.By OLP clinical investigation,analysis the clinical TCM syndrome distribution and related factors,and calculates common syndrome diagnostic threshold and grading criteria,in order to develop objective clinical and practical TCM diagnostic quantitative criteria and the clinical efficacy assessment standard foundation.Method:1.Literature Investigation:by collecting OLP literature related to TCM syndrome to explore OLP syndromes and various symptoms and syndromes under the distribution of signs,establish the initial preparation of oral TCM syndromes information questionnaire.2.Clinical Research:by analyzing TCM syndromes information form of 500 cases from multi-center investigation,use variable clustering factor analysis and cluster sample survey of clinical data for statistical analysis,and compare them with the traditional differentiation,then try to calculate and weight the symptoms and signs, thus to determine the diagnostic threshold syndromes and syndromes classification criteria.Results:1.Through literature research,we found that the top 11 commonly seen differentiations are as follows:yin deficiency and fire exuberance(58),damp-heat accumulation of spleen (48),qi stagnation and blood stasis(34), liver qi depression(31), spleen deficiency and dampness exuberance(31),liver fire exuberance(38),blood deficiency and wind dryness(29),qi and blood deficiency(29),heart fire flaming up(31),qi and yin deficiency(26),spleen and kidney deficiency(21).2.Through the literature investigation,we found that the top 10 most commonly seen symptoms and signs are:pain,burning sensation,yellow tongue coating,rough sense,red tongue, numbness, dry mouth,foreign body sensation,restless sleep last night, oral ulcers,wherein the pain feeling, burning sensation,rough, numbness, foreign body sensation are oral local symptoms.3.Among clinical investigation in Chengdu area of 500 cases of OLP patients, experts differentiate 12 patterns,No.1 is yin deficiency and fire exuberance (98cases, 19.6%),damp-heat accumulation of spleen (93cases,18.6%),liver qi depression(72cases,14.4%),spleen deficiency and dampness exuberance(67cases, 13.4%),liver fire exuberance(47cases,9.4%),qi stagnation and blood stasis(32cases, 6.4%),heart fire flaming up(27cases,5.4%),yin deficiency and damp-heat (21cases,4.2%),spleen and kidney deficiency(20cases,4%),blood deficiency and wind dryness(11cases,2.2%),qi and blood deficiency(6cases,1.2%),liver and kidney yin deficiency(6cases,1.2%).4.Top 10 symptoms and signs out of 101 items are:reticular type, pain, stripe type, dry mouth,erosive,tongue,papular type,rough feeling,yellow tongue coating,restless sleep last night.5.By clustering variables grouped into four categories:yin deficiency and fire exuberance,damp-heat accumulation of spleen,liver qi stagnation,and spleen dampness are in good agreement with the clinical classification.Using factor analysis we got five main principal components,which explain 70.521% of the total variance, the first principal component mainly for spleen dampness syndrome;the second principal component mainly for damp-heat accumulation of spleen syndrome;the third main component mainly for liver qi stagnation syndrome;the fourth and fifth principal components are partial manifestation of OLP lesions;cluster analysis of samples obtained with the traditional patterns were obvious consistency,yin deficiency and fire exuberance,damp-heat accumulation of spleen,liver qi stagnation,and spleen dampness took the largest proportion,but there are also differences between two methods.6.The diagnostic threshold of each pattern:yin deficiency and fire exuberance: 7.1406-15.8910,damp-heat accumulation of spleen:9.9582-16.3378,liver qi stagnation: 9.8581-16.7061, and spleen dampness:10.2286-16.0235.Conclusion:1.Through literature investigation?is found that the most commonly seen patterns of OLP are:yin deficiency and fire exuberance (62.50%),damp-heat accumulation of spleen (39.84%),qi stagnation and blood stasis (32.81%),liver qi depression (25.00%),spleen deficiency and dampness exuberance (20.31%),liver fire exuberance(15.63%),these syndromes distribution reflects the basic pathogenesis of OLP.2.Found in clinical surveys:patterns of yin deficiency and fire exuberance, damp-heat accumulation of spleen,liver qi depression, spleen deficiency and dampness exuberance,liver fire exuberance, qi stagnation and blood stasis,these six types up to a total of 409 cases,made 81.80% of the total number of cases.This disease is based on root deficiency and branch excessive or mixed deficiency and excessive syndrome,the root is liver,kidney,and spleen deficiency,the branch is mainly about damp,heat (fire) based,mixed qi stagnation,blood stasis and other factors,which together cause functional disorders of zang-fu organs,local lesions, symptoms and tongue and pulse are the main clinical manifestations.3.Between clinical syndromes and local oral survey show some correlation: Syndromes and damp heat (fire) related factors often appear pain, burning sensation, itching,lesions of erosive-based,or diversified mixed lesions;patterns related to qi stagnation,blood stasis,deficiency syndromes often associated with pain,numbness, foreign body sensation,lesions form a mesh type,stripe type,papular type and other non-erosive lesions, one or more lesions appear together.4.500 cases of clinical investigation in patients with OLP demographic data have certain characteristics,correlated with age,sex,lifestyle,etc.This disease occurs in adults over the age of 35 female patients,and is associated with smoking and other factors,which is corresponding to literature reported,and the duration ranging from half a year to 20 years.5.Applying factor analysis and cluster analysis can help with obtaining the main clinical symptoms associated with OLP,using percentile method to determine the diagnostic threshold and criteria and classification of major syndromes,develop objective clinical,practical TCM diagnostic quantitative criteria,and establish the clinical efficacy standard foundation of Traditional Chinese Medicine.