Clinical Features And TCM Syndrome Differentiation Of Rosacea

Purpose:to discuss the clinical features,risk factors,etiology and TCM pathogenesis of acne rosacea by the analysis on clinical data and diagnostic information of traditional Chinese Medicine of acne rosacea patients,so as to improve the overall understanding of the disease,provide new ideas for the traditional Chinese medicine,and objective basis for standardized clinical study.Methods:in this study,a one-to-one questionnaire survey is adopted,the 181 acne rosacea patients were from Department of Dermatology,Jiangsu Province Traditional Chinese Medicine Hospital visiting from April 2016-Jan 2017,patients according with this research were included and the control group was set by gender and age at 1:1,all the information collected were recorded into the Excel database,and SPSS20.0 software was used for correlation statistical analysis.Univariate and multivariate Logestic regression analysis was used to analyze the risk factors of the disease,and the main pathogenic factors of the disease and the classification of syndrome types were summarized by means of systematic cluster analysis and factor analysis.Results:1.General situation:among 180 cases,there were 33 males and 148 females,with a male to female ratio 1:4.48,the average age was 36.17 ±11.294 years old,the age of 20-50 years old was the high incidence of the disease;course 3 days-25 years,an average of 2.49 ±3.57 years,the course of women were shorter than that of men..2.Diagnosis and treatment status:150 patients with previous history of diagnosis and treatment,40 cases(22.1%)indicated that the treatment was invalid,11 cases(6.1%)showed symptom increased after treatment,the suspicious misdiagnosis rate was up to 34%;previous treatment process,system treatment with oral antibiotics(64.7%),Chinese medicine decoction(56.9%),(19.9%)antihistamines,topical treatment with hormone(51.7%),calcineurin inhibitors(33.7%).3.Clinical features:The common clinical types were erythematotelangiectasia(ETR),accounting for 57.5%,and papulopustular(PPR),accounting for 33.7%;paroxysmal flushing(88.4%),persistent erythema telangiectasia(86.2%),angiotelectasis(82.3%)were common skin manifestations,and buccula(83.4%),nose(68.0%),mouth(66.3%)were most common involvement sites,dry(68.4%),pruritus(66.7%),incandescence(64.2%)were three main symptoms;high temperature and high fever,spicy food spicy food,sun,mood fluctuations were the most common predisposing factors of the disease.The severity of paroxysmal flushing and dry facial skin were higher in erythematotelangiectasia(ETR)than that in papulopustular(PPR),and the severity of persistent erythema telangiectasia,papulopustular,heat and/or tingling,edema,hypertrophy proliferative changes were higher in papulopustular(PPR)than that in erythematotelangiectasia(ETR).4.Risk factors:single factor Logestic regression analysis showed:spicy spicy food,digestive system symptoms,irritable personality,and sunscreen were closely related to acne rosacea,p value<0.05,all these factors were analyzed by multiple linear conditional logistic regression,it was concluded that spicy spicy food,irritable personality were risk factors for acne rosacea(OR>1),and sunscreen was a protective factor(OR<1).5.TCM etiology and pathogenesis and syndrome type distribution:by using factor analysis,it was concluded that phlegm,dampness,heat and blood stasis were the main pathogenic factors of the disease;Cluster analysis results showed:thelungand gasterexcessiveheat syndrome,spleen stomach damp heat syndrome,phlegm stagnation,qi stagnation and blood stasis,syndrome of stagnation of liver fire were clinical common patterns of syndrome.Conclusion:Acne rosacea was predilection in middle-aged women,often accompanied by facial discomfort symptoms,so it was necessary to strengthen the understanding of the disease,and distinguish from hormone dependent dermatitis,allergic dermatitis,seborrheic dermatitis in clinical.And spicy food,irritable personality were risk factors for the disease,sunscreen was the protective factor for the disease.Phlegm,dampness,heat and blood stasis were the main pathological factors,the locations of disease involved in lung,spleen,liver,heart,and phlegm dampness played an important role in the pathogenesis.