Correlation Between Different Types Of Alopecia Areata And TCM Constitution And Mental Factors

Alopecia areata(AA)is a type of patchy hair loss that occurs suddenly.Sometimes there is no apparent self-symptoms after hair loss.It is a common clinical disease in dermatology.It includes localized alopecia areata(partial hair loss),total baldness(referring to the entire scalp hair loss[AT]),and general baldness(referring to the total loss of all body hair except eyebrows,beards,etc.[AU]).Alopecia areata where the hair loss area exceeds 50%is called a severe alopecia areata.Alopecia areata can occur at any age,especially in young people.It has a certain degree of self-healing.However,about 50%of cases relapse after stopping,and it is difficult for severe alopecia areata to heal itself.At present,the main system drugs for treating severe alopecia areata are glucocorticoids,immunosuppressive agents,and external agents including biological response modifiers and immune stimulants.Minoxidil may also be recommended,usually in combination with another treatment.New directions include biologics targeting immune response as well as lasers and autologous platelet-rich plasma(PRP)and low level laser therapy(LLLT).There are many treatments are available;however,the efficacy of these treatments has not been confirmed,especially in severe cases,and relapse rates are high.Therefore,effective,targeted,and side-effect treatment methods remain to be explored by us.In recent years,many scholars have found that neuropsychiatric factors are closely related to the pathogenesis and development of alopecia areata.They found that most patients with alopecia areata have at least one psychological stimulus before their onset,and patients with psychological problems are more severe and have poorer efficacy.Chinese medicine also believes that emotions do not hesitate,depression hurts the liver,leading to liver failure,witch results in hair lossing,and shedding.So assessing the patient’s psychological condition to explore differences in psychological conditions between patients with different types of alopecia areata,may have certain application value and scientific significance in assessing patient’s condition and predicting disease trend.Besides many studies found that psychotherapy has a certain effect on the treatment of alopecia areata,Chinese medicine-related treatment of liver qi stagnation is also safe and effective.However,currently used psychological assessments and personality tests,such as the 90 symptom self-evaluation scales(SCL-90)and the Eysenck Personality Questionnaire,require a lot of time for patients to fill in,and it takes a lot of time statistics and analysis results.Due to the special nature of mental illness in treatment,professional psychologists are often required to intervene,which takes longer and is more expensive.All of the above limits our general outpatient clinics to use psychological tests to assess the psychological status of patients and to use psychotherapy to treat alopecia areata.Objective:1.Testing patients’ psychological and TCM constitution to analyse the differents in different disease duration,different clinical stages,different severity of alopecia arenata patients psychological status and differences in TCM constitution.Explore the emotional development of alopecia areata,development and prognosis Impacts to explore the assessment of mental state and the possibility of TCM constitution identification in predicting disease development trends;2.Explore the feasibility of psychological intervention and TCM diet regimen treatment of alopecia areata.Methods:We Collected 63 patients with alopecia areata treated in the dermatology clinic of China-Japan Hospital as subjects.From the physical examination center of our hospital,24 normal persons with similar age,gender and educational background and similar subjects were selected as the normal control group.To determine the area of hair loss,clinical stage,and disease duration.Each subject was asked to fill in 90 symptom self-rating scales,SAS,SDS,DLQI and Professor Wang Qi’s TCM physique.Identify the table and record the final result.Then analyze the differences in score results between different groups of patients and normal controls were analyzed.At the same time,33 patients were randomly selected from 63 patients with alopecia areata as the experimental group and 30 patients as the control group.The patients in the experimental group requested that in addition to the use of medications,follow the given personalized intervention packages(according to the results of different psychological tests,each person should be given different psychological interventions)to conduct psychological interventions on their own,and follow the dietary requirements of Chinese medicine for diet and rest.The control group maintained the original treatment plan unchanged.After 3 months,the efficiency of each group was counted.Reslut:1.Of the 63 patients with alopecia areata,56 patients were active,only 3 were in recovery,and 4 were in stable phase.Due to the small sample size,statistical analysis of different clinical stages has not been conducted.2.Comparison of psychological test scores among patients with different disease durations:The scores of SAS and SDS scales were significantly different between patients with long course and short course and normal controls(P<0.05).And long course>short course>normal control group.There was no significant difference in SCL-90 between the three groups(P>0.05),Short-course patients with DLQI score>patients with long duration(P<0.05).3.The scores of psychological tests among different severity levels:The scores of SAS,SDS,and SCL-90 in alopecia areata,severe alopecia areata and normal controls were statistically significant(P<0.05),and severe alopecia areata>mild alopecia areata>normal controls.There was no significant difference in DLQI between patients with alopecia areata with different severity(P>0.05).4.Comparison of TCM Constitution Types between Alopecia areata and Normal Population:There is a difference between Yang deficiency and phlegm in the identification of TCM in alopecia areata and normal population(P<0.05),and the characteristics of Yang deficiency in alopecia areata are more obvious than those in normal population.The characteristics of phlegm and dampness in the crowd are more obvious than in alopecia areata.5.After 3 months evaluation of treatment efficiency,the total effective rate in the experimental group was 81.8%,and the total effective rate in the control group was 56.7%.The difference in efficacy between the two groups was statistically significant(P<0.05).Conclusion:Alopecia areata patients with more serious psychological problems have more severe symptoms and longer duration.Psychological testing may be used as a means to predict the development of alopecia areata;the characteristics of Chinese yang deficiency and physique of patients with alopecia areata are more obvious than those of normal people,while the yang deficiency quality is characterized by introversion as the main psychological characteristic in line with the patient’s psychological status,and the yang deficiency Cold stagnation,poor blood,in line with the description of alopecia areata pathogenesis in Chinese medicine;psychological intervention and TCM constitution identification of a given method of diet regimen treatment of alopecia areata to some extent.