| Objective:TO study the distribution of anal pruritus and explore the interrelationship between the characteristics of anal pruritus and the physical fitness of the pruritus,and to provide the anorectal surgeon with a better understanding of the disease,at the same time,to provide some theoretical basis for individualized medication.Methods:In this research,the patients 'data was collected from the Department of Anorectal Surgery of Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2018 to March 2019,that diagnosed as anal pruritus.Those data would be included when it meet the inclusion criteria and at the same time did not meet the exclusion criteria.The patients who were included had to complete a questionnaire provided by researcher.The questionnaire would be finished under the guidance of the investigator at the time of the visit.A total of 150 patients who met the criteria of this study and had complete data were included.The observation indicators mainly include basic indicators such as gender and age,clinical characteristics and TCM constitution.The collected data would be imported into the database,and to be statistical analysed by using the SPSS22.0 software.Statistical methods:For non-continuous data,the rank sum test method would be used,and the chi-square test method or the Fisher exact probability test method would be used for the count data.Resu ts:1.Basic data of patients:About the gender,female was in the majority for the incidence of anal pruritus,and the ratio of female to male is 1:2.It made difference in statistical aspect.About the age,according to the data,the patients mean age was 39.94±11.4 years,the oldest one was 66 years old.While the youngest one was 20.Most patients were aged between 30 and 50 years old,it is about 80(53.3%)sample were contained in this section.The courses of this disease,the duration range from 3 days up to 10 years,and the average duration is 13.52 months.Most patient' s course time was within 1 year(83.3%),and the most duration was 2 months(13.3%).Body mass index(BMI):The average BMI was 23.13,which range from 16.7 to 30.4,77(51.3%)patient were included in the normal weight range,when 62(41.3%)be in the overweight range.Most of the patients had normal weight.Though there was a tendency to be overweight.The types' distribution of TCM differentiation,the damp-heat was dominant that has a total of 74 cases(49.33%).Followed by spleen and kidney yang-deficiency type(44 cases,accounted for 29.33%).There 23(accounting for 15.33%)patient were diagnosed as blood deficiency and wind dryness type(23 cases,accounting for 15.33%),and 9(6.0%)patient were diagnosed as cold-heat complicated syndrome.TCM constitution distribution:Among the 150 patients,36 cases were identified as phlegm-dampness constitution,which accounted for 24.00%;32 cases were identified as damp-heat constitution,which accounted for 21.33%;31 cases were identified as yang-deficiency constitution,which accounted for 20.67%;19 cases were identified as qi-deficiency constitution,which accounted for 12.67%;10 cases were identified as qi-stagnation constitution,which accounted for 6,67%;9 case were identified as special-constitution,which accounted for 6.00%;7 cases were normal-constitution,which accounted for 4.67%;4 cases were blood-stasis constitution,which accounted for 2.67%;3 cases of yin-deficiency constitution,which accounted for 1.30%.The order of TCM constitution of anal pruritus was as follows,phlegm-dampness(24.0%),damp-heat(21.3%),yang-deficiency(20.6Y%),qi-deficiency(12.7%),qi-s tagnation(6.7%),special-constitution(6.0%),normal-constitution,blood-stas is(2.7%),yin-deficiency(1.3%).2.Group comparison:TCM constitution&body mass index,phlegm-wet constitution had 15(41.7%)case of normal weight and 20(55.6%)case of overweight,while the damp-heat had 9(28.8%)case of normal weight and 22(68.8%)case of the overweight.According to the statistics,the body weight of phlegm-dampness and damp-heat were consisted of overweight most,in other words patients of these two constitution were tend to be obese.The composition ratio was statistically significant in difference.The constitution of TCM&skin itching.The itching of damp-heat and qi-stagnation was mainly moderate and severe pruritus.The severe itching of damp-heat and mass accounted for 90.6%,and the pruritus of qi-stagnation accounted for 70.0%.Moderate pruritus of phlegm-dampness accounted for 58.3%,and severe itching accounted for 38.9%.Moderate pruritus of yang-deficiency accounted for 51.6%,and the severity was 41.9%.The skin itchy of qi-stagnation,phlegm-dampness and damp-haet was heavier than other constitutions.The difference of skin itching was statistically significant.The relationship between TCM constitution and TCM syndrome differentiation,the syndrome differentiation of damp-heat was 30(93,8%)cases in damp-heat constitution,Patients in phlegm-dampness constitution were identified as 27 cases(75.0%)of damp invasion of lower energizer syndrome and 7 cases of spleen and kidney yang-deficiency(accounting for 19.4%).There were 22 cases(71.0%)identified as spleen and kidney yang-deficiency syndrome in yang-deficiency constitution,and 6 cases(19.4%)of blood deficiency and wind dryness type.While there were 9 cases of spleen and kidney yang deficiency syndrome(accounting for 47.4%)and 6 cases of blood deficiency and wind dryness syndrome(42.1%)consisted in qi-def iciency.There were 6 cases of damp-heat syndrome in normal-constitution,accounting for 85.7%.For different TCM constitutions,there were also differences in the dialectical distribution of TCM.The statistical value P was less than 0.05,which made a significant difference statistically.Conclusion:The treatment of anal pruritus is a very difficult problem for clinicians.Female is tend to cause the disease,especially young women.Compared with the previous literature,the age of onset is younger than before.The characteristics of the disease have a certain correlation with the TCM constitution.The most common types of TCM constitution of anal pruritus are phlegm-dampness,damp-heat,and yang-deficiency.And some characteristics of the disease are affected by the constitution.Patients of anal pruritus with damp-heat constitution have more severe itching than other constitutions,and patients with yang-deficiency are more likely to have anal sphincter relaxation.According to these theories,the corresponding Chinese medicine nursing measures are put forward to help patients with anal pruritus get out of the trouble of this disease. |
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