| Purpose:To conclude the characteristics of clinical data and disease-related factors,understand the clinical treatment conditions and summarize the treatment experience through exploring the medical records of patients with acute herpes zoster who have been treated in the Dermatology Department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine with western medicine in combination with TCM clinical pathway in the past two years so as to provide more standardized diagnosis and treatment ideas for the future integrated treatment of herpes zoster with traditional Chinese and western medicine.Material and method:Retrospective study and analysis were conducted on the hospitalization data of patients with acute herpes zoster who were treated with western medicine in combination with the clinical pathway of traditional Chinese medicine from November 2017 to November 2019 in the inpatient wards of Dermatology Department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,573 patients were selected according to the inclusion and exclusion criteria,the general data(age and gender),clinical data(season,predisposing factors,affected nerves and misdiagnosis of the first diagnosis,etc.)and integrated Chinese and western medicine therapy data,etc.of them were collated,the relief condition of general symptoms of different age groups(youth,middle-aged and elderly groups)was compared to analyze whether there was any difference in the prognosis of disease,the data to be studied were entered into Excel and statistical analysis was conducted with the SPSS 22.0 statistical software.Results: 1.General information: The minimum age of the included patients in the acute phase was 21 years old,the maximum age was 91 years old and there was a significant difference between male and female at each age group(P<0.05).2.Pathogenic factors: The disease can occur in all the four seasons.The number of patients in autumn was relatively large through observation over the included patients(P<0.01).The common predisposing factors of patients include fatigue,emotional factors,exogenous disease and local trauma,etc.,but there was no obvious predisposing factor for most patients.Therein,361 patients(63.0%)were with one or more internal medicine diseases,with hypertension,diabetes and coronary heart disease being the most common.3.Clinical characteristics: 48.5% of patients were with both pain and rash simultaneously,45.0% of patients were with pain as the first symptom,6.3% of patients were with rash as the first symptom and 0.2% of patients were only with rash without pain.In this study,the number of patients with rash on the right side was larger than that on the left side,but there was no statistical difference between them(P>0.05).Affected nerves: intercostal nerve> trigeminal nerve> cervical plexus nerve> lumbosacral nerve> brachial plexus nerve> facial nerve.The syndromes of traditional Chinese medicine are mainly manifested as stagnated heat of liver channel(96.0%).4.Prognosis of disease: The shortest hospital stay of the 573 patients included was 6 days,the longest hospital stay was 21 days and the average was(11.71 ±1.92)days;the average time used to stop blister was(4.72 ±1.12)days and the pain relief time was(6.30 ±1.76)days.The comparison of different age groups showed that the difference of patients from different age groups was of statistical significance in terms of hospital stay and pain relief time(P <0.05)and there was no statistical significance about the difference in the time used to stop blister(P> 0.05).The pain and skin lesion scores of patients with acute herpes zoster were significantly different before and after treatment in the hospital(P <0.01).5.TCM clinical pathway:The completion rate of western medicine treatment in combination with the clinical pathway management of traditional Chinese medicine in our hospital was 92.7%.6.Treatment effect: 97 cases were cured(16.9%),437 cases were effective(76.3%)and 39 cases were not cured(6.8%)among 573 patients,with the combination of traditional Chinese and western medicine treatment,there was a high patient satisfaction and the total effective rate was 93.2%.In terms of the efficacy,the youth group was better than the middle-aged and elderly groups(P <0.05).Conclusion:In our hospital,the patients with acute herpes zoster treated by western medicine combined with clinical pathway of traditional Chinese medicine have significant advantages in shortening the length of stay,pain relief,skin lesions improvement and comprehensive efficacy evaluation,which is conducive to the standardized diagnosis and treatment of the disease and worthy of promotion. |
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