| Objective: To analyze the case data of damp-heat immersion generalized eczema patients,summarize and compare the characteristics,influencing factors and therapeutic effects of damp-heat immersion generalized eczema in middle-aged group and elderly group.To provide the basis and thinking for the clinical treatment of this disease.Data and methods :From January 1,2019 to December 31,2019,the medical records of321 patients with damp-heat immersion generalized eczema were collected in the dermatology ward of Liaoning University of traditional Chinese Medicine,Screening for appropriate eczema patients according to the NRA criteria,And divided into middle age group and old age group according to age,For both groups,Age,Season of onset,Hospital days and course of disease,Causes,The state and location of the lesions,Past history,History of allergies,Laboratory tests,Traditional Chinese and Western medicine,EASI VAS scores and other data registered in the table,By using SPSS21.0 Chinese version of statistical software,Counting data by chi-square test,An independent sample t test is used to measure the normal distribution,Non-parametric rank sum test,Pearson correlation coefficient is used to analyze the correlation between the two groups,According to the test level P<0.05 is statistically significant.Results:1.Gender:A total of 321 patients were collected in this study,including 96 middle-aged patients,including 57 women(59.38%),39 males(40.63%),Gender ratio 1:1.46,more females;A total of 225 elderly patients,Of which 85 were women(37.78%),140 males(62.22%),Men and women 1.64:1,more males,Analysis of gender differences by chi-square test(P<0.05),And the elderly group significantly more than the middle age group,The highest number of patients aged 61-65.2.Course of disease:The duration of middle age group was 3 days,Maximum 40 years,The average duration was 20.33 months.The duration of the disease was 1 day,Maximum 50 years,The average duration was 86.98 months.Nonparametric rank sum test was used to analyze the difference between the two groups(P<0.05),The elderly group was significantly longer than the middle-aged group.3.Predisposing factors :17 cases with obvious inducement in middle-aged group(17.71%),15 cases due to external contact(15.63%),21 cases in aged group(9.37%),18 cases of contact(8%),Statistical analysis showed significant differences(P<0.05),The middle-aged group was mainly exposed to hormones,irritants and sun exposure.4.Skin lesions:32 cases of scalp in middle-aged group(33.33%),Facial 34 cases(35.42%),79 upper limbs(82.29%),80 lower limbs(83.33%),70 cases of trunk(72.92%),46 hands(47.92%),bipedal 46(47.92%),14 cases of hip(14.58%);Skin lesions in the scalp of 105 elderly patients(46.67%),Facial 79(35.11%),189 upper limbs(84%),195 lower limbs(86.67%),168 cases of trunk(74.67%),In 62 cases(27.56%),bipedal 59(26.22%),hip in 13cases(5.78%).Both groups were mainly in the trunk and limbs,Among them,there were differences in hands,feet,scalp and buttocks(P<0.05).5.Lesions :96 cases(100.00%)of erythema lesions in middle-aged group,95 cases of papules(98.96%),Scratches in 64 cases(66.67%),Blood scab 76 cases(79.17%),Exudation in 33cases(34.38%),Dry desquamation in 37 cases(38.54%),8 cases(8.33%)of mossy,Pigmentation in 15 cases(15.63%);Erythema lesions in elderly group 222 cases(98.67%),222 papules(98.67%),There were 183 scratches(81.33%),Blood scab 178 cases(79.11%),Exudation in 65 cases(28.89%),Dry desquamation 119 cases(52.89%),22 cases of mossy(9.78%),Pigmentation in 59 cases(26.22%),The lesions in the two groups were mainly erythema and papules,Among them,scratches and detritus showed differences(P<0.05),The elderly group was more obvious in these two aspects than the middle-aged group.6.History of past illness:High blood pressure in 20 patients(20.83%),Coronary heart disease in 4 cases(4.17%),Thyroid disease hyperthyroidism 6 cases(6.25%),Dermatology disease(urticaria,etc.)11 cases(14.58%);Hypertension in 77 elderly patients(34.22%),Coronary heart disease 37(20%),21 cases of dermatological diseases(urticaria,allergic dermatitis,tinea corporis,etc.)(10.67%),Thyroid disease hypothyroidism 18 cases(8%),Microangiopathy23(10.22%),After chi-square test,the elderly group had significant differences in hypertension,coronary heart disease,thyroid disease and microangiopathy(P<0.05),Among them,the elderly group in hypertension,thyroid disease caused by hypothyroidism,microangiopathy such as varicose veins of the lower extremities significantly more than the middle-aged group,The middle-aged group had more hyperthyroidism than the elderly group.7.Laboratory tests:Abnormalities in middle age group of liver function in 24 cases(25%),In the elderly group,95 cases(42.22%)were abnormal,Among them,the AST?GLOB?A/G index was significantly higher than the middle-aged group,difference(P<0.05).The total cholesterol in middle-aged group was increased in 4 cases(4.17%),In the elderly group,32cases(14.22%)were significantly higher than those in the middle-aged group,statistically significant(P<0.05).An increase of 23 cases(23.96%)in Ig G middle-aged group,82 cases(36.44%),statistically significant(P<0.05),An increase of 22 cases(22.92%)in ?-HBDH middle age group,77 cases(34.22%)in elderly group were significantly higher than those in middle-aged group(P<0.05),C reactive protein increased 24 cases(25.00%)in middle age group than 33 cases(14.67%),Differences exist(P<0.05).Crab,cod,cockroach and dog fur dust were detected by special allergen(P<0.05),There were 5 cases(5.21%),4 cases(4.17%),10 cases(10.42%)and 15 cases(15.63%);In the elderly group,3 cases(1.33%),2cases(0.89%),10 cases(4.44%),59 cases(26.22%).8.Treatment :321 inpatients selected traditional Chinese medicine decoction,Chinese patent medicine,Chinese medicine injection,There were 85 cases(88.54%),6 cases(6.25%),23cases(25.00%);There were 203 cases(90.22%),18 cases(8%),33 cases(14.67%),Both groups had statistical significance in traditional Chinese medicine injection(P<0.05).In the middle age group of 92 cases(95.83%),and the overall use frequency of 225(100%)in the elderly group was higher than that in the middle-aged group(P<0.05).In the middle age group,35 cases(36.46%)were more than 43 cases(19.11%),statistically significant(P<0.05),Application of compound boric acid solution and compound Qingyou ointment in the elderly group was higher than that in the middle-aged group(P<0.05),There were 78 cases(81.25%)and 46 cases(47.92%);There were 204 cases(90.67%)and 135 cases(60.00%).9.Curative effect :Statistics 321 inpatients through standardized treatment,The average skin lesions in the elderly were 31.99±8.60,7.73±5.70,The middle age group was27.98±8.54,5.61±4.28,Difference(P<0.05)and the older the treatment,the less effective,The admission and discharge VAS scores were 80.38±0.94,34.15±3.79,The middle age group was79.76±1.72,30.49±0.54,Have statistical significance(P<0.05)the older the itching is less easy to alleviate.The study found 68 cases in the middle-aged group,In 28 cases,Total effective 100 per cent;There were 151 cases in the elderly,In 73 cases,One invalid case,The total effective rate is 99.55.Conclusion:1.The total number of inpatients in the elderly is higher than that in the middle age,middle-aged women have more incidence than men,and older men have more incidence with age.Strengthen the understanding and prevention of this disease in this age group.2.The middle-aged group was more likely to form skin lesions in both hands,feet and buttocks,while the elderly group was more likely to form skin lesions in the scalp and calf.Care and prevention of this site should be strengthened.3.The greater the age,the more obvious the degree of eczema itching and difficult to alleviate,the older group is more prone to scratch,dry desquamation,pigmentation skin lesions.The purpose of diagnosis and treatment is to improve the quality of life of patients.4.Elderly groups are more likely to be associated with hypertension,coronary heart disease and other basic diseases,as well as microangiopathy and thyroid disease caused by hypothyroidism,with the elderly,AST??-HBDH? total cholesterol and other indicators more abnormal,the middle-aged group was more prone to hyperthyroidism.In the treatment of eczema,the potential risk factors to improve vigilance,actively consult the relevant departments to assist in diagnosis and treatment.5.The middle-aged group was more sensitive to seafood,and older people are more sensitive to dog dander.Care should be taken to avoid contact.6.Regulating the immune function of the body can promote the healing of skin lesions.7.The 10 drugs with the highest frequency of oral Chinese medicine in the middle and old age patients with damp-heat immersion eczema are: Rehmannia glutinosa,licorice,honeysuckle,alisma,peony skin,Fangfeng,gardenia,Schizonepeta,Scutellaria baicalensis,white fresh skin.Follow-up with the highest frequency of addition and subtraction of 10 traditional Chinese medicine: skin seed,Coix seed,crochet,Radix Ginseng,hemp seed,Cortex Phellodendri,Atractylodes,Poria cocos,fried Tribulus terrestris,Angelica sinensis.8.Middle-aged and hot-aged eczema patients in our hospital with traditional Chinese medicine and the professional wet decoction and ventilation treatment,assisted by the basic treatment of western medicine,which can achieve remarkable results in a short time. |
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