| Objective: Through the retrospective analysis of the pathogenesis,disease history,development relationship between psoriasis vulgaris and pustular psoriasis,laboratory tests,medication rules,prognosis and prognosis of hospitalized patients with pustular psoriasis,the comorbidity factors and treatment experience of wet toxicity obstruction pustular psoriasis were summarized,and this paper was provided as a reference for the prevention and treatment of this disease in the future.Materials and methods: The clinical data of 76 hospitalized patients with pustular psoriasis confirmed in the Department of Dermatology of the Affiliated Hospital of Liaoning University of Chinese Medicine from October 2012 to October 2022 were collected,and the general situation of the onset(age,gender,season of onset,predisposing causes,disease history,family history,etc.),clinical manifestations(skin lesion location,skin lesion morphology,tongue,pulse,etc.),laboratory tests(blood routine,liver and kidney function,immune function,blood lipids,etc.),treatment and medication(internal administration of Chinese medicine decoction,External drugs,etc.),efficacy evaluation and other items were recorded,and SPSS26.0 statistics were used for relevant data analysis.Results:1.General situation: A total of 76 cases met the criteria were included in this study,including32 cases(42.10%)of localized pustular psoriasis,44 cases(57.89%)of generalized pustular psoriasis,and 17 cases(22.36%)of previous psoriasis vulgaris.(1)Males accounted for 26 cases(34.21%),females accounted for 50 cases(65.79%),the male-to-female ratio was 1:1.08,and there were more females than males(P<0.05).(2)The hospitalization age of patients was 10 years old and 82 years old,the average age was54.73±13.97 years,the average hospitalization days were 13.84±3.15 days,and the course of the disease ranged from 7 days to 43 years.The age of onset showed a difference between groups(P<0.005).The onset of solar terms is mostly in the spring equinox,white dew,and winter solstice.(3)In terms of bad living habits,34 smokers(44.74%)and 40 drinkers(52.63%),generalized pustular psoriasis were more than localized pustular psoriasis(P<0.05).2.Triggers: 36 cases(47.37%)did not have clear predisposing factors,and 18 cases(23.68%)had symptoms of upper respiratory tract infection in this case;The number of patients who stopped or reduced the recurrence of related oral drugs accounted for 13 cases(17.11%);Exposure to irritants or unknown external drugs accounted for 8 cases(10.53%);Mistreatment accounted for 5 cases(6.58%);Emotional stress factors accounted for 3 cases(3.95%);One case(1.32%)was precipitated by exertion.3.Disease history: 27 cases(35.53%)had a history of previous cardiovascular system diseases,including 16 cases(21.05%)with hypertension or elevated blood pressure,9 cases(11.84%)with a history of endocrine system diseases,7 cases(9.21%)with a history of digestive system diseases,3 cases(3.95%)with a history of neurological diseases,2 cases(2.63%)with a history of respiratory diseases,2 cases(2.63%)with a history of blood system diseases,and 2 cases(2.63%)with a history of rheumatic immune system diseases.4.Laboratory tests:(1)Blood routine: CRP increased in 48 cases(63.16%),white blood cell elevation accounted for 20 cases(26.32%),neutrophil elevation accounted for 18 cases(23.68%),and erythrocyte sedimentation rate accelerated accounted for 11 cases(14.50%).Statistical analysis showed that there were differences between patients with generalized and localized patients in elevated leukocytes and neutrophils,and abnormal increase in erythrocyte sedimentation rate(P<0.05).(2)Biochemical function: 9 cases(11.84%)were elevated alanine aminotransferase,12 cases(15.79%)were elevated glutamyl transpeptidase,15 cases(21.05%)were decreased total protein,9 cases(11.84%)were elevated uric acid,2 cases(2.63%)were creatinine increased,8 cases(10.53%)were elevated lactate dehydrogenase,7 cases(9.21%)were elevated hydroxybutyrate,and 23 cases(30.26%)were elevated triglycerides.Total cholesterol was elevated in 32 cases(42.11%).Elevated blood glucose accounted for 20 cases(26.32%)Statistical analysis showed that there were differences between patients with generalized and limited patients in abnormally elevated uric acid,creatinine,lactate dehydrogenase,hydroxybutyrate dehydrogenase,total cholesterol,and triglycerides(P<0.05),and there were differences in abnormal triglycerides between the group without a history of uncommon disease and the group with a history of vulgaris(P<0.05).(3)Immune examination: Ig E elevation accounted for 14 cases(18.42%),immune imbalance accounted for 73 cases(96.05%).statistical analysis showed no difference between generalized patients and limited patients,and no difference between generalized patients with vulgar history and no vulgar history.(4)Blood pressure: 16 cases(21.05%)had elevated blood pressure,and statistical analysis showed no difference between generalized patients and limited patients,and no difference between generalized patients with a history of vulgaris and patients with no history of vulgaris.5.Traditional Chinese medicine treatment: A total of 76 songs were collected in this study,the four qi of traditional Chinese medicine were mainly cold,the five flavors were mainly bitter,sweet and spicy,and the first three drugs were liver,lung and stomach;The frequency of traditional Chinese medicine is ranked;The cluster analysis of the top 20 flavors of traditional Chinese medicine was clustered into 4 categories,the first category: forsythia,danpi,poria,honeysuckle,white flower snake tongue grass,white grass root,red peony,chicken blood vine,locust flower;The second category: comfrey,danshen,clay porridge,ginseng,plum;The third category: Lotus hemibranch,Radix radix,Coix seed,Baishu,Wild Chrysanthemum,Yellow Cypress,Ze Yuan,Gardenia,Skullcap;Fourth category: licorice,raw land,white fresh skin,welling,dandelion.6.Efficacy:73 cases of definite efficacy among 76 patients,65 cases(85.53%),8 cases(10.53%)were effective,3 cases(3.95%)were ineffective,and the total effective rate reached96.05%.Conclusion:1.Pustular psoriasis tends to occur in winter and spring,and repeated attacks are cyclical,and can be affected by all ages.2.From the initial age of patients with generalized pustular psoriasis,the age of patients with no previous history of unusual type is younger than that of patients with history of ordinary type.3.Upper respiratory tract infection and alcohol consumption are independent influencing factors of pustular psoriasis.4.Alcohol consumption,elevated white blood cells,and elevated neutrophils are independent risk factors for pustular psoriasis,and upper respiratory tract infection is a predisposing factor.5.The combination of traditional Chinese medicine and Western medicine has a significant effect on the treatment of pustular psoriasis with wet toxicity. |
