摘要
[目的]探讨中重度手足皮肤反应(hand-foot skin reaction,HFSR)的中医证型及证型分布特征。[方法]采用临床流行病学研究中的回顾性时间横断面观察法,收集140例中重度HFSR患者的中医证候资料。通过聚类分析方法提取证候资料,得出中重度HFSR患者的中医证型,并进一步分析各证型的分布特征。[结果]中重度HFSR中医证型分为3类:热毒蕴肤证、湿热瘀阻证、血虚风燥证;进一步从中分析出HFSR的病因病机为热毒、湿、瘀、血虚、风燥5个因素。中医证型频率分析显示,热毒蕴肤证占15.00%,湿热瘀阻证占56.43%,血虚风燥证占28.57%。所有患者平均疼痛数字评分(numerical rating scale,NRS)为(4.45±2.15)分,其中热毒蕴肤证平均NRS评分(4.14±1.35)分,湿热瘀阻证平均NRS评分(5.86±1.34)分,血虚风燥证平均NRS评分(1.83±0.87)分。轻度疼痛以血虚风燥证为主(71.15%);中、重度疼痛均以湿热瘀阻证(75.44%、93.55%)为主,差异有统计学意义(P<0.01)。[结论]中重度HFSR临床最常见证型为湿热瘀阻证,血虚风燥证次之,热毒蕴肤证最少见;其中湿热瘀阻证患者的疼痛程度相对较重,而血虚风燥证相对较轻。
[Objective]To explore the characteristics and distribution of traditional Chinese medicine(TCM)syndromes in patients with moderate to severe hand-foot skin reaction(HFSR).[Methods]The TCM syndromes data of 140 patients with moderate to severe HFSR were collected by retrospective time-cross-sectional observation method in clinical epidemiological research.Cluster analysis was used to analyze the characteristics of TCM syndromes,and it further explored the distribution characteristics in different TCM syndromes.[Results]Patients were classified into three types according to the characteristics of TCM syndromes:heat-toxin syndrome,dampness-heat stasis syndrome,and blood deficiency and wind-dryness syndrome.The etiology and pathogenesis of HFSR were heat-toxin,damp,blood stasis,blood deficiency and wind-dryness.The analysis of TCM syndromes frequencies showed that the heat-toxin syndrome accounted for15.00%,the dampness-heat stasis syndrome accounted for 56.43%,and the blood deficiency and wind-dryness syndrome accounted for28.57%.The average numerical rating scale(NRS)score was 4.45±2.15 in all patients.Among them,the average NRS score in heat-toxin syndrome group was 4.14±1.35,the average NRS score in dampness-heat stasis syndrome group was 5.86±1.34,and the average NRS score in blood deficiency and wind-dryness syndrome was 1.83±0.87.In patients with mild pain,blood deficiency and wind-dryness syndrome was the most-common syndrome(71.15%);while in patients with moderate and severe pain,dampness-heat stasis syndrome was account for 75.44%and 93.55%respectively,which showed significant difference in NRS scores among the three groups(P<0.01).[Conclusion]Moderate-to-severe HFSR could be divided into three types.The dampness-heat stasis was the most-common syndrome,followed by the blood deficiency and wind-dryness,and the heat-toxin was the least syndrome.Patients with dampness-heat stasis syndrome were associated with more severe pain than patients with blood deficiency and wind-dryness syndrome.
作者
寿柳梅
陈佳露
邵田娱
张瑶
舒琦瑾
SHOU Liumei;CHEN Jialu;SHAO Tianyu(The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine),Hangzhou,310006,China;Zhejiang Chinese Medical University)
出处
《浙江中医药大学学报》
CAS
2023年第9期1002-1008,共7页
Journal of Zhejiang Chinese Medical University
基金
浙江省中医药科技计划项目(2020ZB076、2022ZB113)
浙江省舒琦瑾名老中医专家传承工作室建设项目(GZS_(2)021024)
浙江中医药大学研究生科学研究基金项目(2021YKJ03)。
关键词
手足皮肤反应
聚类分析
中医证型
证型分布
病因病机
热毒蕴肤证
湿热瘀阻证
血虚风燥证
hand-foot skin reaction
cluster analysis
TCM syndromes
syndrome distribution
etiology and pathogenesis
heat-toxin syndrome
dampness-heat stasis syndrome
blood deficiency and wind-dryness syndrome
