影响斑秃皮肤镜镜像特征的相关因素分析

发布时间：2018-01-03 16:05

本文关键词：影响斑秃皮肤镜镜像特征的相关因素分析　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨斑秃临床特征与皮肤镜镜像特征的相关性,分析斑秃皮肤镜镜像特征相关的因素,为斑秃的临床诊断、病情评估及预后判断等提供依据。方法收集180例斑秃患者的临床病例及脱发区皮肤镜镜像资料,对病情分期、严重程度、病程、年龄、性别等不同临床特征的斑秃皮肤镜镜像进行统计分析。结果1.斑秃皮肤镜镜像特征发生率分别为黑点征(78.9%)、断发(63.9%)、感叹号发(20.60%)、短毳毛(83.9%)、黄点征(79.4%),出现黑点征、短毳毛、黄点征任一征像的斑秃患者占99.4%(179/180),提示黑点征、短毳毛、黄点征为敏感性指标。2.斑秃中医脏腑辨证主要为肝肾不足证(96例)、脾肾两虚证(72例)、脾虚证(12例)。短毳毛发生率在不同中医证型组间差异具有统计学意义,脾虚证短毳毛发生率明显低于肝肾不足证、脾肾两虚证。3.恢复期短毳毛发生率(96.8%),活动期各镜像发生率分别为黑点征(88.7%)、断发(76.3%)、短毳毛(82.5%)及黄点征(85.6%)。黑点征、断发、黄点征发生率在活动期高于恢复期,短病程组短毳毛发生率高于病程长组,重型斑秃短毳毛发生率低于轻型,差异均具有统计学意义。4.儿童黄点征发生率低于成人,而感叹号发发生率高于成人;男性黑点征、断发发生率均高于女性,差异具有统计学意义。5.经多因素logistic回归分析,黑点征、断发均与斑秃活动性(OR=2.867)、男性(OR=2.482)呈正相关,短毳毛与斑秃活动性(OR=0.397)、病程(OR=0.169)负相关,黄点征与斑秃患者年龄增长呈正相关(OR=9.143),感叹号发与斑秃患者年龄增长呈负相关(OR=0.244)。结论1.斑秃皮肤镜镜像主要是黑点征、断发、感叹号发、短毳毛、黄点征。其中黑点征、短毳毛、黄点征为敏感性指标。2.黑点征、断发与病情活动性正相关,可作为斑秃病情活动性判断指标之一;病程越短,毛发再生速度越快;儿童斑秃感叹号发多见,黄点征少见,成人则反之。3.毳毛与病情活动性负相关,提示病情趋于恢复;短毳毛还与中医证型有关,短毳毛稀少倾向于提示脾虚证。斑秃皮肤镜镜像特征对防治方案的拟定及选择可能有一定的指导价值。
[Abstract]:Objective to investigate the correlation between the clinical features of alopecia areata and the mirror-image characteristics of dermatoscope, and to analyze the factors related to the mirror-image characteristics of alopecia areata. Methods the clinical data of 180 patients with alopecia areata and dermatoscopic image data of alopecia areata were collected to determine the stage, severity, course and age of the disease. Results 1. The incidence of the mirrored image of alopecia areata was 78.9% and 63.9% respectively. Exclamation point hair is 20.60m, short vellus hair is 83.9m, yellow dot sign 79.4, black dot sign, short vellus hair. The percentage of patients with alopecia areata with any sign of yellow dot is 99.4% 179 / 180, suggesting black dot sign, short vellus hair. The yellow dot sign is sensitive index .2. the syndrome differentiation of viscera organs of alopecia areata in TCM mainly includes liver and kidney deficiency syndrome in 96 cases, spleen and kidney deficiency syndrome in 72 cases). The incidence of short vellus hair in different TCM syndrome groups had statistical significance. The incidence of short vellus hair in spleen deficiency syndrome was significantly lower than that in liver and kidney deficiency syndrome. The incidence of short vellus hair in convalescence period was 96.80.The incidence of mirror images in active period was 88.7m, respectively. The incidence of black spot sign, broken hair, yellow spot sign was higher in active stage than in convalescence stage, and the incidence of short vellus hair in short course group was higher than that in long course group. The incidence of short vellus hair of severe alopecia areata was lower than that of light, the difference was statistically significant. 4. The incidence of yellow spot sign in children was lower than that in adults, but the incidence of exclamation points was higher than that in adults. The incidence of black spot sign and amputation in male was higher than that in female, and the difference was statistically significant. 5. By multivariate logistic regression analysis, black spot sign, broken hair and alopecia areata activity were 2.867). There was a positive correlation between short vellus hair and the activity of alopecia areata 0.397a, and the course of disease was 0.169). The yellow dot sign was positively correlated with the age of patients with alopecia areata. Conclusion 1.The mirror image of alopecia areata is mainly black dot sign, cut hair, exclamation mark hair, short vellus hair, yellow dot sign. The short vellus hair and yellow dot sign were sensitive index. 2. Black spot sign, the breakage was positively correlated with the disease activity, it could be used as one of the indexes to judge the disease activity of alopecia areata. The shorter the course of disease, the faster the hair regeneration. In children, exclamation points were more common, yellow dots were rare, whereas in adults, there was a negative correlation between vellus hair and disease activity, indicating that the disease tended to recover. Short vellus hair is also related to TCM syndromes, and short vellus hair tends to suggest spleen deficiency syndrome. The mirror-image characteristics of alopecia areata skin mirror may have certain guiding value for the formulation and selection of prevention and treatment plan.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.71

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