本文關(guān)鍵詞：影響斑禿皮膚鏡鏡像特征的相關(guān)因素分析　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的探討斑禿臨床特征與皮膚鏡鏡像特征的相關(guān)性,分析斑禿皮膚鏡鏡像特征相關(guān)的因素,為斑禿的臨床診斷、病情評(píng)估及預(yù)后判斷等提供依據(jù)。方法收集180例斑禿患者的臨床病例及脫發(fā)區(qū)皮膚鏡鏡像資料,對(duì)病情分期、嚴(yán)重程度、病程、年齡、性別等不同臨床特征的斑禿皮膚鏡鏡像進(jìn)行統(tǒng)計(jì)分析。結(jié)果1.斑禿皮膚鏡鏡像特征發(fā)生率分別為黑點(diǎn)征(78.9%)、斷發(fā)(63.9%)、感嘆號(hào)發(fā)(20.60%)、短毳毛(83.9%)、黃點(diǎn)征(79.4%),出現(xiàn)黑點(diǎn)征、短毳毛、黃點(diǎn)征任一征像的斑禿患者占99.4%(179/180),提示黑點(diǎn)征、短毳毛、黃點(diǎn)征為敏感性指標(biāo)。2.斑禿中醫(yī)臟腑辨證主要為肝腎不足證(96例)、脾腎兩虛證(72例)、脾虛證(12例)。短毳毛發(fā)生率在不同中醫(yī)證型組間差異具有統(tǒng)計(jì)學(xué)意義,脾虛證短毳毛發(fā)生率明顯低于肝腎不足證、脾腎兩虛證。3.恢復(fù)期短毳毛發(fā)生率(96.8%),活動(dòng)期各鏡像發(fā)生率分別為黑點(diǎn)征(88.7%)、斷發(fā)(76.3%)、短毳毛(82.5%)及黃點(diǎn)征(85.6%)。黑點(diǎn)征、斷發(fā)、黃點(diǎn)征發(fā)生率在活動(dòng)期高于恢復(fù)期,短病程組短毳毛發(fā)生率高于病程長(zhǎng)組,重型斑禿短毳毛發(fā)生率低于輕型,差異均具有統(tǒng)計(jì)學(xué)意義。4.兒童黃點(diǎn)征發(fā)生率低于成人,而感嘆號(hào)發(fā)發(fā)生率高于成人;男性黑點(diǎn)征、斷發(fā)發(fā)生率均高于女性,差異具有統(tǒng)計(jì)學(xué)意義。5.經(jīng)多因素logistic回歸分析,黑點(diǎn)征、斷發(fā)均與斑禿活動(dòng)性(OR=2.867)、男性(OR=2.482)呈正相關(guān),短毳毛與斑禿活動(dòng)性(OR=0.397)、病程(OR=0.169)負(fù)相關(guān),黃點(diǎn)征與斑禿患者年齡增長(zhǎng)呈正相關(guān)(OR=9.143),感嘆號(hào)發(fā)與斑禿患者年齡增長(zhǎng)呈負(fù)相關(guān)(OR=0.244)。結(jié)論1.斑禿皮膚鏡鏡像主要是黑點(diǎn)征、斷發(fā)、感嘆號(hào)發(fā)、短毳毛、黃點(diǎn)征。其中黑點(diǎn)征、短毳毛、黃點(diǎn)征為敏感性指標(biāo)。2.黑點(diǎn)征、斷發(fā)與病情活動(dòng)性正相關(guān),可作為斑禿病情活動(dòng)性判斷指標(biāo)之一;病程越短,毛發(fā)再生速度越快;兒童斑禿感嘆號(hào)發(fā)多見,黃點(diǎn)征少見,成人則反之。3.毳毛與病情活動(dòng)性負(fù)相關(guān),提示病情趨于恢復(fù);短毳毛還與中醫(yī)證型有關(guān),短毳毛稀少傾向于提示脾虛證。斑禿皮膚鏡鏡像特征對(duì)防治方案的擬定及選擇可能有一定的指導(dǎo)價(jià)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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R758.71

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