Association between Lifestyle and Behavior and Skin Physiological Function in Patients with Chronic Pruritus
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摘要:
目的 调查慢性瘙痒患者生活行为方式对皮肤生理功能的影响，为瘙痒患者健康管理提供依据及措施方案。 方法 对慢性瘙痒患者进行生活行为方式调查，包括饮酒、吸烟、饮水、饮食，膳食平衡指数（dietary balance index，DBI）、锻炼5种常见因素；完成经表皮水分流失、表皮含水量、表皮脂质、皮损红斑指数检测，评估患者瘙痒程度，并分析患者生活行为方式与其皮肤生理状况的相关性。 结果 吸烟者91例（44.4%），饮酒者18例（8.78%）；日均饮水量（1211.90±520.28） mL，显著低于健康标准（P < 0.05）；DBI负端分显著高于正端分，膳食质量距显著偏移标准值（ P < 0.05），196例（95.6%）锻炼不充分。吸烟可增加患者瘙痒体验程度，生活方式与皮肤生理功能指标相关（ P < 0.05）。膳食结构和质量在疾病中呈现出复杂性影响。 结论 瘙痒患者的多种生活行为方式偏离健康要求，而生活方式也对皮肤生理功能产生影响。因此在瘙痒患者的管理中，对生活行为方式的个体化指导、干预与管理，应列为瘙痒预防和诊治的重要措施。 Abstract:Objective By investigating the influence of chronic pruritus patients' lifestyle and behavior on skin physiological function, this paper provides basis and measures for the health management of patients with pruritus. Methods Lifestyle and behavior of patients with chronic pruritus were investigated, including five common factors: alcohol consumption, smoking, water intake, diet, dietary Balance Index（DBI）, and exercise. The measurement of transepidermal water loss（TEWL）, capacitance（CAP）, sebum（SEB）and erythema index of skin lesions were completed to evaluate the pruritus degree of the patients, and correlation between the lifestyle and behavior patterns of the patients and their skin physiology were analyzed. Results There were 91 smokers（44.4%）and 18 drinkers（8.78%）; the average daily water intake was（1211.90 ± 520.28）ml, which was significantly lower than the health standard（P < 0.05）. the lower bound score（DBI-LBS）was significantly higher than the higher bound scores（DBI-HBS）, and the dietary quality was significantly deviated from the standard value（ P < 0.05）. 196 patients（95.6%）did not get enough exercise. Smoking could increase the degree of pruritus, while lifestyle was correlated with skin physiological function indexes（ P < 0.05）. Dietary structure and quality have complex effects on diseases. Conclusion The lifestyle of pruritus patients deviates from the health standards, despite the lifestyle also affects the physiological function of the skin. Therefore, in the management of pruritus patients, individualized guidance, intervention and management of life behavior, should be identified as important measures of pruritus prevention and treatment. -
Key words:
- Pruritus /
- Lifestyle and behavior /
- Skin physiological function
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表 1 吸烟、饮酒、膳食DBI的指标定义及取值方法
Table 1. Index definition and value method of DBI of smoking，drinking and diet
分类 分值 亚类 分值 取值方法 吸烟 0～2 不吸烟 0 平均每天小于1只烟，且持续不超过6个月 轻度吸烟 1 20 a以下或每天吸烟少于20支 重度吸烟 2 超过或等于20 a且每天吸烟20支及以上 饮酒 0～2 不饮酒 0 每周饮酒不超过2次 偶尔饮酒 1 每周饮酒超过2次，且每周乙醇总量14份以下 饮酒 2 每周饮酒超过2次，且每周乙醇总量14份以上 膳食DBI指数 谷类 −12～12 谷类 −12～12 低能量组：−12 = 0 g，0 = 250～300 g，12 > 550 g 中等能量组：−12 < 100 g，0 = 350～400 g，12 > 650 g 高能量组：−12 < 200 g，0 = 450～500 g，12 > 750 g 每增加（减少）50 g，分值增加（减少）2分 蔬菜和水果 −12～0 蔬菜 −6～0 −6 = 0 g，−4 = 1～199 g，−2 = 200～399 g，0≥400 g 水果 −6～0 −6 = 0 g，−4 = 1～49 g，−2 = 50～99 g，0≥100 g 奶类和豆类 −12～0 奶类 −6～0 −6 = 0 g，−4 = 1～49 g，−2 = 50～99 g，0≥100 g 豆类 −6～0 −6 = 0 g，−3 = 1～39 g，0≥40 g 动物性食物 −12～8 禽肉类 −4～4 −4 = 0 g，−2 = 1～49 g，0 = 50～99 g，2 = 100～149 g，4≥150 g 水产品 −4～4 −4 = 0 g，−2 = 1～49 g，0≥50 g 蛋类 −4～4 4 = 0 g，−2 = 1～24 g，0 = 25～49 g，2 = 50～74 g，4≥75 g 注：14.18 g乙醇为1份。 
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表 2 生活方式调查结果[（
$ \bar x \pm s$ ），分]Table 2. Lifestyle scores [（
$ \bar x \pm s$ ），scores]项目 $ \bar x \pm s$ 标准值 t p 饮水 1211.90 ± 520.28 1500 −7.930 < 0.001 谷物 3.15 ± 7.12 0 6.339 < 0.001 蔬菜 −2.18 ± 1.34 0 −23.394 < 0.001 水果 −2.02 ± 2.38 0 −12.168 < 0.001 蛋类 −2.41 ± 2.47 0 −13.963 < 0.001 水产类 −3.78 ± 0.71 0 −76.440 < 0.001 禽肉类 0.99 ± 2.67 0 5.324 < 0.001 豆类 −5.03 ± 1.93 0 −37.276 < 0.001 奶类 −4.66 ± 2.40 0 −27.741 < 0.001 DBI- TS −15.95 ± 9.73 0 −23.455 < 0.001 DBI- LBS 22.89 ± 6.29 0 52.077 < 0.001 DBI- HBS 6.55 ± 5.38 0 45.311 < 0.001 DBI- DQD 29.55 ± 6.47 0 65.311 < 0.001 Met 10.22 ± 8.27 150 −118.485 < 0.001
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表 3 皮肤生理功能检测结果[（
$ \bar x \pm s$ ），分]Table 3. Result of skin physiological function [（
$ \bar x \pm s$ ），scores]项目 部位 ${\rm{\bar x}} \pm {\rm{s}}$ t P CAP 皮损处 24.09 ± 15.70 15.484 < 0.001 正常处 39.12 ± 15.19 SEB 皮损处 15.63 ± 9.18 5.434 < 0.001 正常处 30.30 ± 17.18 EI 皮损处 402.63 ± 125.74 −13.242 < 0.001 正常处 289.57 ± 93.99 TEWL 皮损处 19.31 ± 14.45 −6.406 < 0.001 正常处 12.71 ± 10.38
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表 4 生活方式与皮肤生理功能及瘙痒程度的关系
Table 4. The correlation analysis of lifestyle，skin physiological function and degree of pruritus
项目 r/P 瘙痒程度 CAP SEB EI TEWL DBI-LBS r 0.088 −0.119 −0.165* −0.257** 0.096 P 0.210 0.090 0.018 < 0.001 0.171 DBI-HBS r 0.119 −0.057 0.106 0.174* 0.012 P 0.088 0.413 0.163 0.013 0.866 DBI-DQD r −0.181* −0.143* −0.073 −0.094 0.109 P 0.010 0.040 0.298 0.180 0.118 DBI-TS r 0.022 0.057 0.137* 0.239** −0.046 P 0.749 0.413 0.049 0.001 0.511 饮水 r −0.011 0.026 −0.102 −0.148* 0.049 P 0.874 0.715 0.146 0.034 0.715 Met r 0.001 0.046 0.159* 0.103 −0.227** P 0.998 0.515 0.012 0.140 0.003 * P < 0.05，** P < 0.005。
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表 5 食物亚类和皮肤生理功能及瘙痒程度的相关分析
Table 5. Correlation analysis of food subclasses with skin physiological function and degree of pruritus
食物亚类 瘙痒程度 CAP SEB EI TWEL r P r P r P r P r P 谷类 0.198** 0.004 0.043 0.605 0.100 0.167 0.262** < 0.005 0.012 0.864 蔬菜 0.100 0.165 0.158* 0.022 −0.012 0.947 0.040 0.602 0.079 0.246 水果 −0.052 0.495 0.153* 0.033 0.019 0.735 −0.049 0.456 −0.106 0.134 蛋类 −0.081 0.244 −0.105 0.124 0.077 0.243 0.131 0.072 −0.159* 0.024 水产类 0.123 0.085 0.060 0.369 0.041 0.617 0.018 0.821 −0.200** 0.004 禽肉类 −0.089 0.181 −0.022 0.735 −0.039 0.602 −0.061 0.384 0.161* 0.025 豆类 0.224** 0.002 0.039 0.606 0.160* 0.020 0.061 0.421 −0.059 0.376 奶类 0.198** 0.004 −0.018 0.757 0.061 0.359 0.114 0.113 −0.074 0.337 * P < 0.05，** P < 0.005。
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