Association between Lifestyle and Behavior and Skin Physiological Function in Patients with Chronic Pruritus
-
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
-
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。 
下载: 导出CSV
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
下载: 导出CSV
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
下载: 导出CSV
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。
下载: 导出CSV
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。
下载: 导出CSV
-
[1] Weisshaar Elke,Szepietowski Jacek C,Dalgard Florence J,et al. European S2k guideline on chronic pruritus[J]. Acta Dermato-venereologica,2019,99(5):469-506. doi: 10.2340/00015555-3164 [2] Weisshaar E. Epidemiology of itch[J]. Current problems in dermatology,2016,50:5-10. [3] 何明月,赵桂华. 慢性皮肤病患者生活质量的研究进展[J].护理实践与究,2013,10(5):118-119. [4] Fourzali Kayla M,Yosipovitch Gil. Management of itch in the elderly:A review[J]. Dermatology and Therapy,2019,9(4):639-653. doi: 10.1007/s13555-019-00326-1 [5] Janelle Pavlis,Gil Yosipovitch. Management of Itch in Atopic Dermatitis[J]. American Journal of Clinical Dermatology,2018,19(3):319-332. doi: 10.1007/s40257-017-0335-4 [6] 苗鸿雁. 饮食以及行为习惯对老年皮肤瘙痒症的影响[J].内蒙古医学杂志,2015,47(9):1077. [7] Yosipovitch Gil,Misery Laurent,Proksch Ehrhardt,et al. Skin barrier damage and itch:Review of mechanisms,Topical management and future directions[J]. Acta Dermato-venereologica,2019,99(13):1201-1209. [8] 王东进. 生活方式与整体健康观[J].哈尔滨工业大学学报(社会科学版),2020,22(1):38-44. [9] Stander S. Classification of itch[J]. Current problems in dermatology,2016,50:1-4. [10] Organization W H. Global Status Report on Noncommunicable Diseases[J]. Women,2011,47(26):2562-2563. [11] Risk factors for noncommunicable diseases: The WHO STEP wise approach. summary[R]. Geneva: World Health Organization, 2001. [12] Moy K A,Fan Y,Wang R,et al. Alcohol and tobacco use in relation to gastric cancer:A prospective study of men in Shanghai,China[J]. Cancer Epidemiol Biomarkers Prev,2010,19(9):2287-2297. doi: 10.1158/1055-9965.EPI-10-0362 [13] 张庆丽,郑苇,李泓澜,等. 健康生活方式指数与男性胃癌关系的前瞻性队列研究[J].中华预防医学杂志,2017,51(5):386-392. [14] 陈昊,陈霄雯,蔡雨阳,等. 中国社区控烟10年文献研究[J].上海交通大学学报医学版,2014,34(8):1234-1238. [15] Balaghi S,Faramarzi E,Mahdavi R,et al. Fluids intake and beverage consumption pattern among university students[J]. Health Promotion Perspectives,2011,1(1):54-61. [16] Xu Xiaoyue,Hall John,Byles Julie,et al. Assessing dietary quality of older Chinese people using the Chinese diet balance Index(DBI)[J]. PloS one,2015,10(3):e0121618. doi: 10.1371/journal.pone.0121618 [17] Ainsworth B E,Haskell W L,Leon A S,et al. Compendium of physical activities:Classification of energy costs of human physical activities[J]. Medicine and Science in Ssports and Exercise,1993,25(1):71-83. doi: 10.1249/00005768-199301000-00011 [18] Bahman Sotoodian,Howard I,Maibach. Noninvasive test methods for epidermal barrier function[J]. Clinics in Dermatology,2012,30(3):301-310. doi: 10.1016/j.clindermatol.2011.08.016 [19] 赵欣研,田燕,汪黎,等. 急性皮肤屏障损伤修复过程中各项生理物理参数的变化规律及LED红光对其干预作用的评价[J].中国美容医学,2015,24(13):45-51. [20] Markus,Denzinger,Jens,et al. A quantitative study of transepidermal water loss(TEWL)on conventional and microclimate management capable mattresses and hospital beds[J]. Journal of Tissue Viability,2019,28(4):194-199. doi: 10.1016/j.jtv.2019.06.002 [21] Momota Yutaka,Shimada Kenichiro,Noguchi Azusa,et al. The modified corneocyte surface area measurement as an index of epidermal barrier properties:inverse correlation with transepidermal water loss[J]. Veterinary Dermatology,2016,27(2):67-69. doi: 10.1111/vde.12287 [22] World Health Organization. A price China cannot afford - health, economic and social losses caused by the tobacco epidemic in China[M]. Manila: World Health Organization, Regional Office for the Western Pacific, 2017: 1. [23] Maigeng Zhou,Haidong Wang,Xinying Zeng,et al. Mortality,morbidity,and risk factors in China and its provinces,1990—2017:A systematic analysis for the Global Burden of Disease Study 2017[J]. The Lancet,2019,394(10204):1145-1158. doi: 10.1016/S0140-6736(19)30427-1 [24] 杨功焕,马杰民,刘娜,等. 中国人群2002年吸烟和被动吸烟的现状调查[J].中华流行病学杂志,2005,26(2):77-83. [25] 王苏,杨森,张学军. 吸烟、饮酒与银屑病[J].临床皮肤科杂志,2017,46(7):531-533. [26] GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries,1990-2017:A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet(London,England),2019,393(10184):1958-1972. [27] 刘平,陶淇惠,李志艳,等. 2013至2017年11 641例患者常见过敏原流行特征分析[J].中华检验医学杂志,2019,42(5):371-374. [28] 王哲,王跃平. 270例大同地区儿童食物过敏原检测与分析[J].中国保健营养,2019,29(35):2. [29] Misery Laurent. Itch Management:General principles[J]. Current problems in dermatology,2016,50:35-39. [30] World Health Organization（2014）. Global status report on non-communicable diseases[R]. Geneva, World Health Organization, 2014. [31] 孙贵范,杨博逸. “慢病风险10指标”及“主动健康100分健康风险评估干预系统”在慢性病防控信息采集和健康评价中的作用[J].中国医疗器械信息,2014,20(5):2-5. -
点击查看大图
图(1) / 表(5)
计量
- 文章访问数: 1916
- HTML全文浏览量: 1716
- PDF下载量: 26
- 被引次数: 0
