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中华诊断学电子杂志 ›› 2026, Vol. 14 ›› Issue (01) : 17 -23. doi: 10.3877/cma.j.issn.2095-655X.2026.01.002

专题笔谈

咬甲癖的诊断与治疗研究进展
孙振晓1,(), 于相芬2   
  1. 1276000 临沂市疾病预防控制中心
    2276005 临沂市精神卫生中心精神科
  • 收稿日期:2025-11-12 出版日期:2026-02-26
  • 通信作者: 孙振晓

Research advances in the diagnosis and treatment of onychophagia

Zhenxiao Sun1,(), Xiangfen Yu2   

  1. 1Linyi Center for Disease Control and Prevention, Linyi 276000, China
    2Department of Psychiatry, Linyi Municipal Mental Health Center, Linyi 276005, China
  • Received:2025-11-12 Published:2026-02-26
  • Corresponding author: Zhenxiao Sun
引用本文:

孙振晓, 于相芬. 咬甲癖的诊断与治疗研究进展[J/OL]. 中华诊断学电子杂志, 2026, 14(01): 17-23.

Zhenxiao Sun, Xiangfen Yu. Research advances in the diagnosis and treatment of onychophagia[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2026, 14(01): 17-23.

咬甲癖又称为慢性习惯性咬指甲,是一种反复啃咬指甲的行为障碍。该病不仅会造成指甲及角质层损害,还会造成错颌畸形、牙龈炎、牙周炎等口腔疾病及颞下颌关节功能紊乱。此外,该病还会对患者心理及社会功能造成负性影响,导致耻感及生活质量下降。其诊断主要依靠病史采集、对患者咬甲行为的观察、全面的指(趾)甲检查及全身皮肤检查,应与甲营养不良、拔甲癖、甲癣(真菌感染)、甲部银屑病、甲部扁平苔藓、免疫介导的血管炎及甲下黑素瘤相鉴别。咬甲癖的治疗包括心理行为治疗、药物治疗及中医药治疗等,但目前多数为病例报道,应进行多中心、随机对照研究以进一步验证各种治疗方法的疗效,为优化临床治疗提供科学依据。笔者对咬甲癖的流行病学、发病机制、临床表现、诊断、鉴别诊断及治疗等进行综述,为临床诊疗工作提供参考。

Onychophagia, also known as chronic habitual nail-biting behavior, is a behavioral disorder characterized by repeatedly biting nails. It can not only cause damage to nails and cuticles, but also lead to oral diseases such as malocclusion, gingivitis, periodontitis, and temporomandibular joint dysfunction. The disease also exerts negative effects on patients′ psychological and social functioning, leading to feelings of shame and a decline in quality of life.Its diagnosis mainly relies on detailed medical history collection, observation of the patient′s nail-biting behavior and comprehensive examination of the fingernails (toenails) along with general skin examination. Differential diagnosis should include onychodystrophy, onychotillomania, onychomycosis (fungal infection), nail psoriasis, nail lichen planus, immune-mediated vasculitis and subungual melanoma. The treatment for onychophagia includes psychological behavior therapy, drug therapy, and traditional Chinese medicine therapy. Evidence for the treatment of onychophagia primarily comes from case reports. Multi-center, randomized controlled trials are needed to further validate the efficacy of these treatments, thereby providing a scientific basis for optimizing the treatment of onychophagia. This paper systematically reviews the epidemiology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis, and treatment of onychophagia, providing reference for clinical diagnosis and treatment.

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