Lu Wen, Zhu Ligang, Tian Qianmo, Bai Xinyu, Kuang Weiwei, Fang Zhongnv, Ren Hong, Chen Renqiong, Xie Chuntao
Department of Acupuncture-Moxibustion and Tuina, the First People's Hospital of Lianyungang, Lianyungang 222002, Jiangsu Province, China.
Department of Clinical Laboratory, the First People's Hospital of Lianyungang, Lianyungang 222002, Jiangsu Province, China.
Zhongguo Zhen Jiu. 2018 Aug 12;38(8):833-8. doi: 10.13703/j.0255-2930.2018.08.010.
To compare the difference of serum sex hormone between female patients with post-adolescent acne and healthy women, and to explore the efficacy and action mechanism of acupoint catgut embedding, fire needle, auricular acupuncture on skin lesion in female patients of post-adolescent acne.
A total of 107 female patients of post-adolescent acne were divided into an integrated acupuncture group (54 cases, 4 cases were excluded) and a medication group (53 cases, 5 cases were excluded). The patients in the integrated acupuncture group were treated with comprehensive treatment of acupoint catgut embedding, fire needle, auricular acupuncture; the acupoint catgut embedding was applied at Dazhui (GV 14), Yintang (GV 29), Yangbai (GB 14) through Yuyao (EX-HN 4) and other acupoints based on syndrome differentiation; the fire needle was applied at skin lesion; the auricular acupuncture was applied at erjian (HX), e (AT), kou (CO), etc. The patients in the medication group were treated with oral administration of tanshinone capsules (4 capsules each time, 3 times a day) and external use of adapalene gel (one treatment per day at night). Patients in the two groups were treated for 8 weeks. The skin lesion of acne was evaluated before treatment as well as 4 weeks and 8 weeks after treatment in the two groups; the serum levels of testosterone (T) and estradiol (E) were tested 24 hours before menstruation in the integrated acupuncture group (50 cases) and healthy control group (46 cases), and the change of serum sex hormone after treatment was observed in 21 patients with sex hormone disorder in the integrated acupuncture group.
Before treatment, the level of E in the integrated acupuncture group was significantly lower than that in the healthy control group (<0.01), but T/E in the integrated acupuncture group was significantly higher than that in the healthy control group (<0.01). After treatment, the level of E was significantly increased (<0.01) and T/E was reduced (<0.01) in the 21 patients with sex hormone disorder in the integrated acupuncture group. The skin lesion scale of acne was significantly reduced in the two groups after 4-week and 8-week treatment (all <0.01); the difference between the two groups was not significant after 4-week treatment (>0.05); the skin lesion scale of acne in the integrated acupuncture group was significantly lower than that in the medication group after 8-week treatment (<0.01). The efficacy between the two groups was not significant after 4-week the treatment (>0.05); after 8-week treatment, the cured and effective rate was 66.0% (33/50) in the integrated acupuncture group, which was superior to 45.8% (22/48) in the medication group (<0.05).
Compared with healthy women, the level of serum sex hormone of E is reduced in the female patients of post-adolescent acne, resulting in relative increased level of T; the acupoint catgut embedding, fire needle, auricular acupuncture have better efficacy than medication for post-adolescent acne, which have regulation effects on sex hormone disorder.
比较青春期后痤疮女性患者与健康女性血清性激素的差异，探讨穴位埋线、火针、耳针治疗青春期后痤疮女性患者皮损的疗效及作用机制。
将107例青春期后痤疮女性患者分为综合针刺组（54例，剔除4例）和药物组（53例，剔除5例）。综合针刺组采用穴位埋线、火针、耳针综合治疗；穴位埋线根据辨证选取大椎（GV 14）、印堂（GV 29）、阳白（GB 14）透鱼腰（EX-HN 4）等穴位；火针针刺皮损处；耳针取耳尖（HX）、耳背沟（AT）、口（CO）等。药物组口服丹参酮胶囊（每次4粒，每日3次），外用阿达帕林凝胶（每晚1次）。两组均治疗8周。观察两组治疗前、治疗4周及8周后痤疮皮损情况；检测综合针刺组50例患者及健康对照组46例患者月经前24小时血清睾酮（T）、雌二醇（E）水平，并观察综合针刺组21例性激素紊乱患者治疗后血清性激素变化。
治疗前，综合针刺组E水平显著低于健康对照组（<0.01），但综合针刺组T/E显著高于健康对照组（<0.01）。综合针刺组21例性激素紊乱患者治疗后E水平显著升高（<0.01），T/E降低（<0.01）。两组治疗4周和8周后痤疮皮损评分均显著降低（均<0.01）；治疗4周后两组差异无统计学意义（>0.05）；治疗8周后综合针刺组痤疮皮损评分显著低于药物组（<0.01）。治疗4周后两组疗效差异无统计学意义（>0.05）；治疗8周后，综合针刺组治愈率及有效率为66.0%（33/50），优于药物组的45.8%（22/48）（<0.05）。
青春期后痤疮女性患者血清性激素E水平较健康女性降低，致T相对升高；穴位埋线、火针、耳针治疗青春期后痤疮疗效优于药物，对性激素紊乱有调节作用。
