| ObjectiveAcne vulgaris is a common skin disease, its pathogenesis is mainly related to endocrine disorders, hormone levels, bacterial infection and hair follicles, sebaceous gland inflammation and other factors, multiple in the period of youth men and women. Taiwan rain wet more Sheng and hot climate, the disease incidence is higher, and often this is Peter, difficult to cure. Traditional Chinese medicine in the treatment of acne vulgaris with rich clinical experience and exact curative effect advantage, but because of its syndrome differentiation standard is not standardized, thus preventing a scientific explanation for the clinical diagnosis and treatment principle, therefore, the pathogenesis and regularity of acne vulgaris epidemiological studies, standardize the treatment standard be imperative. Therefore, in this paper, in order to carry out in Taiwan area by the research of TCM clinical epidemiology of acne as a foundation, has carried on the exploration to the rule of syndrome and treatment of acne vulgaris.Traditional Chinese medicine thought that the occurrence of acne is the body imbalance of yin and Yang, Qi and blood feud, reflection of pathological changes of the viscera. In this study, based on a large number of clinical sample survey, in full to summarize the syndrome characteristic based on the former acne, endocrine mechanism from the relationship between serum sex hormone level of acne and Chinese medicine syndrome, provides research ideas for the standardization of clinical treatment for acne.MethodsThe research object of acne vulgaris patients. Had received qualified research object questionnaire130, of which screening criteria meet the acne patients before100,30cases of health as control group. Source:cases for people and hall, kaohsiung chang TCM clinic on traditional Chinese medicine clinic, taichung chong DE TCM clinic patients dermatologist outpatient service, collect the screening criteria of the accord with acne patients before100;30cases of health as control group.30cases in subjects are from hsinchu, also kaohsiung, taichung three hospital health medical center. The Chinese medicine dialectical, serum sex hormones for index. Serum eight sex hormones including testosterone (T), estradiol (E2), progesterone, prolactin (PRL), follicle-stimulating hormone (FSH), corpus luteum erythropoietin (LH), male androstenedione, dehydroepiandrosterone sulfate as dhea-s,) and cortisol testing detection..ResultsThis study were qualified research object130cases, we found that:(1) The onset age range especially in19~35year-old youth is relatively outstanding,13-18teenager visiting rate is higher, the middle-aged patients also occupied a certain treatment ratio.(2) Skin type belongs to oil type in52cases (52%);4cases of dry type (4%);17cases of intermediate (17%);27cases of mixed type (27%). Various types of skin incidence were oil type> mixed type> middle> drying. Oil type the highest, lowest dry type.(3) The occurrence of acne and related symptoms associated with the menstrual cycle. The former was relieved in12cases,88cases of premenstrual exacerbation, premenstrual exacerbation in the majority. It accounted for51%with single or combined symptoms in51patients. Among the30cases of constipation, yellow urine in22cases,16cases and11cases of bad breath, sore throat, dry mouth ulcer in13cases,7cases,4cases of diarrhea, poor sleep in3cases,2cases and1cases of weakness, bitter taste in the mouth,1cases of multiple vector. The first was constipation in the accompanying symptoms.(4)Application of face inspection two-dimensional coordinate system, visible from acne good position, appear in the forehead and chin.(5)The results are:24cases of lung by wind-heat type, damp-heat accumulation type in40cases, phlegm coagulation type in8cases,7cases of qi stagnation and blood stasis, red does not transfer any type of21cases. The most common wet-hot type, incidence rate of40%, the lung by wind-heat type, accounting for24%, red does not transfer any type accounted for21%.(6) Detection of sex hormone in female patients with acne:Patients testosterone, androstene two testosterone, dehydroepiandrosterone sulfate and testosterone/estradiol values were higher than those in the control group, statistically (P<0.01); estradiol, progesterone, prolactin, FSH, no significant change in LH (P>0.05); patients were significantly lower than the control group (P<0.01).(7) Study on the correlation between the syndrome differentiation and serum estradiol, found the lung by wind-heat, accumulation of damp heat, phlegm coagulation, qi stagnation and blood stasis, red does not transfer any type of acne has no significant correlation with the levels of estradiol, phlegm coagulation type, red does not transfer any type of serum testosterone level was obviously increased.Conelusion(1) The occurrence of acne and related symptoms associated with the menstrual cycle. Before the acne occurs on the forehead and chin, but can also occur in the neck, back, chest, buttocks developed parts of sebaceous glands.(2) This study showed that in the premenstrual acne various syndrome types, damp-heat accumulation type. Taiwan climate is hot and rainy, wet-hot type acne is the main syndrome of acne in Taiwan.(3) Female acne patients testosterone, androstene two testosterone, dehydroepiandrosterone sulfate and testosterone/estradiol were significantly higher than those in the control group, patients group than in the control group significantly decreased cortisol. Study on the correlation between the syndrome differentiation and serum estradiol, found the lung by wind-heat, accumulation of damp heat, phlegm coagulation, qi stagnation and blood stasis, red does not transfer any type of acne has no significant correlation with the levels of estradiol, phlegm coagulation type, red does not transfer any type of serum testosterone level was obviously increased. The disease should be emphasized on the basis of "the combination of disease and syndrome", can provide a new method for the treatment of acne. |
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