An Efficacy Study Of Acupuncture On Facial Acne Vulgaris, Serum IGF-1, And DHEA Levels As Well As Its Implications On Depressive And Anxiety Symptoms

1PurposeTo observe the therapeutic effect of acupuncture treatment on the clinical presentation of psychological behavior and blood serum hormone levels; to discuss the physiological mechanism of target hormones in relation to acne genesis and psychological influences; to observe and evaluate the safety protocols of the acupuncture treatment in this study.2METHODS2.1Subject and Grouping:All patients are randomly selected into Treatment and Control Group. According to Chinese Medicine differential disgnosis, patients are sub divided into FeiWei Yunre Group, Piwei Shire Group and Tanyu Rejie Group. The total number of test subjects is62, of which32are in Treatment group, and30are in Control group.2.2Therapeutic Method:Treatment Group:1) Acupuncture treatment for20-25mins. Moderate stimulation bilaterally on LI11, DU20, SJ3, ST36, SP6, LI3, KI3, in addition, facial ASHI points with no manipulation. Feiwei Yunre Group add LI4, ST44; Piwei Shire group add REN12, ST44, ST25; Tanyu Rejie group add ST44, ST40, SP10.2) All treatments followed blood letting cupping, running sups on bladder and Du channel then puncture DU14, BL13, BL17, with cupping to release stagnant blood.3) Blood letting from ErJian,3-5drops.4) Using a sterile syringe needle and clean out the plugs in facial pustules, cysts, on acne affected areas. Dietary advice is given to include more vegetable and fruit, avoid oily, spicy food and raw meat. Exercise and maintain a relaxed attitude.2) Control Group:Dietary advice is given to include more vegetable and fruit, avoid oily, spicy food and raw meat. Exercise and maintain a relaxed attitude.2.3OBSERVATION METHODAll test subjects will fill out TCM Diagnostic Evaluation Questionnaire, SDS questionnaire, SAI-TAI Anxiety Index, Quality of Life Questionnaire before and after the treatment period. Using enzyme-linked immunosorbent assay to evaluate the serum level of IGF-1, DHE A pre and post trial.2.4Evaluation of Clinical Curative EffectAccording to the standard set forth for Acne Vulgaris by the China Dermatological Medical Association for evaluation, sing the number of skin lesions to calculate improvement percentage; compare and contrast the scores obtained in the TCM Diagnostic Evaluation Questionnaire, SDS questionnaire, SAI-TAI Anxiety Index, Quality of Life Questionnaire, and blood serum level of IGF-1and DHEA.2.5Safety ProtocolCompare with initial test period, observe any subsequent side effects or adverse effects, if any. Make recommendations and evaluations on the treatment methodology.3Result3.1Skin Lesion Analysis3.1.1. Groups ResultAfter6weeks of treatment, treatment group lesion improved by74.91%, control group23.56%。3.1.2Group ComparisonAfter6weeks, treatment group improvements are as follows:Pain level0.67±0.09; Itchiness0.20±0.01; Rednessl.04±0.02; Cysts0.55±0.01; Pustules0.69±0.01; for Control Group:Pain level0.20±0.05, Itchiness0.01±0.04; redness0.03±0.01; cysts0.04±0.01; pustules0.03±0.01. All categories have improved in the Treatment group with P<0.05, carrying statistical significance.3.2Traditional Chinese Medicine Symptom Questionnaire3.2.1Group ResultTreatment Group result was52.89±1.98, after6weeks42.95±1.53; Treatment group result t analysis,P<0.05, significant statistical value。 Control Group:Initial score51.36±1.60, after6weeks is49.42±1.56, after t analysis, P>0.05, no statistical significance3.2.1Group ComparisonAfter6weeks of treatment, Treatment group score lowered by9.94±1.980; control group score lowered by1.94±1.6. Treatment group improvemt significantly greater than control group.3.3Zung Self Rating Depression Scare (SDS)3.3.1Group ResultTreatment Group::Initial SDS score was48.27±1.60, after6weeks42.84±1.40, after t-score analysis, P<0.05, has statistical significance; Control group:initial score was46.83±1.30, after6weeks44.15±1.32, P>0.05, no statistical significance3.3.2Group Comparison After6weeks, treatment group score dropped by5.43±0.19; control group2.68±0.02。Chi Analysis P<0.05, statistically significant, treatment group result is better than control group.3.4State Anxiety Index3.4.1Group ResultTreatment group score was47.40±2.07, after treatment41.14±1.63, after t-score analysis, P<0.05, has statistical significance; Control group:initial score was48.46±1.65, after treatment48.36±1.84, P>0.05, no statistical significance3.4.2Group ComparisonAfter6weeks, treatment group score dropped by5.36±0.42; Control group by0.10±0.22。 Chi Analysis P<0.05, statistically significant, treatment group result is better than control group.3.5Trait Anxiety Index Analysis3.5.1Group ResultTreatment group score was47.00±1.57, after treatment40.65±1.37, after t-score analysis, P<0.05, has statistical significance; Control group:initial score was47.86±1.68, after treatment45.54±1.59, P>0.05, no statistical significance3.5.2Group ComparisonAfter6weeks, treatment group score dropped by6.35±0.20; Control group by0.10±0.09。 Chi Analysis P<0.05, statistically significant, treatment group result is better than control group.3.6Blood Serum IGF-1Analysis3.6.1Group ResultTreatment group IGF-1level was312.66±8.71ug/ml, after6weeks,269.38±7.70ug/ml, after t-score analysis, P<0.05, has statistical significance; Control group:initial serum level was332.30±6.753ug/ml, after6weeks326.93±6.25ug/ml, after t analysis, P>0.05, no statistical significance.3.6.2Group Comparison After6weeks, treatment group IGF-1Level dropped by43.28±1.01; control group by5.37±0.37。 Chi Analysis P<0.05, statistically significant, treatment group result is better than control group.3.7Blood Serum DHEA Analysis3.7.1Group ResultTreatment group DHEA level was34.22±2.87ug/ml, after6weeks,32.73±2.67, after t-score analysis, P<0.05, has statistical significance; Control group:initial serum level was30.97±3.54ug/ml, after6weeks30.42±3.46ug/ml, after t analysis, P>0.05, no statistical significance3.7.2Group ComparisonAfter6weeks, treatment group DHEA Level dropped by3.06±1.11; control group by0.55±0.43。 Chi Analysis P<0.05, statistically significant, treatment group result is better than control group.3.8Correlation analysis for IGF-1, DHEA to Depression and Anxiety ScoresCorrelation coefficient of IGF-1to acne lesion count is0.513(P<0.05), Positively correlated。 State Anxiety and Acne lesion count correlation coefficient0.363(P<0.05=positively correlated.IGF-1has not been found to have statistical correlation to any other markers in this study. DHEA has not been found to have correlation to any of the markets in this study.4Conclusion1Acupuncture treatment is effect against various type of Acne vulgaris.2Acupuncture treatment is effective against acne comorbidities like itchiness, pain, redness and cysts.3Acupuncture treatment improved the scores of SDS, SAI, TAI.4Acupuncture treatment can lower blood serum IGF-1, DHEA to improve the negative psychological effect of Acne patients.5Acupuncture is a safe and effective method in treating acne vulgaris while improving depressive and anxious behaviors of the patients.