Clinical Studies Of Yang And Detoxification Treatment Of Nodular Cystic Acne

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized by comedones,papules,pustules,nodules,cysts,and scars,often accompanied by abnormal seborrhea.Along with the improvement of living standard and changes in daily habits and dietary structure,both incidence and hospital visits of acne have increased significantly.As acne vulgaris occurs primarily on the face,it gives great pressure on patients,causing them psychological block and affecting their daily life.Nodulated and cystic acne is an even more serious condition.Pronounced scars often remain after heal in this type and there are limited therapy choices.In modern medicine,the most effective drug for nodulated and cystic acne is isotretinoin.For its severe side effects,this medicine is strictly controlled in use.In the view of Traditional Chinese Medicine, many nodulated and cystic acne belongs to the syndrome of yang stagnation due to coldness.While yin syndrome is seldom mentioned for acne at present,and medical prescription for this syndrome is rare.1.Literature ReviewAcne happens because of wind-heat in the lung in the traditional view,which could hardly epitomize all the symptoms shown in patients.Yang stagnation should play an important role in the pathogenesis of acne according to Neijing and other classic TCM books.Yin syndrome,han syndrome as well as xu syndrome should also be considered for acne.Method of warm and smooth is a commonly used method in surgery.The representative decoction is Yanghe decoction. Mahuangfuzixixin decoction has similar effect according to research work. Isotretinoin has reliable curative effects in the treatment of nodulated and cystic acne,but its side effects could not be ignored.TCM therapy has effect in treating nodulated and cystic acne by promoting blood circulation to dispel blood stasis.2.Investigation in syndrome type of acne according to TCMObjective To affirm the existence of yang stagnation due to coldness syndrome in acne and analyze its distribution character and causing factors.Methods 255 patients were enrolled from the dermatology department of Guang'anmen hospital.Patients' clinical information was collected by inquisition, questionnaire and physical examination.Result 5 syndrome types showed up 324 times in those 255 patients,the most commonly encountered syndrome was accumulation of damp-heat,the second was yang stagnation due to coldness.In male patients the most commonly encountered syndrome was accumulation of damp-heat,while in female patients was yang stagnation due to coldness,the difference was significant(P＜0.01).The relation between lesions and syndrome types were,comedo—wind-heat in the lung channel,papule and pustule—accumulation of damp-heat,nodule and cyst—yang stagnation due to coldness.There were 187 patients with single syndrome,65 with two syndromes, 2 with three syndromes and 1 with no syndrome.3.Clinical research for Tongyangjiedu decoction in treating nodulated and cystic acneObjective To evaluate the clinical effect of Tongyangjiedu decoction in treating nodulated and cystic acne by applying randomized controlled clinical trial.Methods 96 patients with nodulated and cystic acne were divided randomly into 2 groups,44 in group A were treated with Tongyangjiedu decoction,and 43 in group B were treated with Dahuangzhechong tablet.Treatment course was 8-week. Lesions and clinical symptoms were quantified separately and a total score were calculated.These three factors were appraised at pretherapy and post-treatment 2, 4,6,8weeks respectively,and the decreasing rates of total score were used to judge the treatment effect.Result The cure rates in group A and B were 34.1%, 9.3%respectively,the total effective rate in both groups were 86.4%,65.1%,the curative effect difference was significant(x~2=11.403,P＜0.05).Treatment group has better clinical effect than control group.The decreasing rate of total score and symptom score showed significant difference between group A and B from the second week(P＜0.01).There was no significant difference in the decreasing rate of lesion score between the two groups.The rate of adverse events of the group A and B were 6.8%,14.0%respectively,showed no significant difference(P＞0.05).4.ConclusionSyndrome of yang stagnation due to coldness surely exists in acne,especially in female patients and patients feature in nodule and cyst.Tongyangjiedu decoction has great effect in treating nodulated and cystic acne.Besides relieving lesions,it could improve patients' overall condition.It is an proper application for the diagnosing and treating standard of acne in TCM.