| BackgroundAcne vulgaris is a common skin disorder,chronic inflamation of pilosebaceous glands manifests as large deep red pimples with yellow heads, comedones, papules, pustules and nodules1. Prevalence of acne vulgaris is85%from populations between age12-25years old man and woman.100/1000at16years of age.80/1000at25to34years of age and30/1000at35to44years of age. Mostly at triggered adolescent, most severe between16-18years old. Fifty percent of patients have genetic factor in family history.Incidence in adolescents is150/1000.Acne vulgaris must be considered as an illness with potential negative affect of psychological and emotional function of the patient,quite even post inflammatory scaring, keloid scaring and pigmentation can last over years. Adolescent girls are more vulnerable than boys to the negative psychological effects of acne". Various method of acne conventional treatment and give more hope in order to treat this dermatological problem,comparing to many others treatment methode, acupuncture is less expensive, no side effect and have good resultiii. Many scientific and clinical research for a few years acupuncture can treated many kinds of skin problems and for beauty also. Those research are being fundament in order to explain how acupuncture could to treat this problem as hyperpigmentation,skin aging and acne vulgaris. Potential advantage of using various methods of conventional acupuncture treatment, include auricular acupuncture.ObjectiveThis study is to evaluate which method of treatment is more effective for acne treatment, either ear point only or local combination with ear point. Specific aim is to observe which methode to be more effective for certain type and amount of lesion of acne at face.DesignThe subjects are randomly selected from acne vulgaris patients who come to clinic. Person who recruited as subject is about17-35years old. Number of patients is60persons. The patients is devided into2groups, Ear acupuncture only is30persons as control group. Ear and combination with local point stimulation is30persons as treatment group,observation will see the development of disease from determination of scoring of amount of lesion which is classified as mild, moderate and severe, and scoring type of lesion which is classified as acne, pimples, pustule. Efficacy evaluation is classified into cure, improve and healed. Intervention by ear point stimulation only and combination of ear point and local point, the experiment must be done in the same procedure in stimulation and dosage of treatment. All group have20minutes acupuncture treatment,2times a week for4weeks.Methods: Control group:Patient lay down, sterilization must be strict to avoid infection,70%alcohol should be applied timely to it.Place the0,18x7mm needles into ear point of Shenmen (TF4); location is at the upper part of posterior1/3of triangular fossa, at the are4of triangular fossa. Endokrin (CO18); location on outside of the notch of intertragus and anteroposterior part of the cavum concha at area18of the concha. Lung (CO14); location in cavum concha around (CO15) and (CO16) at area14of the concha,Large intestine(C07); on the anterior1/3of the helix crus at area7of the concha. PiZhiXia (AT4)Ⅳ location is on medial side of antitragus at area4at anti tragus;on left and right ears, perpencicular and leave the needles for20minutes. The needles should be given just deep enough to stand and not fall against the ear skin.Treatment group:Patient lay down, sterilization must be strict to avoid infection,70%alcohol should be applied timely to it. Place0,18x7mm needles subcutaneously at the areas where the acne is prevalent(ashe point), the needle should be given just deep enough to stand, and not fall against the skin. The needles are given to normal skin, not into the inflamed area. Ear point Shenmen (TF4),Endokrin (CO18) and Lung (CO14),Large Intestine (CO7), PiZhiXia (AT4) on left and right ears,perpendicular and leave the needles for20minutes.The needles should be given just deep enough to stand and not fall against the ear skin.Main outcome measurement:reduction of amount of lesion, change type of lesion is based on Acne and Related Disorders:Classification of Acne Severity Reference to the State Administration of Traditional Chinese Medicine in2012, TCM Syndrome Diagnostic and efficacy standard.Statistical analysis methodAfter collecting data by experimental study. The statistical analyses using the SPSS for Windows program.Using ChiSquare,Crosstabulation and T-Test independent sample and also using General liniar Model Univariate test(Anova) and Man-Whitney Test.ResultsThe subject of control group is consist of16persons female and14persons male. And the subject of treatment group is consist of19person female and11person that subject in this study is similar.Subject age in control group is20,70±2,67; age in treatment group is20,70±4,15P=0,493; show that the age of subject in this group is similar.Type of lesion between control and treatment group before and after treatment; in control group has3,3%decrease in pimples type and3,3%increase in acne type, no change in pustule type. In treatment group, in pustule type decrease33,7%, in pimples type decrease7%and in acne type decrease53,3%, after treatment. Amount of lesion comparison control and treatment group before treament in control group is50%subject has moderate acne (20-50) and50%in in severe acne (>50). In treatment group there is30%has moderate acne and70%of subject has severe acne. And after treatment in control group decreasing46,7%amount of lesion to be mild acne (<20) and pimples type become only3,3%and no one have severe acne anymore. In treatment group there is all (100%) change to be mild acne after treatment.Correlations in age and lesion type before and after treatment is group16-20years old change26%in acne type;8,4%decrease in pimples type and18,5%decrease in pustule type after treatment.Correlations between age and amount of acne lesion is decrease significantly to be mild acne grade in both group.Type of lesion at1st time visit, in control group,11persons(36,7%) in acne type;13persons (43,3%) in pimples type;6persons(20%) inpustule type. In treatment group,9person (30%) in acne type;10persons(33,3%)in pustule type. P=0,357:not significant difference between2groups. There is similar type between control and treatment group.Amount of lesion3rd visit in control group there is2persons (6,7%) is<20,16persons (53,3%) in20-50amount of lesion and12persons(40%) in amount of lesion is>50. In treatment group is3persons (10%) in<20,19persons (63,3%) in20-50, and8persons (26,7%) in>50amount of lesion. P=0,046, means significance difference between2groups.Type of lesion at4th time visit, in control group,11persons (36,7%) in acne type;13persons (43,3%) in pimples type;6persons (20%) in pustule type. In treatment group,10persons (33,3%) in acne type;15persons (53,6%) in pimples type,5persons (16,7%) in pustule type. P=0,043:significant difference between2groups. The lesion type in treatment group have change significanly from statistic data.Type of lesion at6th time visit, in control group,12persons (40%) in acne type;13persons (43,3%) in pimples type;5persons (16,7%) in pustule type. In treatment group,16(53,3%) person in acne type;13persons (43,3%) in pimples type,1person (3,3) in pustule type. P=0,012:significant difference between2groups. The lesion type in treatment group have change significanly from statistic data.Type of lesion at7th time visit, in control group,12persons (40%) in acne type;12persons (40%) in pimples type;6persons (20%) in pustule type. In treatment group,24persons (80%) in acne type;5persons (16,7%) in pimples type,1person(3,3%) in pustule type. P=0,002:significant difference between2groups. The lesion type in treatment group have change significanly from statistic dataConclusionDescriptive data all patients at1st visit is20persons in acne type,23persons in pimples type and17persons in pustule type. After8th visit, they become38persons in acne type, 15persons in pimples type and7persons in pustule type. It means that any kinds of stimulation gives good improvement for lesion type more than50%from all patients.The evaluation about the correlations between age and lesion type, the results is age19and age21is the most amount of sample populations, after8th treatment, more than50%have a good improvement for lesion type. And also for lesion amount, have significance improvent, to decrease amount of acne in any age.To evaluate the results of acupuncture treatment in female group is more than90%healed. In male group is about more than90%have decrease amount of lesion. So, no big different result of acupuncture treatment between male and female for decreasing amount of lesion. But for type of lesion the female group has better result than male group.may be it because of hormonal factor that influence the healing process.To evaluate the result between2different kinds of stimulation, we use statistic data to access significancy between ear group (control group) and ear and local group (treatment group) by observe changes in type and amount of lesion. In control group only indicated for type of lesion only3,3%improvement.Type of lesion in control group has significance change of lesion after8th treatment.Amount of lesion in control group there is51,7%change grading1step decrease and48,3%change2step from grading of amount of lesion. In treatment group there is27,8%change1step decrease and72,4%decrease2step grading of amount of lesion. P=0,062, means there is significance different between control and treatment group.From result above show that ear acupuncture only can notchange type of lesion,but only can reduce amount oflesion.In general,the results above, explain to us that the results much better in combination between ear and local point both for type and amount of lesion. Even,this study is good enough but still cannot show exactly results because of so many factors that influence theacne grow and even healing process of acne not be involved eg. Stress factor,menstrual cycle, eating habit, skin hygiene, those are many important factor that influence the healing process of acne treatment. So, inspite of that still need futher research about influence factor in order to know exactly which is dominant factor to have successful method in acne treatment. |
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