| BackgroundAcne is a chronic inflammation of the sebaceous hair follicles, prone to occur in adolescence, the majority could be naturally healed or relieved after puberty. Mostly growing in face,chest and back, acne’s basic damages includes blackheads and whiteheads, as well as the formation of inflammatory papules, pustules, cysts, nodules and a series of damages. It often leaves atrophic or hypertrophic scars after ulceration healing, especially in the face, which might severely affects beauty and mental health of patients.In recent years, with the improvement of people’s living standards,elements like lifestyles changing, learning and work pressure, interpersonal tensions, emotional anxiety, poor sleep quality, diet and other internal and external factors have showed not only a yearly increasing trend of acne incidence but also larger age span. There is a tendency towards the adolescents and middle-aged. Due to acne’s severe damage,it brings patients with enormous psychological and social pressure as acne may affect the beauty so that people are increasingly concerned about this issue.Modern medicine believes that acne is a common skin disease influenced by multiple factors. The detailed pathogenesis mainly comes with androgen,sebum secretion, propionibacterium acnes proliferation, hair follicle sebaceous gland duct abnormal keratinization, psychological and genetic factors. A general principle of western medicine treatment of acne is to improve abnormal hair follicles and sebaceous ducts keratosis, inhibit excessive secretion of the sebaceous glands, eliminate pathogenic bacteria and reduce inflammation within the hair follicle. The main treatment method by oral administration, external use, physical therapy and surgical or optical therapy etc, but most of the effect is not satisfactory, and could bring lots of side effects.This disease has been known as "acne", "lung wind acne", "pimple", "wind thorn" or "wine thorn","pink defect". In the past, doctors think that acne pathogenesis with wind heat, blood heat and other relevant factors. Modern physicians put forward new ideas and new theory of damp heat, blood stasis and phlegm proposed node, kidney deficiency, syndrome of disharmony of Chong and Conception Channels, using the combination of syndrome differentiation and disease differentiation, syndrome differentiation by using the triple energizer, viscera syndrome differentiation, syndrome differentiation of TCM syndrome differentiation of main and collateral channels such as method of differentiation of symptoms and signs, traditional Chinese medicine, washing method, external application of Chinese medicine and acupuncture and other methods of treatment. The clinical curative effect is remarkable while costs much less expense and side effect compared with western medicine, which opens a new phase of Chinese medicine in treating acne.Semi needling therapy refers to faster shallow stab, a kind of acupuncture that does not damage blood network and muscle cents. The Official Needling Techniques of Ling Shu Acupuncture has mentioned a semi Semi needling therapy, needling in half, shallow thorn and quickly out of the needle, do not pin to the muscles, such as pull hair,to take skin gas, which corresponding with lung. In this study, Semi needling therapy in treating acne vulgaris, and the traditional acupuncture as a control, aimed at finding a painless or slight pain and curative effect of acupuncture techniques, improve clinical outcomes and reduce the patient’s fear. Patients are willing to accept so that it improves the acne patients’ adherence.ObjectiveA randomized controlled methods were used in this study. Semi needling therapy and conventional acupuncture method were used respectively in the treatment of acne vulgaris, comparative analysis of differences in the efficacy of conventional acupuncture and Semi needling therapy and specific quality of life for patients with acne (Qol-Acne)analysis, to provide effective treatment options for acupuncture treatment of acne vulgaris.MethodsTime and Place:The experiment was carried out from October 2013 to October 2014 at Departments of Acupuncture and Moxibustion, Affiliated Southern Hospital of Southern Medical University and Hospital of Traditional Chinese and Western Medicine.Subjects came from:cases collected by Southern Medical University, its Affiliated Southern Hospital and Hospital of Traditional Chinese and Western Medicine. By mastering inclusion and exclusion criteria strictly,60 cases were collected according to requirements that were randomly divided into Semi needling therapy group (treatment group) and conventional acupuncture group (control group),there were 30 patients in each subject.Subjects’ materials:The study included 60 cases of acne vulgaris, patients were randomly divided into treatment group (Semi needling therapy group) and control group (conventional acupuncture group), the two groups involved 30 cases respectively,the treatment process without loss and excluding cases. Treatment group involved 30 cases, including 16 males and 14 females, with an average age of 26.04 ± 4.02 years, duration of minimum two months up to 5 years.The control group involved 30 cases, including 15 males and 15 females, with an average age of 26.21 ± 4.23 years, duration of minimum 3 months up to a maximum of 8 years. Via the differences found by corresponding statistical test, they had comparability.Process of the experiment:Before and after treatment were recorded acne lesions integration and Qol-Acne acne-specific scale changes in the indicators of life.(1) Lesions Points:Doshi proposed comprehensive acne grading system (GAGS) in 1997, after the first diagnosis and treatment,calculate the integration of different types of lesions respectively. It can be divided into six regions according to the density of sebaceous follicles units, distribution and general area. Ⅰ zone:forehead (2); Ⅱ District:cheek Ministry (2); Ⅲ District:left cheek (2); Ⅳ District:nose (1); Ⅴ Zone: under the chin (1); Ⅵ area:Chest and on the back (3). Factor scores for different partitions within the brackets. Lesion scores for each area (localized lesions of the worst decisions in the area scores):0= no lesions; 1≥1 an acne; 2≥1 a pimple; 3≥1 an abscess; 4≥1 nodules. A regional score= factor score × lesions score. Generally 1 to 18 is mild,19 to 30 is moderate,31 to 38 is severe, more than 39 is extremely severe. In the total integral way for acne condition to make comprehensive evaluation. (2)Specific quality of life(Qol-Acne)analysis:Martin and other developed acne specific quality of life questionnaire (Acne-specific Quality of Life Questionnaire Acne-QoL), including three dimensions:self-perception, social function, emotional function, a total of 14 entries, evaluate the impact of acne on quality of life of patients. Each entry has seven options, from low to high scores for 0-6 minutes Quality of life is the sum of all scores in the field of each entry score. Self-perception , emotional function score was 30 points, the social function of the dimension of the total score of 24 points, the higher the score, indicating better quality of life. Treatment process is as follows:1.Semi needling therapy group:The conventional acupuncture acupoints:Yang Bai (double), Quanliao (double), Hegu (double),Qu Chi (double),Nei ting(double),Dazhui.Lung-heat plus Shaoshang,Chize, dampness -heat plus Zusanli,Sanyinjiao,yinlingquan,Syndrome of disharmony of Chong and Conception Channels plus Xuehai,Geshu,Sanyinjiao;syndrome of intermin-gled phlegm and blood stasis plus Pishu,Fenglong,Sanyinjiao.Semi needling acupoints :facial lesions mainly based. (1) Operating procedure:Conventional acupuncture first ,then do semi needling in the face of local lesions. (2)Operation: ①Conventional acupuncture:Patients take supine position,after routine disinfection,using 0.30mm ×25mm stainless steel needles (Suzhou tianxie Acupuncture Instrument Co.,ltd, GB2024-1994) acupuncture reducing method,30 minutes each time of retaining needle, manipulating needle every 5 minutes.②Semi needling therapy:In the face of local lesions with 0.25mm×13mm stainless steel filiform needle, inserting needle around about 0.5～1cm of the acne, nodules, pustules. Needle tip to the center was 15 ～45 degrees, depending on the lesion size take 3～6 needle. According to the size and number of the acne, pustulars, nodules to determine the needling point,general the needling point between 4～8 points. Needle depth is about 0.1 to 0.2 inches, and with reducing method, then quickly out of the needle, leaving the needle.Shake when out of the needle,see a few bleeding to spilled blood hot.(2)Control group:acupoints:Yang Bai (double),Quanliao(double), Hegu (double),Neiting(double),Dazhui, facial lesions mainly based.Add and subtract:the same with treatment group.Operation:the same with conventional acupuncture of the semi needling therapy group.The two groups were daily treated 1 times,5 times for a course of treatment,2 days rest between each course of treatment, observation of curative effect before and after treatment of 3 courses.Data processing:After the end of treatment, all of the data were summarized. Statistics and analyses of all data were carried out on SPSS20.0. Data were expressed by mean±standard deviation. Based on the statistical method the corresponding selection of different types of research data, the comparison of measurement data using t test, count data were compared using Χ2 test or rank sum test. All statistical tests using two-sided test, P<0.05 was ceconsider the difference was statistically significant.Results(1) Within the two groups after treatment, both groups of patients GAGS lesion score is lower than before treatment, after treatment score was 7.06 ± 4.24 lesions in the control group after treatment, the integration of 13.05 ± 6.52 lesions, lesions were statistically significant differences between the integral (P<0.05) before and after treatment. (2) Comparison between the two groups found that lesions before and after treatment, comparing the difference between the two groups of patients showed improvement in skin lesions in the treatment group calculus is more evident than in the control group, with a statistically significant difference. (3) Before and after treatment, compared two groups of the overall clinical efficacy, the total effective rate of treatment group was 90%, control group total effective rate was 76.67%, the curative effect of the two groups had significant difference, indicating the clinical efficacy of the treatment group was better than the control group.(4)Aspects of the specific quality of life improve acne, the two groups before and after treatment the quality of life of acne specific scale (Qol-Acne) score increased, there are statistically significant differences between the two groups before and after treatment (P<0.05).Conclusion1.Semi needling therapy in treatmenting acne vulgaris is better than conventional acupuncture group, as it is a safe and effective treatment method with simple operation, so that it’s worthy of popularization in clinical.2.Acne significantly affect the quality of life of patients, through to the Semi needling therapy, acne specific quality of life scale (Qol-Acne) score were improved, which show that the Semi needling therapy could significantly improve the patient’s quality of life and psychological status. |
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