Objective Observing the clinical effect of modified heibu ointment in the treatment of moderate and severe acne vulgaris and detecting the regulation of IL-6 and TGF-?1 in serum of SD rats to explore the mechanism of reducing and preventing acne scar formation.Methods Clinical observation:72 patients who met the criteria were randomly divided into two groups:modified heibu ointment treatment group?n=36?and vitamin A acid cream control group?n=36?.The patients in the treatment group were treated with modified heibu ointment,and the patients in the control group were treated with vitamin A acid cream.At the same time,both groups were treated with minocycline hydrochloride for 6 weeks.The improvement of the patient's condition was recorded every 2 weeks.After one month,observed the recurrence of these patients.Animal experimental study:62 SD rats were randomly divided into blank group?10 rats?and model group?52 rats?.In the model group,100%oleic acid was applied evenly to the bilateral inner ear catheters of rats and the acne model was established by injecting Propionibacterium acnes into the auricle of the rats every other day.According to the random number table method,rats of model group were divided into five groups:model group,positive control group of vitamin A acid cream,modified heibu ointment treatment group is divided into high,medium and low dose group.Observing the morphology and histopathologi-cal changes of auricular skin lesions,and detecting the levels of IL-6 and TGF-?1 in the serum of SD rats in each group after 4 weeks of treatment.Results1 Clinical observation?1?In the treatment group,the total effective rate was 94.28%,7 cases were cured,18cases were markedly effective,8 cases were effective and 2 cases were ineffective.In the control group,the total effective rate was 91.17%,4 cases were cured,16 cases were markedly effective,11 cases were effective,3 cases were ineffective.There was no significant difference in therapeutic effect between the two groups?P<0.05?and the clinical efficacy of the two group was similar.?2?The skin lesion scores of the treatment group and the control group decreased after 2weeks,4 weeks and 6 weeks of treatment indicating that the periodic curative effect of the two groups was significant in the course of treatment?P<0.01?.?3?After 2 weeks,4 weeks and 6 weeks of treatment,the treatment group can reduce the production of acne secondary scar in the treatment of moderate and severe acne,and the difference was statistically significant?P<0.05?.?4?After one month of treatment,in the treatment group,there were 25 cases cured and markedly effective,3 cases recurred,and the recurrence rate was 13.64%.And in the control group,20 cases were cured and markedly effective,8 cases recurred.And the treatment group was better than the control group in the recurrence of the disease?P<0.05?.?5?There were 15 cases of mild adverse reactions in the two groups,including 2 cases in the treatment group and 13 cases in the control group.The adverse reactions in the treatment group were significantly lower than those in the control group?P<0.05?.2 Experimental study?1?The morphology of auricle skin lesions in SD rats:Compared with the model group,both the vitamin A acid cream positive control group and the modified heibu ointment treatment group were improved especially the positive control group the high-medium dose group of modified heibu ointment.?2?Histopathological observation of the auricle of SD rats:The thickness of the stratum corneum and fibrous tissue in the positive control group and the high-medium dose group of the modified heibu ointment were decline compared with the model group.And the number of inflammatory cell infiltration and blood vessels is significantly reduced.?3?Detection of IL-6 and TGF-?1 in serum of SD rats:The serum level of IL-6 and TGF-?1 in blank group,positive drug control group,middle and high dose groups of modified heibu ointment were significantly decreased?P<0.05?compared with model group.The results showed that the positive control group,the middle and high dose groups of modified heibu ointment can effectively regulate the level of IL-6 and TGF-?1 in serum of SD rats.Conclusion The overall effect of modified heibu ointment and vitamin A acid cream on the treatment of moderate to severe acne vulgaris is comparable.In terms of recurrence rate,adverse reactions and secondary acne scar,the effect of modified black cloth ointment was better.The mechanism of prevention of secondary acne scars may be related to the decrease of serum IL-6 and TGF-?1 levels.Modified heibu ointment can regulate the development of inflammatory mediators and reduce the inflammatory response.At the same time,the level of TGF-?1 can be regulated in the process of epidermal repair which can prevent the formation of acne scar. |