朱琏抑制Ⅰ型针法治疗脾胃湿热型痤疮的疗效及作用机制研究

Efficacy and action mechanism of ZHU Lian inhibition type Ⅰ acupuncture for acne with spleen-stomach dampness-heat

目的:观察朱琏抑制Ⅰ型针法治疗脾胃湿热型痤疮的疗效,并探讨其可能的作用机制。方法:将82例脾胃湿热型痤疮患者随机分为观察组和对照组,各41例。对照组给予丹参酮胶囊口服(每次1 g,每日3次)配合患处0.1%阿达帕林凝胶涂擦(每晚1次)治疗,连续治疗4周,观察组以朱琏抑制Ⅰ型针法治疗,穴取合谷、内庭、曲池、阳白、四白、气海、血海、阴陵泉及皮损局部,隔日1次,7次为一疗程,共治疗2个疗程。比较两组患者治疗前后痤疮综合分级系统(GAGS)皮损评分、痤疮特异性生活质量量表(Qol-Acne)评分及血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平,比较两组临床疗效,并于治疗后4周随访评估患者复发情况。结果:治疗后,两组GAGS皮损评分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05),两组Qol-Acne评分较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后两组血清TNF-α、IL-6水平均较治疗前下降(P<0.05),观察组低于对照组(P<0.05)。观察组总有效率为95.1%(39/41),高于对照组的82.9%(34/41,P<0.05)。治疗结束后4周,观察组痤疮皮损复发率为10.3%(4/39),低于对照组的32.4%(11/34,P<0.05)。结论:朱琏抑制Ⅰ型针法治疗脾胃湿热型痤疮临床疗效较佳,且复发率低,其作用机制可能与降低血清炎性因子TNF-α、IL-6水平有关。

Objective To observe the efficacy of ZHU Lian inhibition type Ⅰ acupuncture for acne with spleen-stomach dampness-heat, and to explore its possible action mechanism. Methods A total of 82 patients of acne with spleen-stomach dampness-heat were randomly divided into an observation group and a control group, 41 cases in each group.The patients in the control group were treated with danshentong capsules(1 g, 3 times per day) and 0.1% adapalene gel smear(once every night) for 4 weeks. The patients in the observation group were treated with ZHU Lian inhibition type Ⅰacupuncture at Hegu(LI 4), Neiting(ST 44), Quchi(LI 11), Yangbai(GB 14), Sibai(ST 2), Qihai(CV 6), Xuehai(SP 10),Yinlingquan(SP 9) and skin lesions, once every other day, 7 times as a course of treatment, totaling for 2 courses of treatment. The skin lesion score of the global acne grading system(GAGS) and quality of life-acne(Qol-Acne) score as well as the serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) were compared between the two groups before and after treatment;the clinical efficacy were compared between the two groups, and the recurrence rate was evaluated 4 weeks after treatment. Results After treatment, the skin lesion scores of GAGS in the two groups were reduced(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05). After treatment, the Qol-Acne scores were increased in the two groups(P<0.05), and the score in the observation group was higher than that in the control group(P<0.05). The serum levels of TNF-αand IL-6 in the two groups were reduced after treatment(P<0.05), and those in the observation group were lower than the control group(P<0.05). The total effective rate was 95.1%(39/41) in the observation group, which was higher than 82.9%(34/41) in the control group(P<0.05). Four weeks after treatment, the recurrence rate of acne lesions was 10.3%(4/39) in the observation group, which was lower than 32.4%(11/34) in the control group(P<0.05).Conclusion ZHU Lian inhibition type Ⅰ acupuncture is effective for acne with spleen-stomach dampness-heat, and the recurrence rate is low. Its mechanism may be related to the reduction of serum inflammatory factor TNF-α and IL-6.