摘要
目的:比较女性青春期后痤疮患者与健康女性血清性激素水平;探讨穴位埋线、火针、耳针综合针灸疗法治疗女性青春期后痤疮皮损的疗效及作用机制。方法:将107例女性青春期后痤疮患者分为综合针灸组(54例,4例剔除)和药物组(53例,5例剔除)。综合针灸组采用穴位埋线、火针、耳针综合疗法,埋线取大椎、印堂、阳白透鱼腰等为主,配合辨证取穴,并于面部脓疱、囊肿皮损处行火针治疗,取耳尖及额、口等相应部位行耳针治疗;药物组口服丹参酮胶囊,每次4粒,每日3次,外用0.1%阿达帕林凝胶,每晚1次,两组均治疗8周。分别于治疗前、治疗4周、治疗8周后评价两组痤疮皮损。治疗前综合针灸组50例患者及46例健康对照组均于月经来潮24 h内检测血清睾酮(T)和雌二醇(E2)水平,并观察综合针灸组中21例性激素水平异常的患者治疗后的性激素水平变化。结果:综合针灸组治疗前E2水平明显低于健康对照组(P<0.01);T/E2明显高于健康对照组(P<0.01)。综合针灸组21例性激素异常的患者治疗后E2水平显著提高(P<0.01),T/E2显著降低(P<0.01)。两组治疗4周、8周后痤疮皮损积分显著降低(均P<0.01),治疗4周后组间差异无统计学意义(P>0.05),治疗8周后综合针灸组痤疮皮损评分低于药物组(P<0.05)。治疗4周后两组疗效差异无统计学意义(P>0.05);治疗8周后综合针灸组、药物组愈显率分别为66.0%(33/50)、45.8%(22/48),综合针灸组优于药物组(P<0.05)。结论:女性青春期后痤疮患者与健康女性血清性激素水平比较,E2水平降低导致T水平相对升高;穴位埋线、火针、耳针综合疗法对女性青春期后痤疮皮损具有比药物更好的疗效,并对异常的性激素水平具有调整作用。
Objective Tn compare the difference of serum sex hormone between female patients with post-adolescent ache and healthy women, and to explore the efficacy and action mechanism of acupoint catgut embedding, fire needle, auricular acupuncture on skin lesion in female patients of post-adolescent ache. Methods A total of 107 female patients of post-adolescent ache were divided into an integrated acupuncture group （54 cases, 4 cases were excluded） and a medication group （53 cases, 5 cases were excluded）. The patients in the integrated acupunctutre group were treated with comprehensive treatment of acupnint catgut embedding, fire needle, auricular acupuncture; the acupoint catgut embedding was applied at Dazhui （GV 14）, Yintang （GV 29）, Yangbai （GB 14） through Yuyao （EX-HN 4） and other acupoints based on syndrome differentiation; the fire needle was applied at skin lesion; the auricular acupuncture was applied at erjian （HX6.7i ）, e （AT1）, kou （CO1）, etc. The patients in the medication group were treated with oral administration of tanshinnne capsules （4 capsules each time, 3 times a day） and external use of adapalene gel（one treatment per day at night）. Patients in the two groups were treated for 8 weeks. The skin lesion of ache was evaluated before treatment as well as 4 weeks and 8 weeks after treatment in the two groups; the serum levels of testosterone （T） and estradinl （E2） were tested 24 hours before menstruation in the integrated acupuncture group （50 cases） and healthy control group （46 cases）, anti the change of serum sex hormone after treatment was observed in 21 patients with sex hormone disorder in tile integrated acupuncture group. Results Before treatment, lhe level of E2 in the integrated acupuncture group was significantly lower than that in the healthy conrail group （P〈 0.01）, but T/E2 in the integrated acupuncture group was significantly higher than that in the healthy control group （P〈 0.01）. After treatment, the level of E2 was significantly inereased （P〈 0.01） and T/E2 was reduced （P〈 0.01） in life 21 patients with sex hormone disorder in the integrated acupuncture group. The skin lesion seale of acne was significantly reduced in the two groups after 4-week and 8-week treatment （all P〈 0.01）; the difference between the two groups was not signifieant after 4-week treatment （P〉 0.05）; the skin lesion scale of acne in the integrated acupuncture group was significanlly lower than that in the medication group after 8-week treatment （P〈 0.01）. The efficacy between the two groups was not significant after 4-week the treatment （P〉 0.05）： after 8-week treatment, the cured and effective rate was 66.0% （33/50） in the integrated acupuncture group, which was superior to 45.8% （22/48） in the medication group （P〈 0.05）. Conclusion Comqared with healthy women, the level of serum sex hormone of E2 is reduced in the female patients of post-adolescent acne, resulting in relative inereased level of T; the aeupoint catgul embedding, fire needle, acupuncture acupuncture have belier efficacy than medication for post-adolescent acne, which have regulation effects on sex hormone disorder.
作者
卢文
朱礼刚
田阡陌
白昕予
匡薇薇
房忠女
任虹
陈仁琼
解春桃
LU Wen;ZHU Ligang;TIAN Qianmo;BAI Xinyu;KUANG Weiwei;FANG Zhongnv;REN Hong;CHEN Renqiong;XIE Chuntao(Department of Acupuncture-Moxibustion and Tuina;Department of Clinical Laboratory;Affiliated Hospital of Nanjing University of CM;Department of Dermatology,5Medical Examination Center,the First People＇s Hospital of Lianyungang,Lianyungang 222002,Jiangsu Province,China)
出处
《中国针灸》
CAS
CSCD
北大核心
2018年第8期833-838,共6页
Chinese Acupuncture & Moxibustion
基金
江苏省中医药局科技项目:PY 201510
连云港市第一人民医院博士科研基金项目
关键词
痤疮
女性青春期
穴位埋线
火针
耳针
睾酮
雌二醇
aene, female adolescence acupoint eatgut embedding
fire needle
auricular acupuncture： testosterone （T）：estradiol （F2）
