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        Clinical Observation on Pricking Bloodletting Therapy at Back-Shu Acupoints Plus Chinese Herbal Mask in Treating Patients with Acne

        2013-07-18 11:57:23HongTingtingWuLixia

        Hong Ting-ting, Wu Li-xia

        Jingjiang Hospital, Fujian 362200, China

        Clinical Observation on Pricking Bloodletting Therapy at Back-Shu Acupoints Plus Chinese Herbal Mask in Treating Patients with Acne

        Hong Ting-ting, Wu Li-xia

        Jingjiang Hospital, Fujian 362200, China

        Objective: To observe the clinical efficacy on pricking bloodletting and cupping therapy combined with Chinese herbal mask in treating acne.

        Methods: Thirty-seven patients with acne were randomly divided into a treatment group (treated by pricking bloodletting and cupping therapy combined with Chinese herbal mask) and a control group (only by Chinese herbal mask). The therapeutic efficacy was observed after 2-course treatment.

        Results: The total effective rate in the treatment group was 94.7% versus 61.1% in the control group. According to the statistical management, the total effective rate in the treatment group was significantly higher than that in the control group (P<0.05).

        Conclusion: Pricking bloodletting and cupping therapy combined with Chinese herbal mask therapy for acne is more effective than Chinese herbal mask treatment alone.

        Points, Back-Shu; Pricking Blood Therapy; Acne; Cupping Therapy; Acupuncture Medication Combined

        Acne is a chronic inflammatory skin disease of hair follicles and sebaceous glands, pertains to the category of ‘fen ci (comedone)’ and ‘mian pao (pimple)’in traditional Chinese medicine. Acne generally presents in young people’s face, chest and back, manifested in forms of comedone with blackheads, papules, pustules, nodules, cysts and other lesions. In severe cases, it can affect the appearance, cause great psychological pressure to young people. In recent years, we applied pricking bloodletting and cupping therapy at Back-Shu acupoints combined with Chinese herbal mask in the treatment of acne. The report is summarized below.

        1 Clinical Materials

        1.1 Diagnostic criteria[1-2]

        The diagnostic criteria refer to the relevant criteria in theClinical Dermatology. It mostly occurs in adolescents, mainly in the face, chest, back and other areas with abundant sebaceous glands; the lesions include black comedone, pimples and pustules in scattered and symmetric distribution; a yellow white translucent liposome with black head can be discharged after squeezing a comedone; there are usually no subjective symptoms except for occasional pain and tenderness.

        1.2 General data

        Thirty-seven patients were enrolled according to visiting sequences and randomly divided into two groups. There were 19 cases in the treatment group, including 8 males and 11 females, aged from 15 to 36 years old, with a average of 24 years; their duration ranged from 1 to 10 years with an average of 2.5 years. There were 18 patients in the control group including 7 males and 11 females, aged between 14 and 35 years old with an average of 23 years old; their durations were between 1 and 11 years with an average of 2.2 years. There were no significant differences between the two groups in gender, age, and duration according to statistical processing (P>0.05), thus the two groups were comparable.

        2 Therapeutic Methods

        2.1 Treatment group

        2.1.1 Pricking bloodletting and cupping therapy

        Acupoints: Feishu (BL 13), Weishu (BL 21), Pishu (BL 20), Erjian (EX-HN 6), Dazhui (GV 14).

        Operation: The patient took a sitting position with the head and neck slightly forward to fully expose the acupoints of back and neck. After routine disinfection with Povidoneiodine, the acupoints areas were pricked quickly 3-5 times by a disposable blood collecting needle. And then, cupping therapy was applied immediately. The cupping glasses were retained for 10-15 min, so that each point could bleed about 2-5 mL. Cleared the blood after removal of cupping glasses and cleaned the skin with a sterile cotton swab.

        2.1.2 Chinese herbs mask[3]

        Herbs composition:Dan Shen(Radix Salviae Miltiorrhizae) 12 g,Xia Ku Cao(Spica Prunellae) 10 g,Huang Qin(Radix Scutellariae) 10 g,Ku Shen(Radix Sophorae Flavescentis) 30 g,Bai Hua She She Cao(Herba Hedyotidis Diffusae) 15 g,Fang Feng (Radix Saposhnikoviae) 50 g,Sheng Di(Radix Rehmanniae) 30 g,Bai Zhi(Radix Angelicae Dahuricae) 10g,Chi Shao(Radix Paeoniae Rubra) 10 g,Huang Lian(Rhizoma Coptidis) 10 g,Jin Yin Hua(Flos Lonicerae) 10 g,Zi Hua Di Ding(Herba Violae) 10 g.

        Method: Made the above herbs into powder, mixed well and sifted as preparation. When treating a patient, firstly cleaned the skin, and then took 20 g herbs powder mixed with proper amount of honey into a paste, then applied it to the face with 1 cm thick plaster outside, and finally removed it after 30 min.

        Pricking bloodletting and cupping therapy combined with Chinese herb mask was used 2 times per week, and 5 times was a course of treatment with an interval of 3-5 d, totally for two courses.

        2.2 Control group

        3 Therapeutic Efficacy Observation

        3.1 Therapeutic efficacy criteria

        The therapeutic efficacy criteria were based on theGuiding Principles for Clinical Study of New Chinese Medicines[4].

        Clinical recovery: Skin lesions disappear completely, and no new ones appear.

        Marked effect: Skin lesions disappear by≥70%。

        Improvement: Skin lesions disappear by ≥30%, but<60%.

        Failure: Skin lesions disappear by <30% or become more severe.

        3.2 Therapeutic results

        After 2-course treatment, the total effective rate in the treatment group was 94.7%, versus 61.1% in the control group. The difference between the two groups was statistically significant (P<0.05), indicating that the effect of the treatment group was better than that of the control group (table 1).

        Table1. Comparison of therapeutic effect between the two groups (case)

        3.3 Case study

        A 27-year-old single female first visited on May 3, 2009.

        Chief complaint and history of present illness: She had a history of facial acne for 10 years. Acne mainly affected her face and was easily recurrent. Her face was flushing red, and the symptoms became more severe especially before menstruation. She had almost sought treatment everywhere; however, both Chinese and Western medicine treatments were ineffective, resulting in her great psychological pressure. Physical examination showed that there were lots of erythematous papules in different sizes in the cheeks and forehead as well as multiple pustules and pigmentation, and there were more lesions on the cheeks.

        Diagnosis: Acne.

        Treatment: After 3 treatments by the above method, papules obviously decreased and the pustules disappeared. After one-course treatment, acne completelydisappeared and the skin became shiny without any pigmentation. There was no recurrence during 1-year follow-up.

        4 Discussion

        The etiology of acne is very complex, and it is said in traditional Chinese medicine that acne is mostly due to accumulated heat in lungs and stomach caused by improper diet or too much spicy and greasy food. The occurrence of this disease is also related to the patient’s mood, because emotional disturbance can cause liver stagnation to transform into fire, then toxin and heat stay interstices of the flesh or flow in the meridians, leading to qi stagnation and blood stasis blocking the meridians, and lasting for a long time can turn necrotic tissue into pus and eventually form abscess.

        The occurrence of this disease is also closely related to lung, spleen, stomach and liver. Most of the patients belong to excess syndrome. According to ‘reducing for excess syndrome’ principle, pricking bloodletting and cupping therapy at Feishu (BL 13), Weishu (BL 21), Pishu (BL 20) and Erjian (EX-HN 6) can expel the accumulated heat in the lung and stomach[5-8].

        Governor Vessel is the sea of the Yang Meridians and governors all of them, while the Yang Meridians are usually the accumulated location of heat and toxin. Dazhui (GV 14) is one of the Governor Vessel acupoints as well as the crossing point of the Three Yang Meridians of Hand and Governor Vessel. Therefore, bloodletting at Dazhui (GV 14) can clear the accumulated heat in the lung and stomach so as to ensure the smooth movement of qi, clear heat and expel nodule, as well as to invigorate blood circulation and remove blood stasis[9-11]. Besides, combination with Chinese herbs mask as local application can reach directly the affected lesions, because it can clear away heat and resolve toxicity, Soften the hard mass and dissipate the bound pathogens, and Invigorate blood circulation and remove blood stasis.

        The combination of the two methods is significantly effective and safe. Because early treatment is very important for this disease, normative diagnosis and treatment in time can avoid or reduce skin lesion. In addition, ask the patient to keep smooth bowel movements, stay away from spicy and greasy food, while eat more vegetables and fruits; do not squeeze acne to avoid infection; do not abuse cosmetics. And advise them to wash face using warm water or cleanser, which can help the recovery of acne and especially prevent from its occurrence.

        [1] The Ministry of Health, the General Logistics Department of the Chinese People’s Liberation Army. Diagnostic Criteria for Clinical Disease & Cure and Improvement. Beijing: People's Military Medical Press, 1987: 562-563.

        [2] Man LJ, Chen B, Li Y. The clinical observation ofLing Fu Shitreating 60 cases with acne vulgaris. Linchuang Pifu Ke Zazhi, 1999, 28(2): 107.

        [3] Zhang L. A clinical observation of Chinese herbs treating 60 cases with acne. Shanxi Zhigong Yixueyuan Xuebao, 2007, 17(1): 70.

        [4] Ministry of Health of the People’s Republic of China. Guiding Principles for Clinical Study of New Chinese Medicines. Beijing: China Medico-Pharmaceutical Science & Technology Publishing House, 2002: 292-294.

        [5] Zhang BM, Xu SW, Zhang W. Clinical observation of auricular bloodletting therapy for chloasma in 30 cases. J Acupunct Tuina Sci, 2011, 9(3): 152-153.

        [6] Li SJ. Clinical application of pricking bloodletting and cupping therapy around Wangu (GB 12) point treating head and face diseases. Sichuan Zhongyi, 2007, 25(4): 101-102.

        [7] Wang QF, Wang GY. Therapeutic effect observation on treatment of acne with acupuncture plus moving cupping and blood-letting. J Acupunct Tuina Sci, 2008, 6(4): 212-214.

        [8] Wang QF, Wang GY. Therapeutic effect observation on treatment of acne with acupuncture plus moving cupping and blood-letting. J Acupunct Tuina Sci, 2008, 6(4): 212-214.

        [9] Wang GJ. Cotton moxibustion plus plum-blossom needle for treating severe acne vulgaris. Shanghai Zhenjiu Zazhi, 2011, 30(8): 545-546.

        [10] Li SX. Review on the clinical application of pricking bloodletting therapy. Zhongyi Xuebao, 2012, 27(6): 778-780.

        [11] Huang Z. Observations on the efficacy of pricking bloodletting plus acupuncture in treating acne. Shanghai Zhenjiu Zazhi, 2009, 28(12): 705-706.

        Translator: Deng Ying

        Received Date: May 28, 2013

        R246.7

        A

        in the control group only

        the same Chinese herbs mask treatment with the same course.

        Author: Hong Ting-ting, associate chief physician.

        E-mail: zjtnyx@126.com

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