Lishui Central Hospital of Zhejiang Province, Lishui 323000, China

CLINICAL STUDY

Therapeutic Observation on Combined Acupuncture and Medication for Recurrent Facial Dermatitis

Chen Huan, Lu Le-miao, Jiang Yu-zhen

Lishui Central Hospital of Zhejiang Province, Lishui 323000, China

Author: Chen Huan, attending physician.

E-mail: zjtnyx@126.com

Objective: To observe the clinical efficacy of acupoint injection plus medication in treating recurrent facial dermatitis (RFD).

Methods: Fifty-eight patients with RFD were randomized into a treatment group and a control group, 29 in each. The treatment group was intervened by acupoint injection with BCG-PSN plus oral administration of Fexofenadine Hydrochloride, and the control group was by Fexofenadine Hydrochloride only. The clinical efficacies were compared between the two groups, and a follow-up study was conducted to investigate the recurrence rate.

Results: The total effective rate was 96.6% in the treatment group versus 65.5% in the control group, and the difference was statistically significant (P＜0.01). Of the cured and improved patients in the treatment group, the recurrence rates were 10.7%, 25.0%, and 32.1% respectively 3 months, 6 months, and 12 months after treatment, versus 31.6%, 36.8%, and 73.7% in the control group, and the differences were statistically significant (P＜0.05).

Conclusion: Acupoint injection plus medication is an effective method in treating RFD.

Acupuncture Medication Combined; Hydro-acupuncture; Recurrent Facial Dermatitis

Recurrent facial dermatitis (RFD) is a dermatological disease that most commonly affects women. With the improvement of living standard, the application of cosmetics and the aggravated environment pollution have increased the incidence of RFD. As RFD affects face, the patients usually have strong desire for treatment. Antihistamine is currently the predominant treatment for RFD, though the relapse after treatment has become a big trouble. We used acupoint injection with BCG-PSN plus Fexofenadine Hydrochloride in treating 29 patients with RFD, and compared them with another 29 patients treated with Fexofenadine Hydrochloride alone.

1 Clinical Materials

1.1 Diagnostic criteria

The patients were diagnosed with RFD by age, gender, season, recurrence and mild erythematous plaques with greasy scale[1].

1.2 Exclusion criteria

Severe diseases of heart, liver, kidney, nervous system, hematopoietic system, or endocrine system; long-term application of cream or cosmeticscontaining hormones; present or past history of tumor; women during pregnancy or lactation; patients with poor compliance.

1.3 General data

Fifty-eight outpatients with RFD were randomized into a treatment group and a control group, 29 in each. In the treatment group, there were 7 males and 22 females, aged between 19-47 years old, and the disease duration ranged from 7 months to 5 years. In the control group, there were 9 males and 20 females, aged between 22-54 years old, and the disease duration ranged from 9 months to 5 years. There were no significant differences in comparing gender, age, and disease duration between the two groups (P＞0.05), indicating the comparability. The grouping and treatment procedure are shown in Figure 1.

Figure 1. Clinical procedure in the two groups

2 Treatment Methods

2.1 Treatment group

2.1.1 Acupoint injection

Acupoints: Zusanli (ST 36), Guanyuan (CV 4), and Qihai (CV 6).

Operation: A 10 mL syringe was used to draw 2 mL BCG-PSN for acupoint injection.

The treatment was given 3 times a week, for totally 4 weeks.

2.1.2 Medication

Fexofenadine Hydrochloride 60 mg was taken orally twice a day, for totally 4 weeks.

2.2 Control group

The control group was prescribed with the same oral drugs as the treatment group, following the same dose and treatment duration.

3 Observation of Therapeutic Effects

3.1 Criteria of therapeutic effects[2]

Cured: Skin rash and subjective symptoms were completely vanished and not relapsed.

Improved: Skin rash and/or subjective symptoms were completely or partially vanished, but relapsed after treatment was terminated.

Invalid: Skin rash and subjective symptoms were not improved.

3.2 Statistical method

The SPSS 16.0 version statistical software was adopted for data analysis,t-test for measurement data and Chi-square test for enumeration data.

P＜0.05 was considered to have a statistical difference.

3.3 Treatment result

3.3.1 Comparison of clinical efficacies

The total effective rate was 96.6% in the treatment group versus 65.5% in the control group, and the difference was statistically significant (P＜0.01). The total effective rate of the treatment group was superior to that of the control group (Table 1).

Table 1. Comparison of clinical efficacies between the two groups (case)

3.3.2 Comparison of recurrence rates of the cured and improved patients

Of the cured and improved patients in the treatment group, the recurrence rates were 10.7%, 25.0%, and 32.1% respectively 3 months, 6 months, and 12 months after the termination of treatment, versus 31.6%, 36.8%, and 73.7% in the control group, and the differences were statistically significant (P＜0.05), (Table 2).

Table 2. Comparison of recurrence rates of the cured and improved patients (%)

3.4 Adverse reactions

Two patients in the treatment group and 3 cases in the control groups had mild lethargy reaction, which didn’t influence the patients’ work, life, and the treatment.

4 Discussion

The attack of RFD involves various factors, including cosmetics, pollen, dust, heat, light, endocrine disorder, constipation, and nervous and psychological factors[3]. The skin lesions are manifested by red spots, scales, itchy, and scorching hot feeling. RFD happens suddenly, usually in spring or autumn, bringing severe influence to the beauty of face. Recent researches have proved a significant correlation between anaphylaxis and the attack[2]. Anaphylaxis is induced when histamines dissociated from mast cells and basophilic cells stimulate H1receptors from smooth muscle cells and vascular endothelial cells. Therefore, antihistamines have become the common medicine in the treatment of allergy. Fexofenadine Hydrochloride is a novel histamine H1receptor antagonist[4]. Certainly, it’s effective in treating RFD, but the condition may relapse after the termination of the medicine.

Acupuncture is effective in treating facial dermatological diseases such as acne vulgaris[5-10]. RFD belongs to the scope of head and facial eczema in traditional Chinese medicine (TCM). Contributing factors include a weak constitution and external pathogenic factors transforming into heat. Extracted from BCG, BCG-PSN functions to regulate immune system. It promotes the expression of mIL-2R on T-lymphocytes and simultaneously reduces the production of sIL-2R and restores the activation of NK cells[11]. Hence, we adopted BCG-PSN for acupoint injection. Zusanli (ST 36), Guanyuan (CV 4) and Qihai (CV 6) were selected to supplement blood and strengthen the healthy qi. The acupoints and medicine were combined together to fully display their therapeutic efficacies, regulate and improve the body function. According to the study, this integrative method achieved a content short-term therapeutic efficacy and a low recurrence rate. In a word, acupoint injection with BCG-PSN plus oral administration of Fexofenadine Hydrochloride is effective in treating RFD and can significantly reduce the recurrence rate.

Conflict of Interest

The authors declare that there is no conflict of interest.

Acknowledgments

Thank for the support of Lishui Central Hospital of Zhejiang Province.

Statement of Informed Consent

All the parents signed the informed consent.

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Translator: Hong Jue

R246.7

: A

Date: August 23, 2013