Bo Liang,Hui-Ling Liao*

1School of Integrated Traditional and Western Medicine of Southwest Medical University.2Hospital(T.C.M)Affiliated to Southwest Medical University,Luzhou,China.

Background

Acne is a dermatosis which caused by sebaceous follicles chronic inflammatory.It has the characters of papules,pustules,nodules,cysts and other types of rash,as well as often occurs in face,chest,back and other places in adolescent people that accompanied by seborrhea.The morbidity in adolescents is over 90%,while there is still 12-14%morbidity among adults.Acne’s psychological and social effects on adolescents outnumber asthma and epilepsy [1].Regional,personal,family and diet,environment can affect the morbidity of acne[2].Modern science thought that the occurrence of acne was related to many factors,and the inflammatory response caused by propionibacterium is the main causative factor in the pathogenesis of acne[3-5].The main treatment of acne is to correct abnormal keratosis in hair follicles,regulate sebaceous gland secretion and reduce the flora in hair follicles,especially propionibacterium,anti-inflammatory and prevention of secondary infection[6].Medications were included antibiotics,vitamins,13-cis-retinoic acid and so on.Sometimes hormones may result in acne outbreak[7].In addition,laser treatment was also achieved good results.However,acne as a chronic disease,the treatment was bound to accompany the long-term use of various drugs,so the side effects are unavoidable,which is a bottleneck of acne treatment in western medicine[8,9].

Acne is also called"blisters","pimples","alcohol spikes","powder defects","powder flower sores",etc.in traditional Chinese Medicine.As one of the most common non-drug therapies,cupping has shown a beneficial effect in the treatment of acne[10-14].The earliest record of cupping was in the ancient book called52 Bingfang,which was unearthed from Mawangdui tomb(B.C.202~220,Han Dynasty)in Changsha,China in 1973.It recorded:“Use a small ox’or ram’horn to suck the hemorrhoids,tie the root with a small rope,then cut it with knife”.Pricking cupping bloodletting method is a kind of therapy which combines pricking blood and cupping.In a single-blind randomized clinical trial of 38 patients,pricking-bloodletting cupping at Dazhui(DU14)improved the skin lesions of patients with moderate acne[14].Here we present a patient who suffered from acne for 8 years and showed a complete clinical response after two courses of pricking bloodletting cupping treatment.

Case report

In June,2017,a-24-year-old male complained of has suffered from acne for 8 years.Disease history:eight years ago,acne appeared on his face,and then formed papulesand nodules,occasionally accompanied by seborrhea without subjective symptoms.It was obvious in summer,often self-healing in winter followed with scar.Because he was in the condition of adolescence,no treatment was given.Then the patient selected cupping treatment instead.There was a little scattered acne and pimples as well as obvious pockmark on his face.The patient usually has light diet.Sleep and dining is regular.The diagnosis in Western medicine is acne while that in traditional Chinese medicine is acne,which belongs to the syndrome of wind-heat in lung meridian.Treatment principles:dispelling wind and clearing away the lung-heat.The patient was given the combined treatment of pricking cupping bloodletting combined and slide cupping.The points of Feishu(BL13)at bladder meridian of foot-Taiyangand Dazhui(GV14)at governor vessel were prescribed the pricking cupping bloodletting and the points on the back at bladder meridian of foot-Taiyangwere prescribed the slide cupping.

The operation of flash-flame cupping:clamped a 95%ethanol cotton ball with tweezers,ignited the cotton ball,put the flame into the cup and circled the flame inside it 2 to 3 times,and removed the flame and placed the cup onto the intended operation part quickly.The operation of pricking cupping:the patient was taken the prone position and received the routine skin disinfection.Then doctors used three-edged needle to prick points of Dazhui(GV14)and Feishu (BL13).After bleeding,attached the flashing-flame cupping to the appropriate points and retained the cup on the area for 10min(Figure 1A,B).The operation of slide cupping:the doctors coated vaseline in the proposed operation part,attached the flash-flame cupping on the skin,and moved the cup to and fro along the bladder meridian of foot-Taiyangon the back until the skin became reddish,congested and even extravasate(Figure 1C).

The blood was fresh red and the skin was reddish without blood stasis after treatment,which is accordance with the syndrome of wind and heat in lung meridian.During treatment,the patient was advised to wash face with warm water,not to eat spicy and excitant foods and squeeze the affected area,and keep stool smooth.After two courses of treatments,the acne was significantly reduced and the scar was markedly diluted.

Figure 1 Treatment of pricking cupping bloodletting and slide cupping

Discussion

There is principle and method of acne treatment called“eliminate the garbage of water in the body”inHuangDiNeiJing(Qin dynasty,B.C.207~221).In the Ming dynasty(A.D.1368~1644),WaiKeZhengZongmentioned acne as lung wind.In the Qin dynasty(B.C.207~221),YiZongJinJianrecorded:acne is resulted from the blood heat of lung meridian,which usually attack face and nose with the characters of congestion,swelling,pain and iseasy to undergo ulceration.Thesyndrome differentiation is of the wind-heat in lung meridian.Because the lung governs the skin and body hair,accumulated heat in lung meridian and the attack of wind heat external evil have the potentials to stimulate skin and lead to the incidence of acne.The principle of treatment is dispersing wind and clearing lung.Choose Dazhui(DU14),Hegu(LI4),Sibai(ST2),Taiyang(EX-HN5),Xiaguan(ST7),Jiache(ST6)and add Quchi(LI11),Feishu(BL13),whose function to clear the wind heat in lung meridian.The method of pricking cupping always use alternately two groups:Dazhui(DU14),Feishu(BL13),WeiZhong(BL40)and Geshu(BL17),Fengmen(BL12),Chize(LU5).

According to thepatient's situation,doctortook pricking cupping bloodletting on the points of Dazhui(DU14)and Feishu(BL13)as well as sliding cupping on foot-Taiyangbladder meridian.Acupuncture with Dazhui(DU14)and FeiShu(BL13)to clear heat,and cupping is to strengthen the therapeutic effect of pricking blood.Slide cupping on bladdermeridian could dredge meridians and activate collaterals,expel wind and clear heat in lung meridian,and regulate skin function[15,16].

In conclusion,thepatientwith acneshows the effectiveness of pricking cupping bloodletting on disease recovery.

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