Acne (Acne vulgaris)
Acne is an acute or chronic inflammation of the sebaceous glands of the hair follicles. There are various types of damage such as blackheads, papules, pustules, nodules, abscesses, cysts and scars, and it occurs on the face and chest and back. This disease, also known as youth acne, occurs mostly in adolescent men and women and is often accompanied by seborrhea. After puberty, most acne heals naturally or is reduced. The cause of this disease is unclear lung qi and external wind-heat; or it can be caused by poor diet, excessive consumption of fatty, sweet and thick flavors, and steam from the stomach; or it can be caused by menstrual disorders and stagnation of heat.
I. Diagnosis
For diagnosis in Chinese medicine, please refer to the “Chinese Medicine Treatment Guide for Common Diseases in Dermatology”.
Western medicine diagnosis refers to the Clinical Diagnosis and Treatment Guide-Dermatology and Venereal Diseases (edited by the Chinese Medical Association, People’s Health Publishing House) and the Clinical Technical Practice Specification-Dermatology and Venereal Diseases (edited by the Chinese Medical Association, People’s Military Medical Publishing House).
II. Chinese medicine treatment plan
(A) Lung heat and blood heat
Main evidence: papules scattered on the face in line with hair follicles, light red or skin-colored, called white pimples, some with black tips, called black-headed pimples, with thin yellow tongue coating and counted pulse.
Treatment: Promoting the lung and clearing heat.
Remedies: Loquat and Scutellaria Clear Lung Drink, plus or minus Scutellaria Clear Lung Drink. Loquat leaf 9g, Scutellaria baicalensis 9g, Morinda citrifolia 9g, Gardenia jasminoides 9g, Phellodendron cypress 9g, Zhi Mu 9g, Glycyrrhiza glabra 3g, Radix et Rhizoma rawhide 15g, Radix et Rhizoma forsythiae 15g. 1 dose daily with water decoction, divided into 2 doses.
(B) Heat accumulation in the spleen and stomach
Main symptoms: Red rash, persistent food, distension and pain in the abdomen, may be accompanied by abdominal pain, constipation, yellow and greasy tongue coating, moist or slippery pulse. Treatment: Clearing heat, resolving dampness and clearing the internal organs.
Remedy: San Huang Wan combined with Artemisia Inchi Tang, plus or minus. Huang Lian 3g, Scutellaria Baicalensis 9g, Yin Chen 15g, Sheng Shan Yuan 9g, Sheng Coix Seed 15g, Sheng Shan Zha 15g, Bai Hua Shi Tong Cao 30g, Sheng Gan Cao 3g. 1 dose daily with water decoction, divided into 2 doses.
(C) Heat toxicity
Main symptoms: The lesions are mainly papules and pustules, surrounded by flushing, with localized pain, temporary hyperpigmentation or small depressed scar after the pustules are broken or absorbed, with yellow dry tongue coating and number of pulse.
Treatment: Clearing heat and detoxifying the toxin
Remedy: Add and subtract three flowers soup. Yin Hua 30g, Zi Hua Di Ding 30g, Wild Chrysanthemum 15g, Scutellaria Baicalensis 9g, Zhi Mu 9g, Angelica Dahurica 9g, Red Peony 9g, Dali Zi 9g, Lian Qiao 9g, Raw Licorice 9g. Decoction in water, 1 dose daily, divided into 2 doses.
(D) Blood stasis and phlegm coagulation
Main symptoms: Skin lesions are mainly nodules and cysts, nodules are hard and dark red, painful, or fused at the deep end, greenish-purple, or formed into a sac containing mucous secretion, with fluctuating sensation when pressed, often forming keloids after healing, with purple and dark tongue and slippery pulse.
Treatment: To harmonize the Ying and resolve phlegm and disperse the knots.
Remedy: Peach kernel and Er Chen Tang plus or minus. The formula includes: Peach kernel, Radix et Rhizoma, Salviae Miltiorrhizae, Radix et Rhizoma Xiangbei, each 9g, Safflower 6g, Chuanxiong 6g, Oyster 30 (decoction first), Cornu Cervi Pantotrichum 15g, Yinhua 12g, Licorice 3g. Decoction in water, 1 dose daily, divided into 2 doses.
(V) External treatment
1. 60g of each of snake bed seeds, ground bark, white fresh bark and alum. add water and decoction, scrub the affected area while it is hot for 30 minutes each time, 1 to 3 times a day for 10 days, 1 dose of medicine can be used for 6 days.
2. 30g of fresh amaranth (half of the dried product), 9g each of Atractylodes macrocephala, Beechwood and Angelica dahurica, 6g each of Sinapis alba, 10g each of Serpentine, 15g each of Radix et Rhizoma bitter ginseng and Pericarpium chinense, boil water to extract juice and wash the affected area while it is hot, 3-5 times a day, for several days.
3. 30g each of Salvia miltiorrhiza, Radix Angelicae Sinensis, Angelicae Sinensis, Radix Angelicae Sinensis, Radix Angelicae Sinensis, Radix Angelicae Sinensis, and Radix Angelicae Sinensis. The face is first washed with warm salt water (1%), black and white acne, pustules with a needle to pick and squeeze the net, rub the face with hands with a hot feeling, and then smoked face with the heat of the juice, after the 2 new towels immersed in the liquid to wait for the temperature to drop to the skin can adapt to, and take out the towel wring half dry face, each time 30 minutes, twice a day. 1 dose of medicine for 2 to 3 days in summer, 4 to 5 days in winter.
III. Effect of Chinese medicine treatment
(a) Improve clinical symptoms, reduce recurrence and prevent scar formation.
(2) Reduce the dosage of western medicine and reduce the side effects of western medicine.
IV. Difficulties in Chinese medicine treatment
Some patients have obvious inflammation, and although modern medicine has antibacterial drugs such as tetracycline and erythromycin, which are used for antibacterial purposes, their long-term use can lead to side effects such as dysbiosis of flora commonly.
V. Response ideas of Chinese medicine treatment for the difficulties
Chinese medicine has certain advantages in the treatment of acne, and should be actively explored and applied.
Characteristic therapies of Chinese medicine
(1) Acupuncture
At present, acupuncture therapy includes a wide range, in addition to the traditional acupuncture, there are still electric acupuncture, cupping, ear point pressure beans and other contents, in general, its treatment method is still mainly clear and down.
Lung Yu (double), large intestine Yu (double), stomach Yu (double) and large vertebrae points with plum blossom acupuncture stay cupping 5-10min, once every other day, 5 times for a course of treatment, 1 to 2 courses of treatment will be cured.
The operation of bloodletting by puncture is to take the Great Vertebra of the Governor’s Vessel and the Lung Yu and Spleen Yu points of the Bladder meridian, puncture the Yu point with a trigeminal needle, and then puncture the earlobe at the tip of the ear to release blood.
(2) Ear points
Apply Wang Bu Liuxing to the lung, heart, stomach, endocrine, subcortical, and Shen Men. Ask the patient to press 3 to 5 times daily by himself, and replace once every 3 d. 10 times is a course of treatment.
(3) Gua Sha
After disinfecting the skin and applying gua sha oil, first scrape from Fengfu to Dazhi in the neck, then scrape from Fengchi to shoulder well and re-scrape Fengmen, Lung, Heart, Diaphragm, Stomach, Spleen, Kidney Yu, Zhongfu, Quchi, Hegu
The acupuncture points are: Zhongfu, Quchi, Hegu, Liangqiu, Blood Sea, Feosanli, Sanyinjiao, etc., to the extent that the skin is red and there are stasis points and guaa spots under the skin. Finally, the hegu, shaoshen, shangyang and shichong points are punctured with the tip of the plate. Patients are usually instructed to come and scrape at the hour of the day in spring and autumn, after which they can be treated once every 3 to 7 days.
(4) Chinese herbal mask
Homemade herbal mask powder (Huang Lian, Scutellaria, Danshen, White Peony, Aloe, Honeysuckle, White Poria, Dan Pi, Angelica, Jiang Ling 10g each), grind to take a small amount of fine powder and add fragrance oil to mix into massage cream, and then take 50g of fine powder and add 200g of medical plaster, mix well as a mask powder, after cleansing the face, apply the herbal massage cream on the face, massage the face by the meridian for 15-20min, use the herbal mask powder with warm water to make a paste After cleansing the face, apply the herbal massage cream on the face, massage the face for 15-20 min, mix the herbal mask powder with warm water to form a paste, cover the face evenly, remove after 30 minutes, once every other day.