Acne, also known as acne, is a chronic inflammatory disease of the sebaceous glands of the hair follicles. It occurs on the face, chest, back of the shoulders and other sebaceous areas of adolescent men and women. The former includes papules, nodules, pustules, and cysts, while the latter includes blackheads (open acne) and whiteheads (closed acne), and the inflammatory lesions may have scar formation after healing.
Western medical pathogenesis.
Western medicine considers acne to be a disease of the skin appendages caused by a combination of multiple factors, the detailed pathogenesis of which is not yet fully understood. The detailed pathogenesis is not yet fully understood. It is mainly thought to be related to the following factors.
1. Abnormal regulation of sebaceous glands by sex hormone secretion
2. Excessive sebum secretion and hyperkeratosis of the hair follicle
3. Immune response to excessive proliferation of Propionibacterium acnes
4, genetic and psychological factors
In addition, the disease can be triggered or aggravated by a sugar-rich, lipid-rich and stimulating diet, emotional stress, hot climate and certain chemical factors.
Propionibacterium acnes is a Gram-positive anaerobic, intracellular parasitic bacterium that belongs to the normal flora of the skin and generally resides in the hair follicles and sebaceous glands of the skin. As adolescents mature, keratinous plugs appear at the mouth of hair follicles and the secretion function of sebaceous glands increases significantly. Since sebum contains more fatty acids and other components, it is suitable for the growth and reproduction of P. acnes, thus becoming a cause of acne.
Western medical treatment.
Anti-androgen therapy: oral contraceptives, cyproterone, spironolactone, etc.
Retinoic acid drug therapy: inhibit sebaceous gland function; anti-keratinization of follicular sebaceous ducts; inhibit the growth of microorganisms in follicular sebaceous ducts; inhibit inflammation. Isotretinoin, vincristine, etc. are commonly used clinically. Side effects: dry mouth, dry skin; embryotoxicity and teratogenicity, so women taking such drugs should not be pregnant before, during and 1 year after stopping treatment.
Treatment against pathogenic microorganisms: antibacterial and anti-inflammatory. There are tetracyclines, macrolides, clindamycin, cotrimoxazole and quinolones. Drugs of tetracycline, which invariably increase the burden on the liver and kidneys when taken for a long time, are especially contraindicated for pregnant women.
Traditional Chinese medicine etiology and pathogenesis.
Anti-androgen therapy: oral contraceptives, cyproterone, spironolactone, etc.
Treatment with retinoids: inhibit sebaceous gland function; anti-keratinization of follicular sebaceous ducts; inhibit the growth of microorganisms in follicular sebaceous ducts; inhibit inflammation. Isotretinoin, vincristine, etc. are commonly used clinically. Side effects: dry mouth, dry skin; embryotoxicity and teratogenicity, so women taking such drugs should not be pregnant before, during and 1 year after stopping treatment.
Treatment against pathogenic microorganisms: antibacterial and anti-inflammatory. There are tetracyclines, macrolides, clindamycin, cotrimoxazole and quinolones. Tetracycline drugs, long-term use of drugs will invariably increase the burden on the liver and kidneys, and are particularly contraindicated for pregnant women.
1, fire evil burns yin and blood, refining yin and blood to become phlegm, burning yin and blood to become stasis, phlegm and stasis intertwined.
2, due to emotional stimulation, liver qi stagnation, qi depression into fire, fire up inflammation, fumigation on the face.
3. Insufficient kidney yin, dysregulation of the flush, and delusional movement of phase fire.
4. Insufficiency of vegetative yang or improper treatment (e.g. repeated purging of heat and detoxification) leads to weakness of the body’s yuan qi, spleen and stomach, deficiency of cold in the lower yuan, inability to transport fluid to moisten the lungs and stomach, resulting in deficiency of yang floating upward on the face and fire stagnating inside and causing rash.
TCM clinical typing.
1. Wind-heat of the lung meridian: papules mostly on the face and upper chest and back, red in color, or with itching and pain, red tongue, thin yellow coating, floating pulse.
2. Dampness and heat accumulation: papules are red, swollen and painful, or with pus. Accompanied by bad breath, constipation, yellow urine. Red tongue, yellow greasy coating, floating pulse.
3. Phlegm-damp stagnation: papules with pus, nodules, cysts, scarring and other damages, accompanied by dullness and loose stools. Pale tongue, greasy coating, and slippery pulse.
4.Disorders of flushing: the rash increases or worsens during menstruation in female patients and decreases after menstruation. Red tongue, greasy coating, and floating pulse.
In addition, acne of the yin deficiency and fire and liver depression and qi stagnation types are also seen clinically.
Treatment principles.
1. Wind-heat in the lung meridian, damp-heat accumulation, phlegm-damp stagnation – clear heat and dampness, cool the blood and detoxify the toxin
2. Dysregulation of the Qi and Blood – Promoting Qi and Blood circulation, regulating the Qi and Blood.
3, Yin deficiency and fire – nourishing Yin and clearing heat, inducing fire to return to the source
4, liver Qi stagnation – dredge the liver and regulate Qi
Treatment methods.
Body acupuncture treatment.
Prescription: local and hand Yangming meridian points are the main points.
Main points: Yangbai, zygomatic s, Dazhi, Hegu, Quchi, Neiting
1, wind-heat in the lung meridian – Shaoshang, Shouze, Fengmen
2, Damp-heat stagnation–Shan San Li, San Yin Jiao, Yin Ling Quan
3, phlegm-damp stagnation–Spleen Yu, Fenglong, Sanyinjiao
4.Dysregulation of Chong Ren – Blood Sea, Diaphragmatic Yu, Sanyinjiao
Zhou’s and other acupuncture main points: Quchi, Hegu (both bilateral). Wind-heat in the lung meridian with Dazhi, Lung Yu and Fengchi points (both sides); damp-heat in the spleen and stomach with Foot Sanli and Nei Ting points (both sides); dysfunctional punching of the body with Tianshu, Gongsun, Sanyinjiao (both sides) and Guan Yuan points. The hand method is flat tonic and flat diarrhea, retaining the needle for 20 min, once a day, 20 times for a course of treatment. Inverted San San lotion was applied externally to the affected area. The total effective rate was 91.9%.
Abdominal acupuncture treatment.
1. He’s abdominal acupuncture points: main point: inducing qi to return to the origin (Zhonggui, hypogastrium, Qihai, Guangyuan). Auxiliary points: abdominal four points (slippery flesh door, Wai Ling left and right total of four points), upper rheumatism point (double), qi point (double). Facial acupuncture points Yin Tang, Zygomatic s (bilateral), Di Cang (bilateral), Sun (bilateral), and A-Yi points. Control group: topical application of compound metronidazole solution was used on the affected areas. The total effective rate was 83.3% in the treatment group and 63.6% in the control group . (He Xuyan. Clinical observation of 24 cases of facial acne treated with ventral acupuncture combined with superficial facial acupuncture. Inner Mongolia Traditional Chinese Medicine, 2009, (8): 33-34)
2, Mi’s abdominal acupuncture points: main points: cause Guiyuan, abdominal four Guan, lung meridian wind-heat type plus Shang Qu (bilateral, shallow stab); gastrointestinal damp-heat type plus Jianli (shallow stab); liver meridian depression-heat type plus Shui Shui (shallow stab); Chong Ren disorder type plus Qi point (0.5 inch next to Guan Yuan), Qi Pun (0.5 inch next to Qi Hai) (both bilateral, medium stab), the results of the four types of evidence of the efficiency of 86.8%, 89.2%, 86.85, 90.5%. 86.85, 90.5%. (Mi Jianping, Yu Cheok Sheet. Clinical observation of acne treatment by ventral acupuncture with fire acupuncture. Shanghai Journal of Acupuncture and Moxibustion, 2009, 28(2): 85-86)
Auricular acupuncture treatment.
Since testosterone levels in acne patients are significantly higher than normal, some studies have found that auricular acupuncture can effectively increase serum β-endorphin levels and regulate central neurotransmitter secretion; improve ovarian function, delay functional decline, and increase estradiol levels, and some scholars even believe that auricular acupressure therapy can significantly reduce serum testosterone levels.
Liu et al. observed the effect of auricular acupressure for common acne on serum testosterone estradiol by taking the auricular acupoints Lung, Endocrine, Adrenal, Shen Men, Subcortical, and Cheek as the main points. The lung meridian and wind-heat type plus the large intestine point, the spleen and stomach damp-heat type plus the spleen, stomach and large intestine points, and the impulse disorder type plus the liver and kidney points. The patch was changed once every other day, 10 times for a course of treatment. The effective rate was 94.6%. (Liu Lian, Li Long, Zhao Jianhua. Effect of auricular acupressure on serum testosterone estradiol in acne vulgaris. Chinese Acupuncture, 2004, 24(1): 57-58 )
Pricking treatment.
Fu et al. used a trigeminal needle to prick, two horizontal fingers on both sides of the spine, about 12-15 stitches on each side from shoulder to waist, squeezing out 1 to 2 drops of blood by force, and wiping it with a sterilized dry cotton ball, once every other day. In the control group, tincture of chloralurin was applied to the face three times a day, morning, noon and night. On the 10th, 20th and 30th days of treatment, the treatment group was significantly better than the control group, and the total effective rate of the treatment group was 85.4%; 93.7%; 94.9%, respectively. (Fu Guojun, Xu Min, Ye Wenjing et al. Observation on the efficacy of back picking therapy in the treatment of acne. Hebei Journal of Traditional Chinese Medicine, 2003, 18(1): 35- )
Liu used a trigeminal needle to pick off part of the subcutaneous fibrous tissue at the body pillar point, disinfected locally, covered with dressing, fixed with adhesive tape, and picked the treatment once in 7 days, and observed the efficacy after 5 times. 96 patients, 79 cases were cured and 17 cases improved, with an efficiency of 100%. (Liu Yuezhen. Treatment of acne with trigeminal acupuncture at the body pillar point in 96 cases [J]. Chinese Acupuncture, 2002;22(7):467-467 )
Acupuncture cupping.
Huo took Dazhi and bilateral Lung Yu, sterilized them routinely, punctured them with three strokes of the three-pronged needle, and cupped them for 3 -5 minutes. The above methods were used once every other day. In the control group, Di Wei cream was applied externally to the affected area once a day in the morning and once in the evening, and the results were observed after 10 times. The total effective rate was 65.00% in the treatment group and 38.46% in the control group, and the total effective rate of both groups was P<0.05, which was statistically significant. (Huo Huan-Min, Yang Xue-Ping. Acupuncture and bloodletting treatment of 4O cases of acne vulgaris. Journal of Traditional Chinese Medicine, 2006, 15(3): 45-46)