In Chinese medicine, there are diagnostic methods that link facial parts to the internal organs. For example, in “The Five Colors”, the face is divided into Mingtang, Fan, and Shade to correspond to the organs of the internal organs, and in “Suwen”, the facial parts correspond to the five organs. In the treatment of post-pubertal acne in women, we have found that many patients believe that the rashes on different parts of the face are related to different organs, and their sources of information are mostly beauty salons and the Internet. In order to clarify the relationship between acne rash sites and the identification of internal organs, we have done the following related research. Wang Lijun, Department of Dermatology, Wuxi Chinese Medicine Hospital
1.Data and methods
1.1 Case selection
Outpatients with female acne, aged ≥25 years, with a disease duration ≥3 months, who were willing to accept detailed inquiries and fill out a questionnaire. The contents of the questionnaire included general information (gender, age, disease duration, rash site), and Chinese medical evidence (with reference to the section of Chinese medicine diagnosis on the identification of internal organs and the common evidence of post-pubertal acne in the literature).
1.2 Methods
One-way sequential test with open type of quality response. According to the results of the consultation and the survey data filled out by the patient, the identification type obtained after identification was compared with the rash site of the patient, and the rate of conformity between the identification of the internal organs involved and the rash site was ≥50% was considered valid, otherwise it was considered invalid. Test conditions: 1. the identification rate of π≥π1=70% was considered valid, 2. the identification rate of π≤π0=30% was considered invalid; α=0.05, β=0.05. The formula U: Y=1.738+0.5n; L: Y=-1.738+0.5n was derived.
1.3 Correspondence between parts and viscera: Referring to the “Spiritual pivot・Five colors chapter” and “Suwen・Puncture heat chapter” as follows: five viscera partition: left cheek-liver; right cheek-lung; forehead-heart; W-kidney; nose-spleen, six viscera partition: nose root Both sides – gallbladder; under the cheekbones – large intestine; above the end of the nose – small intestine; under the nose – bladder; both sides of the tip of the nose – stomach.
2. Results
A total of 15 patients were included in the observation, with the maximum age of 38 years and the average age of 31.14±4.79 years; the longest duration of disease was 13 years and the average duration of disease was 3.68±4.73 years; the maximum number of sites involved was 4 and the average was 2.71±0.73.
The relationship between the identification results and site conformity in 15 patients was in the following order: conformity, non-conformity, non-conformity, non-conformity, conformity, non-conformity, non-conformity, conformity, non-conformity, conformity, non-conformity, non-conformity, non-conformity and non-conformity.
Sequence diagrams were drawn based on the results of the analysis, and it was observed up to the 14th patient when it was concluded that the rash sites of female postpubertal acne patients were not necessarily related to the TCM organ identification.
Discussion.
Usually, acne naturally subsides after puberty in most people, but in clinical practice we find that there are also people who develop acne after puberty or even in adulthood, and others who develop it from puberty until adulthood, most often in females, which is called late-onset or persistent acne. It is assumed that long-term chronic tension stimulates the pituitary-adrenal axis, leading to increased secretion of adrenal-derived androgens, which in turn contributes to the development of acne1.
In our clinical work, we have found that a significant proportion of patients strongly believe that rashes on different parts of the face are related to the organs, tracing their origin mainly to folklore, propaganda from beauty salons, and even doctors in certain hospitals, etc. The traditional Chinese medicine diagnosis method does have some similar records such as the five facial organs, the five viscera of the eyes, the five viscera of the tongue, the reflex zones of the ears and feet, and so on. Our observation is that the patient’s identification of the internal organs and the rash site are considered to have a definite connection between the two if they match ≥ 50%, and the test standard is π≥π1=70%, which is a relatively lenient standard. In this case, we still concluded that the rash site of the patient was not necessarily related to the internal organs of TCM, which means that this conclusion is more credible. The holistic concept is one of the characteristics of TCM, and this principle should always be kept in mind when diagnosing. The four methods of understanding the disease, namely, observation, smell, questioning and cutting, each has its own role and should not be neglected, which is called “four diagnoses together”. The conclusion of our test once again verifies this assertion, which reminds us that there is no shortcut to a clear diagnosis, but only a comprehensive and systematic understanding of the disease can make a correct judgment.