【作者】 凌静；

【导师】 丁慧；

【作者基本信息】 广州中医药大学 ， 中医学， 2011， 硕士

【摘要】 目的：痤疮是一种常见的损美性疾病,表现为面部、胸部和背部的粉刺、丘疹、脓疱、结节及囊肿,是一种毛囊及皮脂腺的慢性炎症。本研究通过比较两组女性痤疮患者治疗前、第1疗程后、第2疗程后及随访1个月的皮损积分,客观评价阴三针对女性痤疮的临床疗效,以及疗效与中医证型和月经不调间的关系,初步探讨阴三针治疗女性痤疮的机制,为针刺治疗女性痤疮提供临床依据。方法：将门诊女性痤疮患者随机分为治疗组和对照组,共60例。根据中医辨证分型为四型：冲任失调型18例,肺经风热型17例,湿热蕴结型18例,痰湿凝滞型7例。通过调查患者的月经情况发现,月经不调患者27例,占45%；经前皮损加重患者18例,占30%0。根据皮损严重程度分为四级：轻度8例,中度23例,重度26例,特重3例。治疗组针刺阴三针和手三针,对照组仅针刺手三针。隔日治疗一次,6次为1疗程,治疗2个疗程后结束,适逢行经期者当周休息1周。1个月后随访。采用痤疮综合分级系统(GAGS)对患者皮损进行评分,计算每个疗程后及随访时的皮损积分和临床疗效指数。采用SPSS18.0软件包进行统计学分析。结果：治疗组30例总有效率为93.33%,对照组总有效率为86.67%,经比较差异有统计学意义(P<0.05)。随访1个月,治疗组复发1例,对照组复发3例,皮损积分比较差异有统计学意义(P<0.05),中医各证型治疗后总有效率比较,治疗组冲任失调型100%,肺经风热型100%,湿热蕴结型87%,痰湿凝滞型20%；对照组冲任失调型100%,肺经风热型100%,湿热蕴结型90%,痰湿凝滞型25%。比较临床疗效各级别例数后发现,冲任不调型两组间有显著性差异,余证型在两组间差异无统计学意义。组内证型两两比较显示治疗组冲任失调型和肺经风热型疗效与其余证型相比有显著性差异,而对照组仅对肺经风热型差异有统计学意义。治疗组月经不调患者总有效率85.71%,对照组月经不调患者总有效率76.92%,差异有统计学意义(P<0.05)；普通患者间疗效无显著性差异。结论：两组患者经治疗后皮损均有改善。从第一疗程开始,治疗组的积分便明显低于对照组,提示治疗组可缩短治疗周期。治疗组对月经不调患者或冲任失调型患者疗效均高于对照组,随访情况也优于对照组。提示阴三针治疗女性痤疮具有起效快、治愈率高、复发率低的优势。无论患者是否伴随月经不调,均能取得较好疗效。更多还原

【Abstract】 Objective:To observe the clinical effect of Yin-Three-Needle Technique on female acne, and preliminary estimate the possible mechanism by studying the comparisons of acne lesions and effective rates from two groups.Methods:Randomized 60 female acne patients into Yin-Three-Needle group and control group. According to the differentiation standards of Chinese Medicine: there were 18 cases on Chong-Ren disorders,17 on Wind-Heat of Lung Channel, 18 on damp-heat syndrome,7 on dampness in total.27 cases complained of irregular menstruation, constituted 45% of 60 cases. Acne lesions were graded by GAGS (The Globe Acne Grading System), which is a quantitative scoring system in which the total severity score is derived from summation of six regional sub scores. The Yin-Three-Needle group received Yin-Three-Needle and Hand-three-Needle; while the control group received only Hand-three-Needle every other day, avoiding the menstruation week, collected severity scores of lesions after the 6th visit and the 12th visit. The follow-up visit was set on one month later. All data were analyzed under PASW Statistics 18.0. Results:Yin-Three-Needle group ended with effective of 93.33%, while control group was of 86.67%, indicating statistical significance (P<0.05). During follow-up visit, there were one recurrent patient in Yin-Three-Needle group, and 3 in control group. Their lesion scores showed a statistical significance (P<0.05). Compared the effective among the 4 differentiation types, Chong-Ren disorders and Wind-Heat of Lung Channel were 100%, while damp-heat syndrome was 87%, and dampness was 20% in. Yin-Three-Needle group; Chong-Ren disorders and Wind-Heat of Lung Channel were 100%, while damp-heat syndrome was 90%, and dampness was 25% in control group. Statistics showed only Chong-Ren disorders indicated statistical significance between two groups. Intra-class comparison of the Yin-Three-Needle group showed Chong-Ren disorders and Wind-Heat of Lung Channel were superior to other syndromes on effective rates, while control group only displayed a superiority in Wind-Heat of Lung Channel. Among cases complained with irregular cycles, their effective was 85.71% in Yin-Three-Needle group, and 76.92% in control group. This difference were proven statistical significance by PASW Statistics 18.0. The effective among regular cycle patients were almost the same.Conclusion:Two groups were both effective in lowering lesion scores, while the Yin-Three-Needle group lowered the scores more quickly, with less recurrence cases, indicating the Yin-Three-Needle group are capable in shorten the treatment cycle with a more lower lesion scores. What’s more, Yin-Three-Needle group achieved even better effective in irregular menstruation female than the control group. Yin-Three-Needle is an efficient, time-saving, and safe therapy in treating female acne.更多还原