【作者】 王芳；

【导师】 傅杰英；

【作者基本信息】 广州中医药大学 ， 针灸推拿， 2010， 硕士

【摘要】 目的：通过本研究,观察岭南地区痤疮患者常见体质类型及痤疮发病特点,对两组阳虚体质痤疮患者治疗前后的症状、体质积分进行比较,客观评价针灸改善阳虚体质治疗岭南痤疮的临床疗效,为调理体质治疗痤疮的有效性提供临床依据。方法：采用随机对照的方法,将符合标准的66例阳虚体质痤疮患者随机分为调体组(治疗组)和传统针刺组(对照组)各33例。①两组分别给予皮损局部处理：分别取面部较成熟的粉刺或脓疱、囊肿2-3个,75%酒精消毒后,用5号注射针头挑刺,清除黑头、白头粉刺或脓疱、囊肿之脂栓、脓栓、脓血等,1周1次。②两组分别给于传统辨证取穴：颧骼、大椎、曲池、合谷、内庭,并随证加减。一周针3次。③治疗组加用调体穴位：神阙、关元、肾俞、足三里、涌泉。(神阙隔盐隔姜灸、涌泉温和灸,余穴温针灸)。针2次灸1次,神阙禁针。一周治疗3次,1个月为一疗程,连续治疗3个疗程后观察总体疗效。采用SPSS17.0统计软件包进行统计学分析：计量资料采用t检验；计数资料采用X2检验；等级资料采用非参数检验。结果：治疗组与对照组总有效率分别为93.3%和71.9%,经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,治疗组肺经风热型91.7%,湿热蕴结型87.5%,痰湿凝结型100%,对照组总有效率肺经风热型71.2%,湿热蕴结型83.3%,痰湿凝结型69.2%。两组痰湿凝结型有效率比较,差异有统计学意义(P<0.05),肺经风热型和湿热蕴结型总有效率比较,差异无统计学意义(P>0.05)。在痤疮皮损改善方面,治疗组和对照组治疗前后的皮损积分均有明显下降,两组相比,差异有统计学意义(P<0.05)。在阳虚体质改善方面,治疗组治疗前后体质积分有明显下降,差异有统计学意义(P<0.05)。而对照组治疗前后体质积分无明显变化,差异无统计学意义(P>0.05),两组治疗后体质积分比较,差异有统计学意义(P<0.05)。随访2个月,调体组和传统针刺组相比,复发率明显低于传统针刺组。结论：调体组和传统针刺组对于岭南痤疮均取得较好疗效,两组相比调体组总有效率、皮损改善程度均优于对照组。中医各症型比较,在治疗肺经风热型和湿热蕴结型痤疮方面,治疗组与对照组疗效相近,而对于痰湿凝结型,治疗组疗效优于对照组。在阳虚体质改善方面,治疗组治疗前后体质积分明显下降,对照组则无明显变化,两组相比,治疗组在改善阳虚体质方面优于对照组。此外,调体组和传统针刺组相比,调体组复发率明显低于传统针刺组。更多还原

【Abstract】 Objective:Through this study, observe Lingnan Acne patients constitution types and acne characteristics, compare symptoms of Yang-deficient acne and Yang-deficient Constitution Integration in both groups before and after treatment, objectively assess clinical efficacy of treating Lingnan Acne by improving Yang-deficient Constitution, provide clinical evidence of treating acne by regulating imbalanced constitution.Methods:Adopt randomized control method, randomly divided 66 yang deficient constitutional acne patients into treatment group(regulate imbalanced constitution group) and control group (traditional acupuncture group) with 33 patients each.①The damaged-skin lesions were given regional treatment: choose 2 to 3 matured facial rash or pustules, cysts, after sterilization with 75%alcohol, prick with size-5 injection needle to get out of the blackhead, whitehead, acne, pustules, or fat emboli, pus, stagnant blood of cysts, one time each week.②two groups were given the traditional differentiation acupoints repectively:SI18, DU14, LI11, LI4, ST44, and plus corresponding acupoints according to different differentiation.3 times each week.③treatment group plus regulating imbalanced-constitution points:RN8, RN4, BL 23, ST36, KI1. (RN8, moxibustion with salt and ginger; KI1, mild moxibustion, the rest acupoints, moxibustion with warm needle).2 times acupuncture and one time moxibustion each week, and RN8 is prohibit to insert needle.3 Treatments a week, one month as a course, observe overall efficacy after three courses. Used SPSS17.0 statistical software for data processing:Count data were analyzed by Chi-Square Test, measurement data were analyzed by t Test, level data were analyzed by Non-parametric test.Results:The treatment group and control group, the total efficient rate was 93.3%and 71.9%, with statistically significant difference (P<0.05). The total efficient rate for each differentiation:lung wind-heat 91.7%, damp heat stagnant 87.5%, damp phlegm congealment 100%in the treatment group; lung wind-heat 71.2%, damp heat stagnant 83.3%, damp phlegm congealment 69.2%in the control group. There was statistically significance (P<0.05)in differentiation of lung wind-heat, but no statistically significant (P> 0.05)in differentiation of damp heat stagnant and damp phlegm congealment. As improvement in damaged lesions, treatment and control groups before and after treatment were significantly reduced damaged-lesion integration, compared to two groups, there was statistically significant (P<0.05)before and after treatment as improvement in syndrome of Yang-differentiation constitution. Constitution integration decreased significantly in treatment group (P<0.05)but didn’t decrease significantly in control group (P> 0.05). After treatment, there was statistically significant between two groups in constitution integration (P<0.05). Followed up visit for 2 months, recurrence rate of treatment group was significantly lower than control group. Conclusion:The regulating imbalanced constitution group and the traditional acupuncture group had achieved good efficacy in treating Lingnan acne, The regulating imbalanced constitution group were better than traditional acupuncture group in improvement of damaged-skin lesions and overall efficacy rate, Compare TCM differentiation, the treatment group had similar effects as control group in lung wind-heat and damp heat stagnant, but treatment group was better than control group in phlegm damp congealment. Compare Yang-differentiation constitution integration, the integration decreased significantly before and after treatment in treatment group, but in the control group there were not significantly decrease. Treatment group had better efficacy than control group in improvement of Yang-deficient integration. In addition, the regulating imbalanced constitution group had lower recurrence rate that was significantly lower than traditional acupuncture group.更多还原