Clinical observation on collateral-pricking and cupping therapy plus moxibustion for localized neurodermatitis

Shao Yong (邵勇)

Chinese Medicine Hospital of Jingyan County, Sichuan 613100, China

Clinical observation on collateral-pricking and cupping therapy plus moxibustion for localized neurodermatitis

Shao Yong (邵勇)

Chinese Medicine Hospital of Jingyan County, Sichuan 613100, China

Objective:To observe the clinical effects of collateral-pricking and cupping therapy plus moxibustion for localized neurodermatitis.

Moxibustion Therapy; Moxa Stick Moxibustion; Plum-blossom Needle Therapy; Blood-letting Puncturing and Cupping; Neurodermatitis

Neurodermatitis is a disease of skin nerve dysfunction, characterized by thickened skin, deepened skin groove, lichenification and serious paroxysmal itching, similar to collar sores in Chinese medicine. In accordance with the scope of the skin lesion, neurodermatitis can be divided into local neurodermatitis and disseminated neurodermatitis[1]. Currently, there is no specific therapy for neurodermatitis in Western medicine. The therapeutic effect is not so satisfactory, with easy recurrence. From October 2007 to September 2014, I treated 47 cases of localized neurodermatitis with bleeding method by plum blossom needle, cupping method together with moxibustion. Now, the report is given as follows.

1 Clinical Materials

1.1 Diagnostic criteria

The diagnostic criteria in this study were defined in accordance with the diagnostic criteria for collar sores in theCriteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine[2]: skin lesion like skin of ox neck, in intractable hardness, like dried wood, serious itching, occurring frequently in the nape, then eyelid, extensor side of the four limbs and low back, sacral and hip region, in symmetrical distribution, or in liner arrangement. It can occur extensively in the whole body and is mostly seen in the adults with mental derangement and poor sleep. The duration is comparatively long and the histopathologic examination can show epidermal hyperkeratosis, acanthosis, and lengthened trochanterellus, possibly accompanied by mildspongiosis, dermal capillary proliferation, perivascular lymphocytes infiltration, or concurrently by dermal fibroblast proliferation and fibrosis.

1.2 Inclusion criteria

In conformity with the above diagnostic criteria; at the age of 16-65 years old; willing to stop the other therapy and accept the therapeutic plan during the treatment and sign the informed consent.

1.3 Exclusion criteria

Those at the age ＜16 or ＞65 years old; those with coagulation disorders; those with serious hypertension, heart disease, diabetes, tumor, and hepatic or renal diseases; those with mental disorders; those unwilling to accept bleeding method by plum blossom needle or moxibustion; and those allergic to moxibustion.

1.4 Statistical methods

All data were processed by the SPSS 15.0 software. The measuring data were expressed by mean ± standard deviationand analyzed by usingt-test. The counting data were processed by Chi-square test.P＜0.05 expresses a significant difference.

1.5 General data

Totally, 94 recruited patients with localized neurodermatitis were the outpatients treated in the Acupuncture Clinic of our hospital from October 2007 to September 2014. They were randomly divided into a treatment group and a control group by their visit order. In the treatment group, the age ranged from 20 to 58 years old, and the duration ranged from 30 d to 8 years. In the control group, the age ranged from 18 to 57 years old, and the duration ranged from 20 d to 9 years. The differences in the patient’s gender, age, duration and pathological position between the two groups were not statistically significant (P＞0.05), indicating that the two groups were comparable (Table 1).

Table 1. Comparison of general data between two groups

2 Therapeutic Methods

2.1 Treatment group

2.1.1 Collateral-pricking and cupping therapy

After the skin of the sick area was disinfected routinely, a disposable plum blossom needle was used to tap the sick area centripetally with the increasing force till the bleeding spots scattered in the skin of the sick area. The cups in proper size (produced by Beijing Kangda World Medical Appliance Center) were selected and applied to the sick area, for obvious bleeding or bubbles inside the cups. After 5-10 min, the cups were taken off, and blood in the sick area was wiped off and the sick area was disinfected routinely again.

2.1.2 Moxibustion

After the cups were taken off and the skin in the sick area was disinfected routinely, in accordance with the size of skin lesions, 3-5 pieces of moxa roll (Everlasting Pavilion Natural Moxa Biological Products Co. Ltd., Nanyang) were ignited to apply mild moxibustion to the sick area. At the beginning, the patient might feel abnormal itching in the sick area. By continuous moxibustion, itching sensation would decrease gradually, and then the patient might have a comfortable sensation. Moxibustion was given till there was no exudation in the sick area.

The above treatment was given once every four days. The therapeutic effects were observed after five sessions.

2.2 Control group

In the control group, the patients were treated by subcutaneous injection of Triamcinolone Acetonide Acetate Injection (produced by Zhejiang Xianju Pharmaceutical Co., Ltd.).

Method: First, Triamcinolone Acetonide Acetate Injection was shaken well by the hand to have the contents fully dissolved. Then, after the inner cap was disinfected, a 5 mL syringe was used to extract 5 mL Triamcinolone Acetonide Acetate Injection. Then, after the skin in the sick area was disinfected again, based upon the size of the sick area, the syringe was inserted subcutaneously, by the surrounding puncture, centripetally to the center of the sick area, at 5-10 spots, to push the medication slowly under the skin (0.5-1 mL in each injecting spot). The treatment was given once per week. The therapeutic effects were observed after four sessions.

2.3 Cautions

Within three days after the treatment, it was prohibited to have water in the sick area, and necessary to avoid mental stimulation and maintain stable emotion, and to have less spicy food and stay awayfrom tobacco and alcohol. It was prohibited to scratch the sick area or wash with hot water or rub the sick area with a hard collar.

3 Therapeutic Effects

3.1 Criteria of therapeutic effects[2]

Cure: Skin lesions and symptoms vanished completely, with residual pigmentation or disappearance of pigment.

Improvement: Skin lesions became thinner, with less scale. Subjective itching was alleviated or skin lesions vanished by over 30%.

Failure: Skin lesions were as same as before, or vanished by less than 30%, without obvious improvement in the subjective symptoms.

3.2 Therapeutic results

After treatment, the curative rate and total effective rate were respectively 80.9% and 100% in the treatment group, versus 48.9% and 87.2% in the control group. The differences in the curative rate and total effective rate between the two groups were statistically significant (P＜0.01, P＜0.05), indicating that the therapeutic effect was better in the treatment group than that in the control group (Table 2).

Table 2. Comparison of clinical effects between the two groups (case)

4 Experience

Neurodermatitis belongs to the scope of collar sores in Chinese medicine. Currently, it is mainly treated in Western medicine by topical application of glucocorticoid drugs and oral administration of anti-histamine drugs, and calcium for symptoms, assisted by oral administration of Vitamin B. But, the therapeutic effects are not satisfactory, with easy recurrence. It is believed in Chinese medicine that emotional disorders and invasion of pathogenic wind are the contributing factors to this condition, and disharmony between Ying-Nutrient qi and blood, and stagnation of qi and blood are its pathogenesis[3]. Because twelve cutaneous regions are closely related to the twelve meridians and Zang-fu organs, to tap the cutaneous regions by a plum blossom needle can dredge qi of the meridians and Zang-fu organs, so as to realize the effects to regulate qi and blood[4-6]. By bleeding the collaterals with the plum blossom needle and cupping method, like opening the door to expel the pathogens, this therapy can be used to expel bad blood and activate blood circulation and disperse blood stasis[5]. It has been found out in the modern study that the specific infrared by igniting moxibustion can produce a penetrating power 3-4 times more than the ordinary infrared, and can also excite the immunocompetence of human cells, excite the cellular life energy, and its burning products can remove free radicals. Heavy moxibustion by moxa roll in the sick area can withdraw the internal heat to the body surface, to guide heat with heat, and expel toxin, clear away heat, resolve toxin and resist inflammation[7-9]. Moreover, smoke from moxibustion can inhibit or kill staphylococcus aureus and has the effects to support the constitution and expel pathogens[10-12]. The two methods in combination can stop itching and pain, regulate yin and yang, and rebuild the balance of the organism[13-15].

It has been proven by the outcomes of this study that the collateral-pricking and cupping therapy plus moxibustion is better in the therapeutic effects than subcutaneous injection of Triamcinolone Acetonide Acetate Injection in the treatment of localized neurodermatitis, and is simple in operation and needs popularizing.

Conflict of Interest

The authors declared that there was no conflict of interest in this article.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in this study.

Received: 28 November 2014/Accepted: 6 January 2015

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Translator: Huang Guo-qi (黄国琪)

刺络拔罐结合艾灸治疗局限性神经性皮炎临床观察

目的：观察刺络拔罐疗法结合艾灸治疗局限性神经性皮炎的疗效。方法：将94例局限性神经性皮炎患者按就诊顺序随机分为2组, 治疗组47例予梅花针放血、拔罐结合艾灸治疗; 对照组47例予醋酸曲安奈德注射液皮下注射。结果：治疗后, 治疗组治愈率为80.9%, 总有效率为100%, 对照组分别为48.9%和87.2%, 两组治愈率及总有效率差异均具有统计学意义(P＜0.01,P＜0.05)。结论：梅花针放血、拔罐结合艾灸是一种治疗局限性神经性皮炎的有效方法。

灸法; 艾条灸; 梅花针疗法; 刺络拔罐疗法; 神经性皮炎

R246.7 【

】A

Author: Shao Yong, bachelor, deputy chief physician.

E-mail: jyzyysy740724@126.com

Methods:A total of 94 cases with localized neurodermatitis were randomly divided into two groups by their visit order, 47 cases in each group. The cases in the treatment group were treated by bleeding method with a plum blossom needle, cupping method and moxibustion. The cases in the control group were treated by subcutaneous injection of Triamcinolone Acetonide Acetate Injection.

Results:After treatment, the curative rate and total effective rate were respectively 80.9% and 100% in the treatment group and were 48.9% and 87.2% in the control group. The differences in the curative rate and total effective rate between the two groups were statistically significant (P＜0.01,P＜0.05).

Conclusion:Bleeding method by a plum blossom needle, in combination with cupping method and moxibustion, is an effective therapy for localized neurodermatitis.