杨沫 黄瑞信 王云 石瑜
（本论文荣获“第五届兰茂论坛”优秀论文二等奖）
摘要：目的：比较火针结合刺络拔罐与单纯刺络拔罐在治疗实热性脓疱型痤疮的疗效差异，诣在为临床治疗该病并提高疗效提供依据。方法：将64例实热性脓疱型痤疮患者随机分为火针结合刺络拔罐治疗组以及单纯刺络拔罐对照组，每组32例。治疗组采用火针点刺脓疱处阿是穴并结合刺络拔罐治疗，7天治疗1次，4次为1个疗程。对照组采用单纯刺络拔罐法，7天治疗1次，4次为1个疗程。2个疗程后进行疗效对比并进行统计学分析。结果:治疗组32例治愈率为28.12%，总有效率93.7%；对照组32例治愈率为6.3%，总有效率75%。治疗组治愈率及总有效率均显著高于对照组（P<0.05）。结论：火针结合刺络拔罐法治疗实热性脓疱型痤疮具有较好的临床疗效，且操作简便、安全，病人容易接受，临床易于推广。该治疗方法为临床治疗实热性脓疱型痤疮开辟了一条新的治疗途径。
关键词：火针；刺络拔罐 ；实热性脓疱型痤疮
Abstract:Objective: To compare the efficacy of fire needle combined with pricking cupping and simple puncture and cupping in the treatment of pustular acne with solid heat,Conclusion it provides a basis for clinical treatment of this disease and improving its curative effect.Methods:A total of 64 patients with pustular acne with solid heat were randomly divided into a combination of fire acupuncture and cupping therapy group and a control group with simple puncture and cupping,32 cases in each group.The treatment group was treated with acupuncture point prismatic pustule and was treated with acupoint, 1 time in 7 days, and 1 course of treatment 4 times. In the control group, the simple method of cupping therapy was used, 1 time in 7 days, and 1 course of treatment 4 times. After 2 courses, the efficacy was compared and statistical analysis was performed.Result:The cure rate of 32 cases in treatment group was 28.12%,The total effective rate was 93.7%.the cure rate of 32 cases in the control group was 6.3%,The total effective rate was 75%.The cure rate and total efficiency were significantly higher in the treatment group than in the control group（P<0.05）.Conclusion:The combination of fire needle and pricking cupping therapy can be used to treat realhot pustular acne with better clinical efficacy,And the operation is simple and safe,Patients are easy to accept,and it is easy to popularize in clinic.The treatment method provides a new therapeutic approach for the clinical treatment of the real hot pustular acne.
Keywords: fire needle, pricking cupping , pustular acne with solid heat
痤疮是一种毛囊、皮脂腺的慢性复发性炎性皮肤病【1】。皮损主要表现为粉刺、丘疹、脓疱、结节、囊肿等，部分遗有瘢痕。好发于面颊、额部，其次是胸背部及肩部，对称分布，常伴有皮脂溢出【2】。主要好发于青春期男女，特别是中重度痤疮，由于出现囊肿、瘢痕、结节等对面部皮肤的损害，严重影响了患者的容貌，对青春期男女的心理健康、自信心和社会交往都带来很大的影响。我们通过临床实践研究及观察，采用火针结合刺络拔罐法治疗实热性脓疱型痤疮得取了较好的临床疗效。现报道如下。
1.临床资料
1.1一般资料
64例患者均来自于云南中医学院门诊部及圣爱中医馆门诊，采用随机数字表，将64例患者分为两组，其中治疗组32例，对照组32例。两组患者从性别、年龄、病程及皮损数目上进行对比，经统计学处理（均P>0.05），无明显差异，具有可比性。见表1。
治疗组与对照组一般资料对比表1
|
组别
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例数（n）
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性别（男/女）
|
年龄（岁）
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病程（年）
|
皮损数目
|
|
治疗组
|
32
|
13/19
|
22.46±3.72
|
1.4±0.7
|
23.93±5.17
|
|
对照组
|
32
|
11/21
|
21.83±2.92
|
1.3±0.9
|
24.19±4.32
|
1.2诊断标准
全部病例均符合国家中医药管理局《中医病证诊断疗效标准》中“痤疮”的诊断标准【3】，并且按赵辨《临床皮肤病学》中痤疮分类及痤疮改良的Pillsbury4级分级法【4】进行诊断分级。①轻度（Ⅰ级）：以粉刺为主，少量丘疹和脓疱，总皮损数少于30个；②中度（Ⅱ级）：有粉刺，中等数量的丘疹和脓疱，总皮损数在31--50个之间；③中度（Ⅲ级）：大量丘疹和脓疱，分布广泛，总皮损数在51--100个之间，结节少于3个；④重度（Ⅳ 级）：结节性、囊肿性或聚合性痤疮，皮损数大于100个，结节或囊肿多于3个。
1.3纳入标准
①符合国家中医药管理局《中医病证诊断疗效标准》中痤疮脓疱型的诊断标准【3】，并按赵辨《临床皮肤病学》Pillsbury分级属于中度Ⅱ级和Ⅲ级及重度Ⅳ级者【4】。②年龄在18-35之间，男女不限；③能接受治疗者，签署知情同意书；④治疗期间停止使用与本疾病治疗有关的其他内服及外用药物；⑤排除严重器质性病变，排除高血压，糖尿病，孕期、经期及哺乳期妇女。