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J. Acupunct. Tuina. Sci. 2011, 9 (3): 152-153 DOI: 10.1007/s11726-011-0496-2

Special Topic Study

Clinical Observation of Auricular Bloodletting Therapy for Chloasma in 30 Cases

耳部放血治疗黄褐斑 30 例临床观察

Zhang Bimeng (张必萌), Xu Siwei (徐斯伟), Zhang Wei (张为) No.1 People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, P. R. China

AbstractObjective: To observe the clinical efficacy of auricular bloodletting therapy in the treatment of chloasma. Methods: Thirty cases of chloasma were treated by auricular bloodletting therapy. Results: Eight cases obtained basic cure, 10 cases marked improvement and 8 cases improvement; the total effective rate was 86.7%. Conclusion: Auricular bloodletting therapy is quite effective for chloasma, with no side effects. Key WordsMelanosis; Acupuncture, Ear; Acupuncture Therapy 摘要目的:观察耳部放血疗法治疗黄褐斑的临床疗效。方法:将 30 例黄褐斑患者应用耳部放血法治 疗。结果:基本治愈 8 例,显效 10 例,好转 8 例,总有效率为 86.7%结论:耳部放血疗法治疗黄褐斑 疗效确切,且无明显不良反应。 【关键词】黑变病;针刺,耳;针刺疗法 【中图分类号R246.7 文献标志码B

Chloasma is a common skin disease with acquired pigmentation, which mostly affects the face symmetrically, like a butterfly wing in shape; hence it is also called butterfly macules. Chloasma is more commonly seen on the nose, forehead, cheeks and mouth, without any subjective symptoms. The skin lesion is light or dark brown pigmentation macules, with clear border, smooth surface, absence of scale, worsening by exposure to sunlight. It is one of the diseases that affect the beauty of the young and middle-aged women. Presently, modern medicine has many methods for chloasma, and has some positive results; but some side effects occur and chloasma frequently recurs. We treated chloasma by auricular bloodletting therapy and reported as follows.

1 Data and Methods

1.1 Diagnostic criteria

Chloasma is confirmed in the light of the "Criteria of Chloasma for Clinical Diagnosis and Effects Evaluation" [1] . Chloasma appears on the face symmetrically in light or dark brown macules, with clear borders, absence of inflammatory symptoms and squama. Chloasma is usually asymptomatic and develops in

Author: Zhang Bimeng, doctor of medicine, associate chief phyisican

postpuberty women. It often worsens in summer and relieves in winter. The hyperpigmentation caused by such diseases as naevus fusco-caeruleus zygomaticus, Riehl melanosis and pigmentary actinic lichen planus are ruled out.

1.2 General data

Thirty cases were all the outpatient women from the department of dermatology in our hospital. All the patients were diagnosed according to the fore- mentioned criteria. The youngest was 22 years old and the oldest was 48 years old; the shortest duration was 5 months and the longest duration was 10 years.

2 Treatment Methods

Auricular point: Rexue (a point located in the inner aspect of the superior antihelix crus) (Fig.1). Techniques: The auricle was disinfected with iodine and then cleansed with 75% alcohol. After sterilizing the hands, the practitioner held the patient’s auricle with his left hand, and held a three-edged needle with the right hand to swiftly pricked point Rexue about 0.1 cm, and then squeezed the point to let out two or three drops of blood; the blood was cleaned with alcohol cotton and the point was pressed with sterilized dry cotton for about 1min. The ears were treated alternately; the treatment was conducted once every other day and ten treatments made up one course.

152 © Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2011

J. Acupunct. Tuina. Sci. 2011, 9 (3): 152-153

J. Acupunct. Tuina. Sci. 2011, 9 (3): 152-153 Fig.1. Location of Rexue 3 Therapeutic Outcomes 3.1

Fig.1. Location of Rexue

  • 3 Therapeutic Outcomes

    • 3.1 Criteria for effects evaluation

The therapeutic effects were evaluated in accordance with the "Criteria of Chloasma for Clinical Diagnosis and Effects Evaluation" [1] . Basic cure: The area of macule reduces >90%; pigmentation basically disappears. Marked effectiveness: The area of macule reduces >60%, and 90%; pigmentation obviously lightens. Improvement: The area of macule reduces >30%, and 60%; pigmentation lightens. Failure: The area of macule reduces 30%; pigmentation lightens little.

  • 3.2 Results

Eight cases achieved basic cure, 10 cases marked effectiveness, 8 cases improvement, 4 cases failure; the total effective rate was 86.7%. No significant side effects were found in these cases.

  • 4 Discussion

Modern medicine holds that the pathogenesis of chloasma is complicated, and its real origin remains unclear at present; its primary causes include endocrine disorder, heredity factors and ultraviolet radiation [2-4] . Currently, modern medicine targets to inhibit the activity of melanocyte, suppress the synthesis of melanin, remove the produced melanin, destroy melanin granules and prevent the skin from exposure to the sunlight. However, long-term use of internal and external therapies may give rise to some side effects. In Chinese medicine, chloasma is related to the liver, spleen and kidney. It usually results from fire transformed from liver-qi stagnation, liver-kidney insufficiency, or spleen failure to process, which causes qi-blood stagnation and subsequently qi-blood fail to nourish the face. Chloasma presents its cardinal symptoms on the skin, but in origin it is caused by abnormal qi-blood flow due to visceral dysfunction.

Ear acupoints are some specific parts on the auricle. When people get sick, certain points on the auricle become tender and sensitive; these points are the positive reactive points of diseases, and it is also the stimulation points in treating diseases [5,6] . Bloodletting therapy at the auricular acupoints can clear depression heat, activate blood and resolve stasis. Modern researches have demonstrated that acupuncture can regulate the endocrine function of pituitary to promote the pituitary to secrete anti-melanocyte stimulus, reduce the secretion of melanin, and regulate skin nutrient supply to remove melanin [7] . Bloodletting therapy at auricular acupoints for chloasma reflect the holism and syndrome- differentiation theory in Chinese medicine; it is effective, convenient to act on chloasma in diverse pathways [8,9] . This study shows that the clinical efficacy is related to patient’s age and duration; the younger and shorter duration the patient is, the better efficacy is. Analytically, for these patients, pathogenic factor is in shallow body, and healthy qi is adequate. Therefore, the pathogenic factor is easily expelled out.

References

[1] Pigment Group, Dermatology and Venereology Committee, China Society of Integrative Chinese and Western Medicine. Criteria of chloasma for clinical diagnosis and effets evaluation. Zhong Hua Shi Yi Zhen Liao Ji Shu, 2005, 23(1): 52. [2] Wang XH. Treatment of 35 cases of chloasma by blood-activating and stasis-resolving therapy. Ji Lin Zhong Yi Yao, 2003, 23(3): 30-31. [3] Zhang SJ. Syndrome differentiation of chloasma and its blood rheology analysis. Zhong Guo Zhong Yi Ji Chu Yi Xue Za Zhi, 1998, 4(11): 36-38. [4] Yang HL, Feng SY, Liao YX, Lin T, Shi ML. Epidemiological survey of the pathogenesis of chloasma in Guangzhou. Lin Chuang Pi Fu Ke Za Zhi, 1996, (2): 89-90. [5] Yuan X. Clinical observation on acupuncture plus auricular point sticking in treating insomnia. J Acupunct Tuina Sci, 2010, 8(5): 302-303. [6] Pei Y, Wang WM. Observations on the efficacy of acupuncture plus auricular point magnetic bead plaster therapy in treating insomnia. Shang Hai Zhen Jiu Za Zhi, 2009, 28(11): 629-631. [7] Feng M, Chang YJ, Gao X, Hu YG. Research advance of chloasma treated by acupuncture. Shang Hai Zhen Jiu Za Zhi, 2007, 26(3): 46-48. [8] Wang JL. Treatment of 30 cases of acne by bloodletting therapy at ear apex and acupuncture. Shang Hai Zhen Jiu Za Zhi, 2008, 27(12): 32. [9] Yang Y. Treatment of 40 cases of chloasma by acupuncture and auricular bloodletting therapy. Shang Hai Zhen Jiu Za Zhi, 2009, 28(4): 234.

Translator: Xiao Yuanchun (肖元春) Received Date: December 8, 2010

© Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2011153