abstracted & translated by
Honora Lee Wolfe, Lic. Ac., FNAAOM (USA)

Keywords: Chinese medicine, acupuncture, dermatology, acne, network vessel bleeding

On page 42 of issue #4, 2004 of Ji Lin Zhong Yi Yao (Jilin Chinese Medicine & Medicinals), Pang Hu and Han Gen-yan titled, "The Treatment of 93 Cases of Acne Mainly with Network Vessel Bleeding." As part of my on-going efforts to rehabilitate the technique of bleeding within acupuncture-moxibustion, a summary of this study is presented below.

Cohort description:

There were 50 males and 43 females aged 16-30 years old enrolled in this study. These patients had suffered from acne for from three weeks to 10 years. Forty-two had papular acne, 30 had pustular acne, 12 had cystic acne, five had necrotic acne, and four had a combination type of acne.

Treatment method:

The four points 0.5 inches lateral to Da Zhui (GV 14) and Tao Dao (GV 13) were chosen for network vessel bleeing. After disinfecting with alcohol and numbing with a local subdermal anesthetic, one set of these points was punctured with a three-edged needle and encouraged to bleed by the application of fire cups.  After 1-2ml of blood was withdrawn, the points were disinfected again and dressed. Every five days, this treatment was done one time, alternating the points that were bled. Five times equaled one course of treatment. During this therapy, patients were forbidden to eat uncooked, chilled, fishy, or acird, spicy foods. In addition, all these patients received the following basic herbal decoction:

Bai Hua She She Cao (Herba Oldenlandiae Diffusae Cum Radice), 30g

Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi), 18g

Ze Xie (Rhizoma Alsimatis Orientalis), 15g

Zhi Zi (Fructus Gardeniae Jasminoidis), 12g

Long Dan Cao (Radix Gentianae Scabrae)

Dan Shen (Radix Salviae Miltiorrhizae)

Chi Shao (Radix Rubrus Paeoniae Lactifloae)

Huang Qin (Radix Scutellariae Baicalensis), 10g each

Chai Hu (Radix Bupleuri), 5g

uncooked Gan Cao (Radix Glycyrrhizae Uralensis), 5g

If there were papular lesions, 15 grams of Fu Ling (Sclerotium Poriae Cocos) and 12 grams of Bai Zhi (Radix Angelicae Dahuricae) were added. If there were pustular lesions, 12 grams of Jin Yin Hua (Flos Lonicerae Japonicae) and 30 grams of Pu Gong Ying (Herba Taraxaci Mongolici Cum Radice) were added. If there were cystic lesions, 18 grams of Zao Jiao Ci (Spina Gleditschiae Sinensis) and 12 grams each of Tao Ren (Semen Pruni Persicae) and Hong Hua (Flos Carthami Tinctorii) were added. If there were necrotic lesions, 30 grams of Bai Jiang Cao (Herba Patriniae Heterophyllae) and 15 grams of Yu Xing Cao (Herba Houttuyniae Cordatae Cum Radice) were added. If there was a combination of these types of lesions, nine grams each of San Leng (Rhizoma Sparganii Stoloniferi) and E Zhu (Rhizoma Curcumae Zeodariae) were added. Presumably one packet of these medicinals was administered as a water decoction per day. Results were analyzed after two courses of treatment, i.e., 50 days.

Study outcomes:

Cure was defined as complete disappearance of the acne in the affected areas with purulent lesions scabbing within 15 days and the skin resuming its normal moisture and sheen, and no recurrence on follow-up after one year. Marked effect was defined as basic disappearance of the acne lesions. However, there were some small scars, but there was no recurrence on follow-up after one year. Improvement meant that the large part of the acne lesions had disappeared, but new lesions were still being produced. Nevertheless, the patient’s condition was marked better than before. Patients were also categorized with this result if they had a recurrence of their acne after discontinuing treatment but the outbreak was markedly less than before. No effect meant that there was no obvious change for the better in the symptoms or they got worse. Based on these criteria, 52 cases were judged cured (55.9%), 21 got a marked effect (22.6%), 16 improved (17.2%), and only four (4.3%) got no effect. Therefore, the total effectiveness rate of this protocol was published as 95.7%.

Discussion:

According to the authors, Drs. Pang and Han, acne corresponds to what is called in Chinese medicine literally "lung wind flour [or powder] thorns" and "facial sores." It is mostly due to lung channel wind heat steaming and fuming and/or over-eating acrid, spicy, oily, greasy foods. In the latter case, damp heat toxins then brew and steam the skin. If heat evils are blazing and exuberant, there will be diffuse, red, papular lesions. If dampness is heavy, turbidity is sticky and stagnant, and the disease is enduring, dampness gathers and mixes with phlegm, congeals and stagnates, and gives rise to cystic nodules. If severe, the movement of the qi and blood in the affected area becomes unsmooth or uneasy. This gives rise to qi stagnation and blood stasis which leads to hard nodules which are slow growing but recalcitrant and difficult to heal.

Because this condition tends to be chronic and enduring, Drs. Pang and Han posit that enduring disease (i.e., heat evils) have entered the network vessels and engendered static blood. Therefore, they believe that network vessel bleeding is particularly indicated for its remedy. This is based on the saying from the Nei Jing (Inner Classic), "[One should] eliminate that which is firm [or well established] and aged." Da Zhui and Tao Dao are both points on the governing vessel, and they can both be used to diffuse the lungs, clear heat, and drain fire. The governing vessel ascends and moves to the crown of the head where the meeting of all yang is located. Network vessel bleeding these points can, therefore, drain yin evils from within the yang. Thus fire evils can no longer steam upward to the face and new lesions are no longer produced. Further, within the acne herbal formula, Bai Hua She She Cao is the sovereign ingredient. It has the effect of clearing heat, eliminating dampness, resolving toxins, and dispersing welling abscesses. It is assisted by Bai Xian Pi, Zhi Zi, Ze Xie, Chi Shao, and Huang Qin which clear heat, cool the blood, eliminate dampness, and resolve toxins. When these two types of therapy are combined, they have the effect of draining fire, resolving toxins, dispelling stasis, and freeing the flow of the network vessels.

Copyright © Blue Poppy Press, 2005. All rights reserved.

For more information on the Chinese medical treatment of acne, see Liang Jian-hui’s A Handbook of Traditional Chinese Dermatology available from Blue Poppy Press.