| BackgroundChronic urticaria(CU)is a common dermatological chronic disease.Studies have found that at least 20%of people have suffered from urticaria in their lifetime.The prevalence of chronic urticaria is higher in Asia than in Europe and North America.Chronic urticaria can occur at any age,and the incidence is higher in women than in men.Chronic urticaria is characterized by the sudden appearance of transient wheals on the skin and mucous membranes,rashes of varying sizes and shapes accompanied by severe itching and indefinite lesions,which can subside spontaneously within 24 hours.This disease has a complicated etiology and delayed healing.The etiology and pathogenesis of this disease remains unclear in modern medicine.Clinically,antihistamine or its combination with other drugs is used as the primary treatment method.Antihistamine takes effect rapidly,but there are certain side effects,and it is prone to drug resistance and a high recurrence rate.Chinese medicine practitioners have profound experience in treating chronic urticaria.In recent years,a large number of studies have confirmed that acupuncture is safe and effective in treating chronic urticaria,with a low recurrence rate,few side effects,and long-term efficacy.In investigating the effects of acupuncture,it would provide great clinical promotion value.ObjectiveLai’s Tong Yuan acupuncture is a kind of acupuncture therapy established by Professor Lai,a famous Chinese medicine practitioner,combining with years of clinical experience.This acupuncture method has been used in clinical practice for many years,with a wide range of indications,outstanding curative effects,and simple operation.It has a significant effect on the treatment of chronic urticaria.A randomized controlled trial design was chosen in this study.The goal is to observe and compare the clinical effects of Lai’s Tongyuan Acupuncture and conventional acupuncture in the treatment of chronic urticaria.To conduct a preliminary study and analysis on the clinical effects and safety of Lai’s Tongyuan Acupuncture for chronic urticaria,and to provide effective treatment options for the clinical treatment of this disease as well as a precise reference for its clinical application.MethodAll the participants in this study were diagnosed with chronic urticaria.They were recruited at Dr.ACM,Xiao Ling Chinese medicine clinic,Jiangnan Xiu Chinese medicine clinic,and publicly recruited patients in Hong Kong from January 2019 to January 2020.A total of 120 patients were included and randomly divided into two groups based on a ratio of 1:1,each group having 60 cases.The observation group was treated with Lai’s Tongyuan Acupuncture,while the control group was treated with conventional acupuncture.Acupuncture points in the observation group(Lai’s Tongyuan Acupuncture)included:Qihai,Guanyuan,Quchi bilateral,Hegu bilateral,Xuehai bilateral,Zusanli bilateral,and Sanyinjiao bilateral.Acupuncture points in the control group(conventional acupuncture)included:Quchi bilateral,Hegu bilateral,Xuehai bilateral,Geshu bilateral,Sanyinjiao bilateral,Waiguan bilateral,and Fengchi bilateral.In both groups,the acupuncture needle was bent,lifted,thrust,and rotated until patients experienced a sensation,then the treatment was retained for 30 minutes.Acupuncture treatment were performed three times per week.4 weeks is considered as one course,a total of 2 treatment courses with 24 acupunture sessions was conducted.The followup consultation was arranged at the 4th week after treatment was completed.The main evalution tool of the curalative effects was calculated by urticaria activity score(UAS),and the secondary indicators include dermatology life quality index(DLQI),urticaria symptom rating(MILOR),and anxiety and depression score(HAD).Patients in two groups were scored four times:before treatment,after the first course,after the second course and follow-up.The changes before and after the treatment in between the groups were compared,and clinical data of two groups were collected.SPSS22.0 software was used to analyze the data,to conduct a preliminary study and analysis on the clinical effect and safety of Lai’s Tong Yuan Acupuncture for chronic urticaria.Result(1)Completion rate:A total of 120 cases were included in this study and randomly divided into two groups,60 each.Nine people dropped out in the observation group,and 11 dropouts in the control group.In the end,there were 100 complete cases,51 in the observation group,49 in the control group.The completion rate between the two groups is statistically the same(P>0.05).(2)Demographic Data:There was no significant difference between two groups in basic information such as marital status,education,occupation,allergy history,gender,age,and course of disease(P>0.05).Before treatment,there was no significant difference in the UAS,DLQI,MILOR,HADa and HADd scores between two groups(P>0.05),which were comparable.(3)UAS score:i.Comparison within the groups:Compared with the baseline,UAS scores of the acupuncture groups after the first and second courses of treatment,and at follow-up were significantly different from the baseline(P<0.01).It suggests that the two acupuncture methods had a significant improvement in urticaria activity.At follow-up,UAS scores of both groups increased,but there was no statistical difference(P>0.05).ii.Comparison between the groups:The results suggested that after two courses of treatment and at follow-up,two groups showed significant differences in the decline of UAS scores(P<0.05),and the decline in the observation group was more significant than the control group.iii.Comparison of score differences between groups:The declines in two groups after two courses of treatment and at follow-up were significantly different(P<0.05).At follow-up,the UAS scores of both groups increased.However,the increase of the Lai’s Tong Yuan group was relatively flat,indicating that the observation group was better than the control acupuncture group in improving urticaria activity and delaying its recurrence and efficacy.(4)DLQI score:ⅰ.Comparison within the groups:Compared with baseline,DLQI scores of two groups after the first and second courses of treatment and at follow-up were significantly different from baseline(P<0.05),suggesting two acupunctures had a significant improvement in the life quality.At follow-up,DLQI score of the observation group increased,but there was no statistical difference(P>0.05).In contrast,the increased DLQI score of the control group had a significant difference(P 0.01),suggesting that the maintenance effect of Lai’s Tong Yuan Acupuncture was better in terms of improvement of life quality.ⅱ.Comparison between the groups:The results suggested that after the first and second courses of treatment and at follow-up,DLQI scores of two groups were statistically different(P<0.05).ⅲ.Comparison of score differences between groups:There was no significant difference in declines in DLQI scores between two groups after one course of treatment(P>0.05).After two courses of treatment and at follow-up,there was a significant difference in declines in two groups(P<0.05).At follow-up,DLQI scores of both groups increased,but the trend of Tong Yuan group was relatively flat,indicating that the observation group was better than the control acupuncture group in improving life quality and delaying its recurrence.(5)MILOR score:ⅰ.Comparison within the group:Compared with baseline,MILOR scores of the two groups after the first and second courses of treatment and at follow-up were statistically different from the baseline(P<0.01),indicating that both groups had obvious effects after acupuncture treatment.At follow-up,the MILOR scores of both groups increased,but there was no significant difference in the increase in Tong Yuan group(P>0.05),while there was a significant difference in the control group(P<0.05).ⅱ.Comparison between groups:The results suggested after the first and second courses of treatment,and at follow-up,there was statistical significance between the two groups(P<0.05).ⅲ.Comparison of score differences between groups:After the first course of treatment,there was no significant difference in the decline of MILOR scores between two groups(P>0.05),the trend in the Lai’s Tong Yuan group was more significant.After the second course of treatment and at follow-up,there was a significant difference in decline in two groups(P<0.05).At follow-up,MILOR scores of both groups increased.However,the trend of the Tony Yuan group was relatively flat,indicating that treatment had a better effect on the improvement of wheal size,duration,and frequency of urticaria.(6)HADa score:ⅰ.Comparison within the group:Compared with baseline,the HADa score after the first and second courses of treatment and at follow-up was significantly different from baseline(P<0.05),indicating that there were obvious treatment effects in both groups after acupuncture treatment.At follow-up,the HADa score of the Lai’s Tong Yuan group was significantly different from baseline(P<0.01),while the control group was not statistically significant(P>0.05).ii.Comparison between groups:There was a significant difference between the two groups after the second course of treatment,and at follow-up(P<0.05),the decline of Lai’s Tong Yuan Acupuncture HADa score was more obvious.iii.Comparison of score differences between groups:After two courses of treatment and at follow-up in two groups,the difference between groups was statistically different(P<0.01).At follow-up,the HADa scores of both groups increased,but the trend in the Lai’s Tong Yuan group was relatively flat,indicating that the observation group has notable advantages in treating anxiety and delaying its recurrence.(7)HADd score:i.Comparison within the group:Compared with baseline,the HADd score after the first and second courses of treatment and at follow-up was statistically different from baseline(P<0.05),indicating that there were obvious treatment effects in both groups after acupuncture treatment.At follow-up,HADd scores of both groups increased,but there was no significant difference between the two(P>0.05).ii.Comparison between groups:There was a significant difference between the two groups after two courses of treatment and at follow-up(P<0.05).The decline of the HADd score of Lai’s Tong Yuan Acupuncture was more significant compared to the control group.iii.Comparison of score differences between groups:There was a statistical difference between the two groups after two courses of treatment and at follow-up(P<0.05).At the follow-up stage,the HADd scores of both groups increased,but the trend of Lai’s Tong Yuan group was relatively flat,indicating that Lai’s Tong Yuan acupuncture method had a better effect on the improvement of depression.(8)Assessment of total effective rate:After the patient completed the treatment,the total effective rate in Lai’s Tong Yuan group was 88.24%,while the control group was 79.60%,with statistical differences(P<0.05).The curative effect in Lai’s Tong Yuan group was 49.02%,while in the control group the effective rate was 44.90%.All the above suggest that the Lai’s Tong Yuan group has better curative effect.(9)Comparison of recurrence rates:After the patient completed the treatment,the patients were brought in for a follow up in the fourth week.The results showed that the recurrence rate in Lai’s Tong Yuan group was 17.78%,while that in the control group was 38.46%.There is statistical significance in recurrence rates between two groups(P<0.05),suggesting the recurrence rate in Lai’s Tong Yuan group was significantly lower than that in the conventional acupuncture group.(10)Assessment of safety:During the study,a small number of patients presented slight localized pain or bleeding after acupuncture removal,which could be relieved after hemostasis by pressure.No other acupuncture accidents or adverse reactions occurred in patients in both groups,and no aggravation occurred,suggesting that acupuncture methods were safe and effective.Conclusion.(1)The Lai’s Tong Yuan acupuncture has obvious curative effect on chronic urticaria,which can effectively improve the symptoms of urticaria pruritus and swelling,and can improve the quality of life and anxiety and depression of patients.The total effective rate was 88.24%,and the significant effect rate was 49.02%,without any worsening cases.(2)Compared with the conventional acupuncture group,the Lai’s Tong Yuan acupuncture has a more significant therapeutic advantage.The Tong Yuan acupuncture has a more significant effect on chronic urticaria and retains its effect,and the healing rate is more noticeable.It also has a significant effect on improving anxiety and depression in patients,which fully reflects the advantages of Tong Yuan acupuncture on the physical and mental regulation of chronic urticaria patients.(3)Lai’s Tong Yuan acupuncture is highly safe in treating CU.There were no acupuncture accidents and other adverse reactions in the two groups,and there was no exacerbation in both groups,suggesting that the acupuncture methods in both groups are safe and effective.(4)The experimental research process is smooth,indicating that it is highly feasible to conduct large-scale randomized controlled trials in the future.The content of this research also provides a reference for the formal future large scale trials.(5)The Lai’s Tong Yuan acupuncture method has outstanding clinical effects on chronic urticaria,also it is safe,convenient,and has a low recurrence rate.It is worth a clinical promotion.The Tong Yuan acupuncture mechanism needs further exploration and research in the future. |
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