The Effect Of Plasma Cortisol In Patients With Chronic Urticaria After Chuankezhi Point Injected To Guan Yuan

ObjectiveThrough the clinical observation, define the clinic effect including the plasma cortisol level of Chuankezhi injection through acupoint injection mthod on patients with Chronic urticaria. Explore the mechanism of this treatment from the immunological level in order to guiding clinical therapy. And then add a new method treating this disease.Methods1.Collect 60 cases of patients with CU, and randomize to three groups, the treatment group 20 cases, and two control groups 20 cases in each group.Respectively, the three groups were given Chuankezhi injection, bcg-polysaccharide nucleic acid (BCG-PSN), physiolgical saline injection 2ml to inject into Guanyuan,2 times a week, and at the same time Mizolastine Sustained-release Tablets 10mg orally,1 times/day, a total of 4 weeks.2. Clinical observation:To evaluate the mark in zeroth,1,2,3,4 weeks and after stopping drug 2 weeks,4 weeks, the number, size of the nettle rash, degree of erythema, skin lesions itching degree rang score. After 4 weeks withdrawal, count recurrence.3.Observation index:Before treatment and after 4 weeks of treatment, detect the blood cortisol concentration values respectively.Results1. After treatment, the clinical symptom scores in three groups decreased obviously compared with pretreatment, the difference is statistically significant (P<0.05);Compared the clinical symptom scores after treatment between the three groups, Chuankezhi group and BCG-PSN group decreased more obviously than physiolgical saline control group, through the analysis of variance,the difference is statistically significant(P<0.05); But the Chuankezhi group compared with BCG-PSN, there was no significant difference.2. After 4 weeks treatment, Chuankezhi group 13 cases were cured,5 cases markedly effective,2 cases improved,0 cases ineffective, the total effective cases were 18 cases and the rate was 90%; BCG-PSN group 10 cases were cured,6 cases markedly effective,4 cases improved,0 cases ineffective, the total effective cases were 16 cases and the rate was 80%;physiolgical saline group 6 cases were cured,4 cases markedly effective,8 cases improved,2 cases ineffective, the total effective cases were 10 cases and the rate was 50%. The effective rate of Chuankezhi group and BCG-PSN group was significantly better than the physiolgical saline group, with significant difference (K<0.05); while compare the efficiency between Chuankezhi group and BCG-PSN group, the difference was not statistically significant (P>0.05).3. After 4 weeks treatment, the cortisol concentration in three groups increased obviously compared with pretreatment, the difference is statistically significant (P<0.05); Comparison of cortisol concentration between the three groups after treatment, Chuankezhi group than in two control groups increased obviously, the difference is statistically significant(P<0.05); BCG-PSN group compared with the physiolgical saline group increased more obviously.4. After 4 weeks treatment, compared the cortisol concentration between Chuankezhi group and the normal control group, no significant difference (P >0.05);The cortisol concentration in BCG-PSN group and physiolgical saline group were still lower than the normal control group, the difference is statistically significant (P<0.05).5. Stop drug 2 weeks after, the clinical symptom scores in Chuankezhi group were significantly lower than those of the physiolgical saline group, the difference was statistically significant (P<0.05), Chuankezhi group and BCG-PSN group was not significantly different (P>0.05); Stop drug 4 weeks after, The clinical symptoms of Chuankezhi group were significantly lower than those of the BCG-PSN and physiolgical saline control groups, the differences were statistically significant (P<0.05).6. Stop drug 4 weeks after, Chuankezhi group there were 2 cases of recurrence, the recurrence rate was 15.38%; BCG-PSN group there were 2 cases of recurrence,the recurrence rate was 20%; Physiolgical saline group there were 2 cases of recurrence, the recurrence rate was 33.33%; Comparison of recurrence rate between the three groups, the difference was not statistically significant (P>0.05).Conelusion1.Chuankezhi acupoint injection of Guan yuan combined with mizolastine in the treatment of patients with CU can significantly improve clinical symptoms, including reduced wheal number, reduce the degree of erythema, narrowing the scope of skin lesions, and relieve itching degree, effect is obviously better than that of physiological saline control group (P<0.05), no significant difference compared with BCG-PSN group (P>0.05).2. Chronic urticaria patients have abnormal immune system, the plasma cortisol concentration is lower than that of normal control group range, Chuankezhi acupoint injection of Guan yuan can obviously increase cortisol concentration, and regulate the immune system in patients with CU, the effect is obviously better than that of BCG-PSN group and physiolgical saline group (P均<0.05).3. Chuankezhi acupoint injection of Guan yuan combined with mizolastine in the treatment of patients with CU can significantly improve clinical symptoms after 4 weeks withdrawal, the effect is obviously better than that of physiolgical saline grou(P<0.05) p, and no significant difference compared with BCG-PSN group (P>0.05).To prevent the recurrence of chronic urticaria compared with BCG-PSN group and the saline group had no significant difference (P均>0.05).