Research For DangGuiYinZi Plus Formula In Treatment Of Dermatosis

Pathogenic factors and mechanisms leading to dermatosis are both complicated and diverse.Patients may show symptoms such as skin lesions, conscious awareness of symptoms,whole body symptoms,as well as changes in tongue appearance,pulse quality,and physical characteristics.As both skin diseases and individuals vary,the external manifestations of the dermatosis are also unique.In Chinese medicine,the etiology and pathogenesis of dermatosis,the same as most diseases,begins with viewing the body as a whole system.Although dermatosis is known to appear on the epidermis,most of its underlying pathogenic factors are due to the partial exuberance or partial debilitation of the body's internal Yin,Yang,Qi, and Blood,leading to disharmony in the functioning of the bowels and viscera. Despite the fact that there are many types of skin diseases,each with a unique set of causes and symptoms,there must still be a certain level of regularity.In the course of treatment,Chinese medicine on one hand uses the appearance of the damage to the skin in classifying the disease pattern, and on the other hand takes a view of the entire body to make a clear differentiation between yin and yang,hot and cold,external and internal, vacuity and repletion,qi and blood,root and tip,as well as all related organs,viscera,channels and network vessels.In clinical practice,having a firm grasp on the regulated method of a full body system perspective,and the process of Chinese medicine's pattern classification and treatment is necessary in classifying and treating any disease.Regardless of how complex the changes of the skin disease may be,by following these principles and the established medical formula,great results can be achieved.This paper gathers information on and researches two different types of skin diseases: Yin vacuity with blood dryness pattern and blood vacuity with dry-wind pattern.Treatment was based on the nourishing blood and moistening dryness, boosting qi and nourishing yin,clearing heat and resolving toxin,cooling and quickening the blood principles.Treatment used DangGuiYinZi plus formula,and there is a discussion of its efficacy.The literary portion of this research first makes a full review of Traditional Chinese Medicine theory in treating dermatosis.It consists of: (Ⅰ)Etiology and pathogenesis of dermatosis.Both classical and modern doctors think that skin diseases can be classified the same as other types of internal medicine diseases.The internal factors causing disease are: internal injury to the seven affects,developing on the internal bowels and viscera,and appearing on the exterior limbs and body;dysregulation of food consumption;and excessive sexual behavior.The external factors are: external contraction of the six excesses,beginning in the channels and network vessels,and developing on the organs and viscera;animal and insect toxins,and laceration or pressure.(Ⅱ)Method of classifying dermatosis: classification should rely on observation of changes in the tongue,pulse, and other symptoms as reactions to the root cause.Additionally if other internal diseases are identified,it is important to categorize the quality and relationship of yin and yang,bowels and viscera,qi and blood,channels and network vessels when establishing the medicinal treatment.Another special characteristic of skin disease is that its appearance is visible to the naked eye.In addition to looking carefully at the skin lesions, the patient's description of sensations such as itchiness,pain,and numbness can also be a reliable reference in making diagnosis,tn examining the skin lesions and determining the patient's condition,there must be a very careful study of:the patterns(such as macula,papules,blisters, pustules,wheal,nodules,pityriasis,erosion,scabbing,ulcers,pus secretions,etc.),the color(such as white,bright red,pink,dark red, dark black,developing darkness or brightness),and the quantity and distribution of lesions over the body.(Ⅲ)Prevention and care of dermatosis:diet should include adequate intake of nutrition and an understanding of beneficial or harmful foods,lifestyle and environmental aspects should pay attention to avoiding residence receiving wind,cold, summer heat,dampness,dryness,fire,the six excesses,as well as parasite or animal toxins,and focus on environmental sanitation.From the point of view of the seven affects,it is important to regularly maintain a happy mood and avoid excessive feelings of joy,anger,anxiety,thought,sorrow, fear,and shock.Also appropriate levels of exercise,avoidance of both over exertion and exercise induced fatigue,can prevent occurrence of disease. In addition,there is a short discourse concerning medicinal treatment, acupuncture,and blood letting as used in the classical records by Chinese doctors in treating dermatosis.Secondly there is a literary review of modern Chinese medicine's use of acupuncture in treating dermatosis. Finally there is a literary review of modern Chinese medicine doctor's use of DangGuiYinZi in treating dermatosis.The second chapter includes a discussion of the DangGuiYinZi formula,as well as analysis of DangGuiYinZi and other added medicines.The third chapter is the research section,the purpose of the study is to test the effectiveness of DangGuiYinZi plus formula in treating a variety of skin diseases including:"Yin blood vacuity and dryness",or "blood vacuity with wind dryness",or a combination of wind and heat,or cold and wind,or stasis.Pattern identification is the essence of Chinese Medicine; it is Chinese Medicine's unique method of diagnosis and treatment.This research highlights the both the importance and relevance of pattern identification and differentiation in clinical diagnosis and treatment.The research methods target a group of 80 patients who received treatment from YangZhong Chinese Medical Clinic from March 2006 thru September 2007,and meet the standard criteria for diagnosis of dermatosis.Cases must meet a detailed list of inclusive criteria and exclusive criteria for selection. DangGuiYinZi plus ZiCaoGen(Radix Arnebiae seu Lithospermi),and DanShen (Radix Salviae Miltiorrhizae)was the standard treatment,patients with inclination to cold added GuiZhi(Cinnamomi Cassiae);patients with inclination to heat added JinYinHua(Lonicerae Japonicae);patients with intense heat added KuShenGen(Radix Sophorae Flavescentis),HuangLian (Rhizoma Coptidis);patients with extreme yin vacuity added HuangJing (Rhizoma Polygonati),XuanShen(Radix Scrophulariae Ningpoensis);patients with stasis added MuDanPi(Cortex Moutan Radicis),XiCao(Rubiaceae), ChiShao(Radix Paeoniae Rubrae);patients with extreme itching added BaiXianPi(Cortex Dictamni Dasycarpi Radicle)and increased the quantity of JiLi(Fructus Tribuli Terrestris).Taiwan ShunTian GMP Medical Manufacturing Company's DangGuiYinZi scientific medical powder concentration and other additive concentrations were used.Dosage depended on the patient's age,but daily dose shall not be less than 10 grams nor greater than 15 grams.The daily dosage was divided into three servings, each following one of the three daily meals,and taken with warm water. Patients were given seven days medication at a time,had one weekly follow-up appointment,and continued timely administration of all medication.One month was considered one course of treatment,and in accordance with regulations treatment was continued for two courses of treatment,A summary of the medicine's effects was determined upon completion of two courses of treatment.A standard for recurrence was set.In the three months following completion of treatment,all patients had a monthly follow-up observation and were classified as completely cured,clear effectiveness, or effectiveness.Evaluation standards of treatment effectiveness were performed on three levels:evaluation of the disease,evaluation of the main indicators,evaluation of secondary indicators,and Chinese medicine classification evaluation.As far as the data of the research population, statistics such as:name,sex,age distribution,course of disease, pre-treatment distribution of degree of dermatosis,pre-treatment level of classification by Chinese medicine,and any use of medication prior to treatment at the onset of the disease were all used during analysis.Chapter 4 the results of treatment,(Ⅰ)Evaluation of the treatment's effectiveness,combining assessment of level of skin irritation,area of the rash,and appearance of the rash to come up with a score,which rated the effectiveness and was divided into four levels.22 cases showing full recovery make up 27.50%of the total;31 cases showing clear effectiveness make up 38.75%;23 cases showing effectiveness make up 28.75%;4 cases showing no effect make up 5.00%;all together the efficacy rate is 95.00%. (Ⅱ)The key indicators of efficacy are the assessment of the area of skin lesions and level of skin irritation.Results of treatment effectiveness in area of the rash:29 cases of a complete clinical recovery,including one case of chapped skin where the rash was no larger than the palm of a hand,an efficacy rate of 36.25%;18 cases of clear effectiveness,an efficacy rate of 22.50%;29 cases of effectiveness,an efficacy rate of 36.25%;4 cases of no effect,a rate of 5.00%;all together the efficacy rate is 95.00%.Results of treatment effectiveness on skin irritation:38 cases of complete clinical recovery,including 4 patients with chapped skin on their hands and feet,but lacking skin irritation,an efficacy rate of 47.50%;17 cases of clear effectiveness,an efficacy rate of 21.25%;23 cases of effectiveness,an efficacy rate of 28.75%;2 cases of no effect,arate of 2.50%;all together the efficacy rate is 97.50%.(Ⅲ)With regards to efficiency of treatment on secondary indicators such as appearance of the rash:34 cases of complete recovery,an efficacy rate of 42.50%;11 cases of clear effectiveness,an efficacy rate of 13.75%;26 cases of effectiveness,an efficacy rate of 32.50%;9 cases of no effect,a rate of 11.25%;all together the efficacy rate is 88.75%.(Ⅳ)A total assessment of both the main disease classification and the secondary disease classification and the effectiveness of treatment as based on Chinese medicine's classification.According to Chinese medicine's classification,prior to treatment there were no cases of mild symptoms, 55 cases of moderate symptoms,making up 68.75%of the total;25 cases of severe symptoms,making up 31.25%of the total.In following the same assessment,post treatment patients showed,2 cases of complete recovery, 2.50%of the total;76 cases of minor symptoms,95.00%of the total;2 cases of moderate symptoms,2.50%of the total;no eases of severe symptoms were seen.The average value of Chinese medicine's main syndrome classification prior to treatment was 19.53±4.40,post treatment the average value was 5.19±3.28,a difference of 14.35±4.09,and an efficacy index of 73.45%.The t-test showed the effectiveness of treatment on the main classification, pre-treatment and post-treatment showed a remarkable difference(p＜0.05); The average value of Chinese medicine's secondary syndrome classification prior to treatment was 12.19±3.66,post treatment the average value was 3.76±2.30,a difference of 8.57±3.43,and an efficacy index of 70.26%.The t-test showed the effectiveness of the treatment on the secondary classification,pre-treatment and post-treatment showed a remarkable difference(p＜0.05).The average value of Chinese medicine's syndrome classification prior to treatment was 32.13±5.66,post treatment the average value was 9.03±5.06,a difference of 23.10±5.84,and an efficacy index of 71.91%.The t-test showed the effectiveness of the treatment on Chinese medicine's classification,pre-treatment and post-treatment showed a remarkable difference(p＜0.05).All of these have significant statistical meaning.Chapter 5 discusses the clinical effectiveness of DangGuiYinZi plus Formula,not only can it improve patient's signs and symptoms,but furthermore it can improve the patient's classified syndrome.Finally a comparative analysis of the effectiveness of DangGuiYinZi formula in improving Chinese medicine's syndrome classification and individual symptoms was performed.A clinical observation of treatment for symptoms and Chinese medicine's classification results showed that DangGuiYinZi plus formula had an overall efficacy rate of 95.00%against every skin disease.Regarding Chinese medicine's syndrome classification,the overall efficacy rate was 100%.Regarding the area of skin lesions,the overall efficacy rate was 95.00%.Regarding the level of skin irritation, the overall efficacy rate was 97.50%.Regarding the appearance of the rash the overall efficacy rate was 88.75%.This clearly illustrates that DangGuiYinZi plus formula has remarkable significance with regards to Chinese medicine syndrome classification.It also has equal significance with regards to the area of skin lesions and level of irritation.Only the appearance of the rash showed slightly poorer efficacy.Conclusion:Dermatosis is not merely a "superficial disease of the skin and hair." The process of occurrence and development of the disease is not solely caused by any one factor,often it is the result of two or more factors occurring at the same time.Therefore during treatment of dermatosis,proper pattern identification and investigation of the cause is very important. Besides observing superficial skin symptoms,such as area of skin lesions, level of irritation,and appearance of the rash,it is also important to rely on Chinese medicine's syndrome classification system with regards to the patient's yin,yang,qi,and blood as being partially exuberant or partially debilitated;or disharmony of the bowels and viscera;or disruption of the free coursing channels and network vessels;or the six excesses,parasitic toxins and so on that directly invade the body causing trauma.GaoJinTing in "Records of Clinical Treatment for Ulcers" says: "the man develops and external sore,is nothing more than yin and yang, hot and cold,vacuity and repletion,root and tip,or internal circulation disorder,thus all coming from the same source." Although various types of dermatosis have different characteristics and external appearance,in accordance with Chinese medicine's whole body concept,using the four diagnosis tools and the eight principles,yin and yang,hot and cold, external and internal,vacuity and repletion,qi and blood,root and tip, to summarize the classification and pattern identification leads to correct treatment.Carefully remember the concepts of one treatment for different diseases and one disease with different treatments.With flexible use of every type of medication the expected effect can easily be received,All of the different types of skin disease researched in this paper,according to the patient's symptoms and clinical presentation,the conclusion from the differentiation of Chinese medicine's classification were Yin vacuity with blood dryness,or blood vacuity with dry wind,thus DangGuiYinZi plus formula was selected for treatment.All 80 cases were assessed for treatment efficacy,and the overall efficacy rate was 95.00%.This confirms that for any disease the concepts from the foundations of Chinese medical theory and the system of pattern identification can be used.