Prof. Cai Ruikang's Academic Experience And Analyzation Of Differentiating Individual, Disease & Syndrome On The Patients With Keloids And Research Of Traditional Chinese Drug In Treating Topically Keloids

Objective:To summrize the academic experience of prof.Cai Ruikang in diagnosing and treating dermatosis,analyze the patients with keloids by differentiating individual,disease and syndrome,observe the clinical effect of topical therapy of self-made traditional Chinese drug and explore its functional mechanism.Methods:124 patients' body constitution types were researched according to＜TCM Classification Standards of Health＞.154 patients'overall and classified clinical data were analyzed. 154 patients were investigated whether they corresponded to＜Diagnostic Standards for Blood Stasis Syndrome＞or not and about accompanied syndromes.43 patients' hemorheological indexes were detected.5 patients' different types of lesions were evaluated with sonography and demoscopy equipments.Clinical curative effects on keloids with self-made drug were observed by randomized and controlled clinical trial. The drug action on the biological activity of keloid-derived fibroblasts were evaluated with regard to their appearance,proliferation,cytotoxicity and the expressions of typeⅠcollagen,matrix metalloproteinasel(MMP-1)and VEGF.Results:①Compared with the normal group,the percentage of wet-heat,blood-stasis,phlegm-wetness,yin-deficiency, special diathesis and qi-deficiency types increased in the patients with keloids.The percentage of wet-heat type increased in male and female patients,at the 17-45 years of age.The percentage of blood-stasis,phlegm-wetness,yin-deficiency and special diathesis types increased in male patients,at the 36-45 years of age.The percentage of phlegm-wetness and yin-deficiency types increased in the patients at the 17-25 years of age.Compared with the patients with acne,the percentage of yin-deficiency type increased in the patients with acne associated keloids(p＜0.05).②81.17%of the patients had their disease started between the ages of 11 and 30 years,and 25.97%had the positive family history of keloid.Chest,back and submaxilla area were the most common sites for scarring.The major initiating factors of scarring were acne(48.70%) and folliculitis(35.71%).Multiple keloids on the chest,back and submaxilla related to acne(87.50%),solitary keloid on the chest to folliculitis(54.90%)and scratching (23.50%),multiple keloids on the limbs and mixed type to scar physique,solitary keloid on any part except chest to surgery.③99.35%of the patients with blood-stasis syndrome and 61.44%,34.64%,26.80%,1.31%with wet-heat,qi-stagnancy, phlegm-wetness,qi-deficiency syndrome were successively observed.Compared with normal group,the number of the patients being detected four elevating hemorheological indexes increased(p＜0.05).Blood or arterial blood shortage was presented in the lesions of keloids.The number,distribution and shape of superficial blood vessel were abnormal.The status of blood flow and the manifestation of superficial blood vessel were different in the light of different types of lesions.④Compared with asiaticoside group,after having been treated with self-made drug unguent for 12 weeks,the differences determined by general assessment,score and grade on the basis of the severity of target lesion were statistically significant(p＜0.05).⑤Within certain concentration,after the extractant from self-made drug taking action,the fibroblast appearance was altered,the cellular proliferating activity was decreased,the LDH activity was increased and the expression of collagenⅠwas suppressed,the expression of MMP-1 was enhanced while the expression of VEQF was increased or decreased.Conclusion:Appling TCM and combination of TCM with Western to diagnoses and treatment of dermatosis is prof.Cai's academic characteristics.The occurance of keloid relate to some body constitution types,blood stasis,systemic and topical dysaemia.The onset causes of different keloid types are different.The curative effect of self-made drug unguent is significant in treating keloids.The medicine may influent the biological mechanism of keloid fibroblasts in various aspects.