| Objectives: We have collected the clinical data of acne patients and performed the lactic acid stimulation tests to identify the skin types with sensitive(lactic acid stimulation test-positive) and non-sensitive(lactic acid stimulation test-negative). By examining the physiological parameters in the skin and analyzing the alterations of skin sensitivity and the physiological parameters upon Xiaoyan I treatment, we aim to understand the relationship between skin sensitivity and prognosis, and explore effective therapies combining both traditional and western approaches for the treatment of acne patients.Methods: 1. Adult acne female patients(n=40) enrolled in Tianjin Chinese Medicine Research Institute Affiliated Hospital from January to July in 2015 were selected for our studies. The patients’ acne degree was graded and the skin damage was quantified. The lactic acid stimulation test was performed as a primary screening method to divide the subjects into a sensitive group and non-sensitive group. Among them, 13 were determined as acne patients with sensitive skin and 13 were determined as acne patients with non-sensitive skin. 2. Characteristics of the patients’ clinical information were analyzed. 3. Treatment: Xiaoyan I(Z20070054, Tianjin Chinese Medicine Institute Affiliated Hospital), administration orally, once a dose,dissolved in hot water(200m L) twice daily. Basic therapy:Viaminate capsule(H50021842,Chong Qing Hua Bang Pharmaceutical, Inc.), administration orally, once a capsule(25mg) twice daily; Topical adapalene gel(HH20070241, Tianjin Chinese Medicine Institute Affiliated Hospita),applying to the damage area, once every night. All patients in sensitive and non-sensitive groups were treated with basic therapy, healthy education, and Xiaoyan I. All treatments lasted for 4 weeks, after which the patients were observed for 2 weeks. 4. All acne patients were observed for the changes of their clinical symptom at 0, 2, 4,and 6 weeks upon treatments. The physiological parameters of the skin were examined by the following: Trans Epidermal Water Loss(TEWL), water content of skin, p H value, and skin grease. The changes in skin sensitivity before and after treatments were also analyzed. 5. Statistical Analysis with SPSSl8.0. Statistical analyses of the experimental data were performed using χ2 test, a two-sided Student’s t test, or f test. Significance was set at a P < 0.05.Results: 1. The lactic acid stimulation test exhibited positive in 13 of the 40 adult acne female patients, and the remaining 27 were negative. Thus, the acne patients with sensitive skin were 32.5%. 2. Statistical χ2 test showed no significant difference between the sensitive and non-sensitive groups in terms of the patients’ skin type, age, being constipated, inheriting, the grades of acne, and disease progression. However, a comparison of treatment history found statistical difference between the two groups. The acne patients with sensitive skin had significantly less previous treatments than those with non-sensitive skin(χ2=9.231, P<0.05). 3. Before treatments, among the four physiology parameters of skin, TEWL, p H value and the water content had no obvious difference between sensitive and non-sensitive groups. The student t test showed that the acne patients with sensitive skin had significantly less epidermal grease than those with non-sensitive skin(t=2.915,P=0.006). 4. After 4 weeks of treatment, χ2 test showed no significant difference in clinical efficacy between the sensitive and non-sensitive groups(χ2=2.15,P> 0.05). While the TEWL, p H value and the epidermal grease had no obvious difference between the two groups, the water content in acne patients with sensitive skin was significantly higher than those with non-sensitive skin(t=2.161,P=0.037). After 2 weeks from the end of treatments, the sensitive and non-sensitive groups exhibited similar p H value and skin grease. Further f test showed that both groups had less skin grease than that prior treatments(FA1=5.757,PA1= 0.007,FA2=21.940,PA2= 0.000), whereas there wasno obvious change in p H value within 6 weeks(FA1=5.757,PA1= 0.007,FA2=21.940,PA2= 0.000). However, there were clear alterations in TEWL and water content between the two groups. The skin water content in sensitive group improved more significantly than that in non-sensitive group( FA1=11.372,PA1= 0.000,FA2=2.842,PA2= 0.090), whereas the skin TEWL in non-sensitive group reduced more dramatically than that in the sensitive group(( FA1=0.812,PA1=0.452,FA2=6.276,PA2= 0.003). 5. The student t test showed that the overall score of lactic acid stimulation test had no significant difference prior and after treatments. The treatment duration(4 weeks) did not clearly improve the skin sensitivity.Conclusions: 1. Our data in combination with clinical information indicated that the skin sensitivity of female acne patients improved, especially in those without previous treatment history whose skin sensitivity increased more dramatically. 2. The skin of acne patients secreted a lot of grease and had higher p H value. Treatment with combination of traditional Chinese medicine limited grease secretion, but had little effect on p H value. 3. After 4 weeks of treatment, the skin’s barrier function had been significantly repaired. Combination of traditional Chinese medicine and a western approach is an effective treatment for acne patients. 4. Among the female acne patients, those with sensitive skin secreted less skin grease. While the patients’ symptom was reduced, their skin’s sensitivity remained unchanged and there was no clear improvement in the skin barrier function. 5. Among the female acne patients, those with non-sensitive skin exhibited a significant reduction in TEWL after treatment. Their skin’s barrier function improved. |
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