Clinical Observation On Acupuncture Treatment Of Vulvar Lichen Sclerosus And Expression Of VEGF And CD34 Before And After Treatment

Objective:1)By observing the changes of clinical indicators,the pathological alterations and clinical effects of the acupuncture therapy of vulvar lichen sclerosis(VLS)were determined.2)The expression,significance and relevance of vascular endothelial growth factor(VEGF)and hematopoietic progenitor cell antigenin(CD34 antigenin)in pathological tissues were explored by immunohistochemical method.3)Through clinical observation with immunohistochemical analysis,the etiology and pathogenesis of VLS were further explored,as well as the mechanism of acupuncture therapy.Methods:30 VLS patients were selected as the experimental group,while 5 normal case as the control group.In addition,the patients formed self control before and after acupuncture treatment.The experimental group was chosen to be the point of the vulva and the bladder stones.In the treatment,the Ashi point and vesical calculi posture were selected to practice the superficial and intensive encircling needling therapy for a duration of 3 courses with 15days/month/course.By comprehensive use of pathological analysis and immunohistochemical detection,to get and analyze comparatively the data and results of the clinical symptom and sign,pathological morphology,VEGF positive expression value and CD34 positive expression value(MVD value)before and after treatment of,as well as the comparison with the normal control group.Results:1)The clinical symptoms of VLS patients were significantly improved after acupuncture treatment(P<0.05).And 3 cases were cured,12 cases were markedly effective,13 cases were effective while 2 case were ineffective at all,with the total effective rate up to 93.3%.2)Before treatment:the VEGF value of the pathological tissue was significantly higher than that in the normal tissues,while the MVD value was significantly reduced(P<0.05).The expression of VEGF is not synchronized with CD34.After treatment:the VEGF value went lowe,while the MVD value increased(P<0.05).There was no significant difference between treatment and control group(P>0.05).Conclusion:1)This study confirms that the overall clinical effect of the acupuncture therapy in VLS is obvious,with the clinical observation indexes of most patients improved markedly.2)The VEGF value was elevated in pathological tissue vs normal tissue,while MVD decreased.However,the VEGF value decreased markedly after acupuncture treatment,while the MVD value recovered markedly.There is a close feedback mechanism between the VEGF and MVD value.These reflects the local micro-circulation disorder in pathological kin tissues may be an important pathogenic factor.3)The superficial and intensive acupuncture surrounding the lesion improves the micro-circulation in local pathological kin tissues,mediating the balance of yin-yang,making up blood,activating meridians and entrails.Therefore this promotes the recovery of vulva.4)The physical stimulation from acupuncture should have a strong intervention on the signaling process of VEGF and CD34,which may be the intrinsic key to the treatment of VLS.