Observation And Study On The Treatment Of Chronic Urticaria By Acupuncture With "Physical And Mental Therapy"

BackgroundUrticaria is one of the most common clinical diseases related to immunity.It is manifested as a sudden rash accompanied by pruritus.It usually subsides within 24 hours and returns to the normal state of the skin.Urticaria can be divided into acute and chronic urticaria.Acute urticaria often has a more urgent onset.If the wind group attacks every day or intermittently,and the chronic urticaria’s course of disease is longer than 6 weeks.Chronic urticaria causes complex diseases and is difficult to be cured because of its unpredictable onset,which requires long-term medication and changes in living habits and lifestyles,and even causes anxiety,depression,and reduces sleep quality,which has a great impact on the lives of patients.In recent years,the prevalence of this disease has been increasing year by year in the world,which is closely related to social factors,natural environment and changes in dietary structure.Because of the etiology and pathogenesis of urticaria is not entirely clear,the main treatment of western medicine such as antihistamine drugs and glucocorticoids,ring spore element,oral calcium channel blockers can temporarily alleviate the clinical symptoms of urticaria and cannot completely cure,and long-term use can lead to significant adverse effects,easy to relapse after drug withdrawal,and bring a lot of troubles to the work and life of patients.According to the viewpoint of traditional Chinese medicine,wind evil is the core pathogenesis of chronic urticaria,which can be divided into two kinds:exogenous and internal injury.Because of the lack of Wei Qi,unable to defend the external evil,and get the attack of wind evil;Or for body weakness,lack of qi and blood,skin loss of nourishment,or rheumatism in the skin,cannot be discharged Urticaria is not a simple skin disease,but a complex psychosomal skin disease occurring under the overall background,which is closely related to people’s mental feelings.The causes of the disease are complex,the disease is prolonged and difficult to heal,and the treatment effect is not ideal.Therefore,new treatment methods are the focus of future research.Acupuncture and moxibustion can improve human blood circulation,fight allergy and regulate immune function.Acupuncture treatment of chronic urticaria is to play this role to inhibit the production of IgE and the release of allergic mediators in the body.Acupuncture therapy can harmonize qi and blood,strengthen the body and dispel pathogenic factors,and is of great significance to improve the internal environment of the body and enhance the immunity of the body,which is in line with the thought of "curing disease and seeking the root" of Chinese medicine.Acupuncture and moxibustion,as a non-drug therapy,has the advantages of stable efficacy and no side effects,and generally has good long-term efficacy,and is highly accepted by patients.Acupuncture and moxibustion in the treatment of chronic urticaria has a lot of basic theoretical research and clinical practice evidence.This study choose a prospective case series studies "physical and mental development" acupuncture method for the treatment of chronic urticaria patients clinical signs and symptoms,quality of life,anxiety and depression,sleep quality and effectiveness of the "physical and mental development" acupuncture method to evaluate the safety of the treatment of chronic urticaria,and evaluate the long-term follow-up of patients with observation curative effect.It provides the idea and reference for the treatment of chronic urticaria with traditional Chinese medicine.PurposeBy observing the effect of acupuncture on the symptoms and signs of patients with chronic urticaria,the changes of UAS7 and AAS scores before and after treatment were analyzed,and the efficacy was evaluated.By observing the changes of quality of life scores of patients before and after treatment,to evaluate the effect of "body and mind together treatment" acupuncture treatment on the quality of life of patients with chronic urticaria;By observing the changes of anxiety and depression before and after treatment,the influence of"body and mind together treatment" acupuncture treatment on the mental mood of patients with chronic urticaria was evaluated.By observing the changes of sleep quality scores of patients before and after treatment,the improvement degree of sleep quality of patients with chronic urticaria was evaluated by acupuncture method of "body and mind together treatment".Finally,the clinical efficacy,safety and long-term efficacy of acupuncture for treating chronic urticaria were evaluated by comprehensively considering the clinical efficacy indexes.MethodsAll 70 patients with chronic urticaria observed in this study were recruited from the dermatological outpatient department of Acupuncture and Moxibustion Hospital,China Academy of Chinese Medical Sciences from September 2018 to March 2021.The main acupuncture points are bilateral Fengchi,Waiguan,Fengshi,Quchi,Shenmen,Jianshi,Baichongwo,Zusanli,Sanyinjiao,Taichong,Guan Yuan,Shenque,Baichongwo flash cupping;One course of treatment was 4 weeks,3 times a week,a total of 12 times.Follow-up was conducted at the 16th week.The main outcome measures were 7-day urticaria activity score(UAS7)and angioedema activity score(AAS).Secondary outcome measures were Chronic Urticaria Quality of Life Questionnaire(DLQI)and Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and Pittsburgh Sleep Quality Index(PSQI)were used to record scores before and after treatment and during follow-up.The efficacy was evaluated.Result(1)7-day Urticaria Activity Score(UAS7):Compared with the baseline period,the itching degree,the number of wind mass and the total UAS7 score were all decreased at the 2nd and 4th week of treatment and at the 16th week of follow-up,with significant differences(P=0.000).(2)Compared with the second week of treatment,the pruritus degree,the number of wind masses and the total UAS7 score were all decreased in the fourth week of treatment,with significant differences(P=0.000).During follow-up(week 16),the degree of pruritus,the number of wind masses and the total UAS7 score all decreased,and the differences were significant(P=0.000).(3)Compared with the 4th week of treatment,there was significant difference in the degree of pruritus in the 16th week of follow-up(P=0.0195),while there was no significant difference in the number of wind masses and the total UAS7 score(P=0.0672).The results showed that the pruritus degree and the number of wind masses of patients decreased after 2 weeks of acupuncture treatment,and the efficacy of 4 weeks of treatment was better than that of 2 weeks of treatment,and the efficacy basically remained unchanged at the 16th week of follow-up,and the effect of acupuncture had cumulative effect.(2)Angioedema Activity Scale(AAS):Compared with the baseline period,urticaria duration,physical discomfort,influence on daily activities,influence on appearance and overall severity were all reduced at the 2nd and 4th week of treatment,with significant differences(P<0.05).Compared with the second week of treatment,the duration of urticaria,physical discomfort,influence on daily activities,influence on appearance and overall severity of urticaria were all reduced at the 4th week of treatment,with significant difference(P<0.05).The effect of acupuncture and moxibustion had cumulative effect.(3)Skin Disease Quality of Life Scale(DLQI):Compared with the baseline period,at the 4th week of treatment,the ten aspects and total scores of DLQI were all lower than those before treatment,with significant difference(P<0.05).It shows that the quality of life of patients with urticaria has been improved after the treatment of acupuncture with "body and mind together" alleviates the clinical symptoms of urticaria.(4)Hamilton Anxiety Scale(HAMA):Compared with the baseline period,the score of HAMA scale decreased at the 4th week of treatment,with a significant difference(Z=5.807,P=0.000).Before treatment,5 patients(7.14%)had no anxiety,28 patients(40.00%)had probable anxiety,27 patients(38.57%)had definite anxiety,and 10 patients(14.29%)had obvious anxiety.After treatment,33 patients(47.14%)with no anxiety increased by 28 compared with before treatment,25 patients(35.71%)with possible anxiety,12 patients(17.14%)with definite anxiety,and 0 patients with severe anxiety,all of w-hich decreased compared with before treatment.Compared with the baseline period,the overall anxiety status of patients was significantly improved(Z=15.774,P=0.000).It shows that the anxiety state of the patients has been improved after the treatment of "body and mind together" acupuncture has alleviated the symptoms of urticaria.(5)Hamilton Depression Scale(HAMD):Compared with the baseline period,the score of HAMD scale decreased at the 4th week of treatment,with significant difference(Z=4.829,P=0.000).Among the 70 patients with chronic urticaria included in this study,16(22.86%)were not depressed before treatment,46(65.71%)were mildly depressed,7(10.00%)were moderately depressed,and 1(1.43%)were severely depressed.After treatment,there were 40 patients(57.14%)without depression,an increase of 24 patients compared with before treatment.There were 29 patients(41.43%)with mild depression,1 patients(1.43%)with moderate depression,and 0 patients with severe depression.Compared with baseline,the overall depression status of the patients improved significantly(Z=4.399,P=0.000).The results showed that the symptoms of chronic urticaria were alleviated and the depressive state of the patients was also improved by acupuncture with the treatment of body and mind.(6)Pittsburgh Sleep Quality Index(PSQI):Compared with the baseline period,the score of PSQI scale decreased at the 4th week of treatment,with a significant difference(Z=9.518,P=0.000).In the 70 patients with chronic urticaria included in this study,14 patients(20.00%)had good sleep quality before treatment,28 patients(40.00%)had good sleep quality,21 patients(30.00%)had normal sleep quality,and 7 patients(10.00%)had poor sleep quality.After treatment,48 patients(68.57%)had good sleep quality,34 patients increased compared with before treatment,17 patients(24.29%)had good sleep quality,5 patients(7.14%)had normal sleep quality,and 0 patients had poor sleep quality.Compared with the baseline period,the overall sleep condition of the patients was significantly improved(Z=5.263,P=0.000).The results showed that the symptoms of chronic urticaria were alleviated and the sleep quality of patients was also improved.(7)Efficacy Evaluation:After 2 weeks of acupuncture treatment,26 cases(37.14%)of the 70 patients with chronic urticaria showed marked effect,35 cases(50.00%)of the effective,9 cases(12.86%)of the ineffective,and the total effective rate was 87.14%.After 4 weeks of acupuncture treatment,the marked effect increased by 28 cases,the ineffective decrease by 7 cases,and the total effective rate was 97.14%,increasing by 10%.The results showed that the acupuncture treatment of "body and mind together" had obvious effect on chronic urticaria,and with the increase of treatment time,the acupuncture effect had cumulative effect.(8)Safety Evaluation:All the 70 patients with chronic urticaria observed in this study could tolerate acupuncture and cupping treatment,and no adverse reactions such as needle dizziness,broken needle and infection occurred during the acupuncture process.Only 1 patient caused local hematoma due to not pressing the pinhole in time after taking the needle,which subsided after hot compress,and no other adverse reactions occurred.Conclusion(1)The acupuncture method of "body and mind together treatment" can reduce the itching degree of patients with chronic urticaria,reduce the number of wind masses,and acupuncture has a cumulative effect on the improvement of symptoms of chronic urticaria.(2)Acupuncture with "the same treatment of body and mind" can reduce the impact of urticaria on patients’ quality of life,relieve patients’ anxiety and depression,and improve patients’ sleep quality.(3)The treatment of chronic urticaria with "physical and mental treatment" acupuncture has the advantages of stable efficacy,no side effects,low incidence of adverse reactions,good long-term efficacy,and high acceptance by patients.