Therapeutic effect of heat-clearing and dampness-eliminating method combined with 5-aminolevulinic acid photodynamic therapy on moderate and severe acne and its influence on MMP-1, MMP-9, IL-1β and TNF-α / 中国基层医药

ABSTRACT

Objective:To investigate the effect of heat-clearing and dampness-eliminating therapy combined with 5-aminolevulinic acid photodynamic therapy on moderate and severe acne and its influence on matrix metalloproteinase-1 (MMP-1), matrix metalloproteinase-9 (MMP-9), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α).Methods:From March 2017 to March 2019, 106 patients with moderate to severe acne admitted to the Traditional Chinese Medicine Hospital of Ningbo were divided into observation group ( n=53) and control group ( n=53) according to the random digital table method.The control group was treated with 5-aminolevulinic acid photodynamic therapy, while the observation group was treated with heat-clearing and dampness-eliminating therapy on the basis of the control group.Both two groups were treated for 6 weeks.The therapeutic effects, skin lesions, dermatological quality of life index (DLQI), MMP-1, MMP-9, IL-1β and TNF-α levels, and adverse reactions were compared between the two groups before and after treatment. Results:The total effective rate of the observation group (94.34%) was higher than that of the control group (73.58%) (χ 2=8.477, P<0.05). The scores of acne[(19.32±2.37)points], inflammatory papules [(25.42±4.17)points] and pustules[(14.32±3.29)points] in the observation group after treatment were lower than those in the control group [(28.74±3.46)points, (32.87±3.78)points, (23.78±4.76)points]( t=16.352, 9.637, 11.902, all P<0.05). After treatment, the scores of DLQI scale in the observation group[(0.65±0.13)points, (0.63±0.15)points, (1.23±0.16)points, (1.18±0.19)points, (1.39±0.23)points, (1.45±0.28)points] were lower than those in the control group [, (1.20±0.17)points, (1.14±0.18)points, (1.92±0.23)points, (1.79±0.13)points, (1.81±0.27)points, (1.87±0.21)points] ( t=18.710, 15.846, 17.929, 19.290, 8.621, 8.736, all P<0.05). After treatment, the serum levels of MMP-1[(34.25±7.48)μg/L], MMP-9 [(108.98±14.25)μg/L], IL-1β [(137.98±10.23)μg/L] and TNF-α[(103.24±10.18)μg/L] in the observation group were lower than those in the control group [(59.37±4.56)μg/L, (164.32±18.48)μg/L, (156.37±13.10)μg/L and (137.91±8.29)μg/L]( t=20.875, 17.264, 8.055, 19.226, all P<0.05). There were no serious adverse reactions in both two groups. Conclusion:The method of heat-clearing and dampness-eliminating combined with 5-aminolevulinic acid photodynamic therapy is effective in treating moderate and severe acne, and can reduce the serum levels of MMP-1, MMP-9, IL-1β and TNF-α.