Clinical Observation on Electrothermal Acupuncture in Treatment of 16 Cases of Vulvar Dystrophy

　　By Yan Bin and Liu Shufen
　　 Jining Municipal Hospital, Inner Mongolia 012000, China

Electrothermal acupuncture, a modification of the traditional "hot-red" puncturing technique, is generally adopted for softening and resolving hard mass, promoting blood circulation and resorption of inflammatory lesions, and for antipruritic and/or analgesic purposes by regulating Qi and blood, dredging the meridians and removing blood stasis. From Nov. 1992 to Sep. l993, we treated l6 cases of vulvar dystrophy with this technique. The results were quite satisfactory as reported in the following.

Clinical Data
The l6 patients in this series were 22�?7 years old and contracted this condition for 0.5-25 years. 15 of them failed in previous treatment by topical use of lotions and ointments or oral TCM and/or western medicines. Proliferative and atrophic changes were found by pathological examination in l and 2 cases respectively. Before treatment, examinations of sugar in urine, and leukorrhea were performed in all the patients to bring such predisposing and inducing factors as diabetes mellitus, trichomoniasis, and fungal vaginitis under control. Of the 16 cases, l0 were differentiated as the type of liver- and kidney-deficiency, 4 with damp-heat going downwards, and 2 the mixed type.

Diagnosis
Diagnostic criteria: l) pruritus and/or pain of vulva; and 2) depigmentation and/or pachyderma, atrophy, xerosis, rhagades, and ulcer of the vulvar skin or mucosa. Patients with vitiligo or carcinoma of vulva were excluded.

TCM Typing
l. Damp-heat going downwards: Pruritus and pain in vulva, swelling or thickening of the vulvar skin, with sticky and foul leukorrhea; oppressed feeling in the chest, vexation with disturbed sleep, bitter taste in mouth, poor appetite, dark urine, rolling and rapid pulse or string-taut and rapid pulse; the tongue was red with yellow and greasy coating.
2). Deficiency of both the liver and kidney: itching of vulva, especially at night; dry or atrophic vulvar skin, or with rhagades; scanty menorrhea, less or no leukorrea; dizziness, dryness of the eyes, soreness and pain in the waist; the pulse was deep and thready, or taut and feeble, and the tongue was pale.
3). The mixed type: Itching or pain and atrophy of vulvar, profuse sticky leukorrhea with foul odor or yellow color; dizziness, bitter taste in mouth, soreness in the waist and back; the pulse was taut and thready, or thready-rapid, or deep, thready and rolling and the tongue was pale or red with thin, yellow and greasy coating.

Treatment
Huiyin (CV l), Qugu (CV 2), Zhongii(CV 3), Guanyuan (CV 4) and Jimai (LR 12) as the main points were first punctured with the optimal stimulation of 50-90mA. After obtaining needling sensation, the needles were inserted from the health skin to the depigmented area without lifting, thrusting and twirling. Then, a limited number of adjunct points were punctured in accordance with the type of the disease and individual condition of the patient. The treatment was given once daily or every other day, 12 days constituting one therapeutic course. During menstrual period, the therapy was suspended.

Criteria of Effectiveness
Cured: Disappearance of pruritus, pain, rhagades and ulcers; recovery of color, luster and elasticity of the affected (or atrophic) skin.
Improved: Partial disappearance or amelioration in signs and local symptoms, with basically normal color luster and elasticity of the skin.
Failed: The symptoms and signs were not improved, or even aggravated.

Therapeutic Results
All the l6 cases received 1 to 6 courses of treatment. The therapeutic results were shown in the following table. The cured rate was 75%, with a total effective rate of l00%.
　　

Table. Therapeutic results