Abstract: Background　Acne is a chronic inflammatory disease of the hair follicle sebaceous glands that is common in adolescence.There are many female patients after puberty，and the rash lasts for a long time，which seriously affects the appearance and health of the patient.Conventional catgut embedding has a good effect on postpubertal acne in women，and smooth catgut embedding is a method of catgut embedding based on the theory of superficial fascia.At present，there is no comparison of the efficacy of two methods of catgut embedding.Objective　To explore the efficacy and mechanism of different facial catgut embedding methods combined with comprehensive acupuncture therapy on adult female acne.Methods　Sixty-one female patients with adult acne were enrolled from acupuncture clinics of the First People's Hospital of Lianyungang from July 2015 to July 2017.They were divided into smooth catgut embedding group（31 cases） and conventional catgut embedding group（30 cases）．Both groups had comprehensive acupuncture therapy.In smooth catgut embedding group，smooth catgut was embedded in face one week after two times of body acupoints embedment.In conventional catgut embedding group，catgut was embedded in face one and seven weeks after two times of body acupoints embedment.Both groups were intervened for 8 weeks as one course.After 12 weeks，the efficacy for acne skin lesions and accompanying symptoms，scores of acne skin lesions and accompanying symptoms and adverse effects were assessed in both groups.Results　The efficacy for acne skin lesions and accompanying symptoms in smooth catgut embedding group was significantly better than that of conventional catgut embedding group（P<0.05）．There were no significant differences in acne lesion score and accompanying symptom score between two groups before and after treatment（P>0.05）．The acne lesion score and accompanying symptom score after treatment were lower than those before treatment in the two groups（P<0.05）.There were no obvious adverse effects in both groups.Conclusion　Different facial catgut embedding methods combined with comprehensive acupuncture therapy has better clinical efficacy on acne lesions and accompanying symptoms in adult female acnes.The mechanism of facial catgut embedding is closely related to the theories of meridians，superficial fascia and defensive Qi.Smooth catgut embedding has less painful than routine catgut embedding and has better wrinkle improvement effect.Therefore，smooth catgut embedding is superior to routine catgut embedding，which is worthy of clinical popularization and application.

Key words: Acne vulgaris；Puberty；Embedding, thread；Acupuncture-moxibustion；Defensive energy；Comparative effectiveness research

摘要： 背景　痤疮是青春期常见的毛囊皮脂腺的慢性炎症性疾病，青春期后女性患者较多，皮疹持续时间较长，严重影响患者容貌美观和身心健康。常规埋线对女性青春期后痤疮有较好疗效，而平滑线埋线是基于浅筋膜理论的一种埋线方法，目前临床尚无两种埋线方法的疗效比较研究。目的　探讨基于面部不同埋线方法的综合针灸疗法治疗女性青春期后痤疮的疗效及其作用机制。方法　选取2015年7月—2017年7月连云港市第一人民医院针灸科门诊收治的女性青春期后痤疮患者61例，分为平滑线组31例和常规埋线组30例。两组均接受综合针灸疗法，在此基础上平滑线组于2次体穴埋线后第2周予平滑线埋线；常规埋线组于2次体穴埋线后第2、8周予常规埋线。两组均干预8周（1个疗程），12周后评定两组痤疮皮损疗效、痤疮皮损评分、伴随症状疗效、伴随症状评分及不良反应发生情况。结果　平滑线组痤疮皮损疗效、伴随症状疗效优于常规埋线组（P<0.05）。治疗前、后两组痤疮皮损、伴随症状评分比较，差异无统计学意义（P>0.05）。两组治疗后痤疮皮损、伴随症状评分均低于本组治疗前（P<0.05）。两组均未发生明显不良反应。结论　基于面部不同埋线方法的综合针灸疗法对女性青春期后痤疮皮损和伴随症状均有较好的临床疗效；面部埋线作用机制主要与经络、浅筋膜、卫气等理论密切相关；平滑线埋线较常规埋线患者痛苦小，且有较好的改善皱纹效果，因此平滑线埋线优于常规埋线，值得临床推广应用。

关键词: 寻常痤疮, 青春期, 埋线, 针灸疗法, 卫气, 疗效比较研究