益肾健脾化瘀法治疗黄褐斑的研究  

Study of Kidney-nourishing and Spleen-strengthening and Stasis-resolving Method in Treatment of Melasma

作　　者：杜晓航[1] 宋秀祖[1] 倪亚杰[2] 许爱娥[1] 

机构地区：[1]杭州市第三人民医院皮肤科,浙江杭州310009 [2]浙江中医药大学,浙江杭州310053

出　　处：《中华中医药学刊》2014年第4期771-773,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81000697)

摘　　要：目的:观察益肾健脾化瘀法治疗黄褐斑的临床疗效及治疗前后黑素细胞及黑素的情况。方法:将130例黄褐斑病人随机分为两组:治疗组90例,给予益肾健脾化瘀祛斑方煎服治疗;对照组六味地黄丸、逍遥丸口服治疗。观察两组患者治疗前后皮损色素、皮损面积、黑素细胞的形态、黑素的含量等指标。结果:治疗组、对照组的有效率分别为88.89%(80/90)、27.50%(11/40),治疗组的疗效明显优于对照组(P<0.01);共聚焦激光扫描显微镜观察130例患者中,75例为真皮型、55例为表皮真皮混合型患者,治疗有效的患者表皮和/真皮的黑素含量明显减少,树枝状的黑素细胞树突明显变短变小或消失。治疗组皮损处与治疗前相比,治疗后MCI显著减少,P<0.05,对照组皮损处治疗前后MCI相比,差异不明显,P>0.05。结论:肾健脾化瘀法可抑制黑素细胞的树突化、减少黑素含量,因而治疗黄褐斑有效。Objective ：To observe the clinical efficacy of kidney - nourishing and spleen - strengthening and stasis - re- solving method in treating chloasma and the change of melanocytes and melanin before and after treatment. Methods ：130 patients with chloasma were randomly divided into two groups ：90 cases were as treatment group and 40 cases as controlgroup. The treatment group were given Yishen Jianpi Huayu Quban Decoction and control group given Liuwei Dihuang Pill and Xiaoyao Pill orally. Skin pigment, the lesion area, melanocyte morphology and the melanin content of the two groups were observed before and after treatment. Results ：The total efficacy of the treatment group and control group was 88.89% （80/90） and 27.50% （11/40） respectively. The treatment group was obviously better than the control group （P 〈 0.01 ）. All 130 patients were detected by confocal laser scanning microscopy. There were 75 cases of dermal type and 55 cases of epidermal dermal mixed type. Epidermal and dermal melanin contents were significantly reduced and dendrites of dendritic melanocyte were obviously shorter and smaller or disappeared of the treatment effective patients. After treatment, MCI of the treatment group lesions was significantly decreased compared with that before treatment, P 〈 0.05. However, there was no significant difference of MCI of the control group before and after treatment, P 〉 0. 05. Conclusions ： The kid- ney- nourishing and spleen -strengthening and stasis -resolving method can inhibit melanocyte dendrites and reduce melanin content, and thus it is effective in the treatment of chloasma.

关 键 词：黄褐斑 共聚焦激光显微镜 治疗 

分 类 号：R816.95[医药卫生—放射医学]