穴位埋线改善肝郁气滞型绝经前期女性黄褐斑临床症状及机制研究  

Effect on clinical symptoms and mechanism of chloasma in premenopausal women with liver qi stagnation treated with acupoint catgut embedding

作　　者：金亚蓓[1] 郑利芳[1] 孙占玲[1] JIN Ya-bei;ZHENG Li-fang;SUN Zhan-ling(Department of Acupuncture and Moxibustion, Zhejiang Hospital of Integrated Chinese and Western Medicine, Hangzhou 310003, China)

机构地区：[1]浙江省中西医结合医院针灸科

出　　处：《中国针灸》2019年第9期932-935,共4页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科学研究基金计划项目：2016ZA150,2016ZA152

摘　　要：目的:探讨穴位埋线对肝郁气滞型绝经前期女性黄褐斑患者的疗效及作用机制。方法:将92例肝郁气滞型绝经前期黄褐斑患者随机分为观察组和对照组,每组46例。观察组给予穴位埋线治疗,穴取肝俞、脾俞、三阴交及面部局部穴位围刺,每周1次;对照组给予口服维生素C(200 mg/次,每天3次)、维生素E(100 mg/次,每日1次)治疗,两组均治疗12周。观察两组患者治疗前后黄褐斑面积及严重程度(MASI)评分,血清性激素之卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平,并于治疗3个月后评定两组临床疗效。结果:最终观察组44例,对照组43例完成研究。观察组有效率为88.6%(39/44),高于对照组的55.8%(24/43,P<0.01)。与治疗前比较,两组治疗后MASI评分均降低(P<0.01,P<0.05),观察组随访时MASI评分较治疗后降低(P<0.01);治疗后及随访时观察组MASI评分均低于对照组(P<0.01)。观察组随访时FSH、LH水平较治疗前下降P<0.01),E2水平与治疗前比较差异无统计学意义(P>0.05),对照组随访时FSH、LH、E2水平与治疗前比较差异无统计学意义(P>0.05);观察组随访时FSH、LH水平低于对照组(P<0.01,P<0.05),E2水平比较差异无统计学意义(P>0.05)。结论:穴位埋线法可显著改善肝郁气滞型绝经前期女性黄褐斑的临床症状,其机制可能与穴位埋线调节体内血清性激素水平从而降低黑色素细胞对雌激素的高度敏感性有关。Objective To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver qi stagnation. Methods A total of 92 patients of chloasma in premenopausal women with liver qi stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu(BL 18), Pishu(BL 20), Sanyinjiao(SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C(200 mg per time, 3 times a day) and vitamin E(100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index(MASI), the serum levels of follicular stimulating hormone(FSH), leuteinizing hormone(LH) and estradiol(E2) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment. Results Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6%(39/44), which was higher than 55.8%(24/43) in the control group(P<0.01). Compared before treatment, the MASI scores after treatment were reduced in the two groups(P<0.01, P<0.05), the MASI score in follow-up in the observation group was reduced as compared with after treatment(P<0.01), and the MASI scores after treatment and in follow-up in the observation group were lower than the control group(P<0.01). Compared before treatment, the levels of FSH and LH in follow-up were reduced(P<0.01), there was no significant difference between before treatment and in follow-up in the level of E2 in the observation group(P>0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E2 in the control group(P>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group(P<0.01

关 键 词：黄褐斑 肝郁气滞 穴位埋线 血清性激素 MASI评分 

分 类 号：R246.3[医药卫生—针灸推拿学]