体视学测量在中药面膜治疗单纯色素型黄褐斑中的疗效评价研究  

Evaluation of efficacy of a Chinese herbal mask in the treatment of melanized-type melasma by stereological measurements

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作  者:孟晓[1] 王俊慧[1] 颜志芳[1] 王宁[1] 崔炳南[1] Meng Xiao;Wang Junhui;Yan Zhifang;Wang Ning;Cui Bingnan(Department of Dermatology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区:[1]中国中医科学院广安门医院皮肤科,北京100053

出  处:《中华皮肤科杂志》2025年第1期53-59,共7页Chinese Journal of Dermatology

基  金:国家自然科学基金(61971449)。

摘  要:目的采用体视学测量法评价中药面膜治疗单纯色素型黄褐斑的有效性及安全性。方法本研究为随机、对照、对评价者和统计者设盲的研究方法。选取符合纳排标准的黄褐斑患者116例,根据1∶1随机数字表法分为两组,每组58例。治疗组给予中药面膜外敷,每晚1次;对照组给予氢醌乳膏外用,早晚各1次;疗程12周,每4周随访1次,停药12周后随访。采用面部图像分析仪、反射式共聚焦显微镜(RCM)采集治疗前后各期图像;以黄褐斑面积和严重指数(MASI)评分和RCM评分作为观察指标,结合体视学测量法比较治疗前后评分变化,计算有效率及复发率,观察不良反应。统计学分析比较采用χ^(2)检验及t检验。结果治疗组54例、对照组47例完成试验。治疗4周及8周后,两组MASI评分和RCM评分比较差异均无统计学意义(均P>0.05);治疗12周后,治疗组MASI评分(2.91±1.16)、RCM评分(5.48±1.60)均明显低于对照组(分别为3.99±2.03、6.66±1.88),两组比较,差异均有统计学意义(t值分别为-3.32、-3.37,均P<0.01)。治疗组有效44例(81.5%),对照组有效34例(72.3%),两组有效率差异无统计学意义(χ^(2)=0.12,P>0.05)。停药12周后随访,治疗组复发2例(3.7%),对照组15例(31.9%),两组复发率差异有统计学意义(χ^(2)=12.34,P<0.01)。治疗组发生不良反应2例(3.7%),对照组6例(11.5%),两组不良反应发生率差异无统计学意义(χ^(2)=1.34,P>0.05)。结论中药面膜治疗单纯色素型黄褐斑安全有效;应用面部图像分析仪和RCM技术获取图像,结合体视学测量法对减少黄褐斑疗效评价的主观性具有一定价值。Objective To evaluate the efficacy and safety of a Chinese herbal mask in the treatment of melanized-type melasma by stereological measurements.Methods A randomized,controlled,evaluator-and statistician-blind clinical study was conducted.A total of 116 patients with melasma who met the inclusion and exclusion criteria were selected and equally divided into two groups by using a random number table method,with 58 patients in each group.The treatment group received topical treatment with a Chinese herbal mask once a night,while the control group received topical hydroquinone cream in the morning and evening twice daily.The course of treatment lasted 12 weeks,with follow-ups every 4 weeks,and an additional follow-up was performed 12 weeks after discontinuation of treatment.A facial image analyzer and a reflectance confocal microscopy(RCM)were used to collect images before and after treatment.Melasma area and severity index(MASI)scores and RCM scores served as outcome measures,and stereological measurement methods were employed to compare scores before and after treatment;response rates and recurrence rates were calculated,and adverse reactions were observed and recorded.Statistical analyses were performed using the chi-square test and t test.Results A total of 54 patients in the treatment group and 47 patients in the control group completed the study.After 4-and 8-week treatment,there were no significant differences in MASI scores or RCM scores between the two groups(all P>0.05);after 12-week treatment,the MASI scores and RCM scores were significantly lower in the treatment group(2.91±1.16,5.48±1.60,respectively)than in the control group(3.99±2.03,6.66±1.88,t=-3.32,-3.37,respectively,both P<0.01).After the end of treatment,there was no significant difference in the response rate between the treatment group(44/54,81.5%)and the control group(34/47,72.3%;χ^(2)=0.12,P>0.05).Twelve weeks after discontinuation of treatment,2 patients(3.7%)relapsed in the treatment group,while 15(31.9%)relapsed in the control group,sh

关 键 词:黄褐斑 显微镜检查 共焦 中药面膜 面部图像分析 体视学测量法 疗效评价 

分 类 号:R758.42[医药卫生—皮肤病学与性病学]

 

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