滋阴清肝消痤颗粒治疗女性痤疮疗效观察及痤疮生存质量量表的测评
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摘要
一、背景
是皮肤科门诊的常见病、多发病。国内外的研究资料显示，青春期人群中80-90％的人都患过痤疮。其发病率逐年上升，且年龄跨度变大。痤疮的防治日益受到关注。
国内外的流行病学资料提示，成年人痤疮以女性为主，且多为持续性。所以女性痤疮的治疗成为了目前痤疮研究的热点。西医治疗寻常痤疮的药物主要有抗雄性激素药、抑制皮脂腺分泌和抗角化药、抗生素和维生素等，另外，还有许多激光等物理治疗方法。但这些药物有着较大的副作用，激光治疗的费用昂贵，对于女性痤疮患者，目前仍需探讨一个可以长期使用又有效的理想治疗方案。
痤疮在中医学中称为“肺风粉刺”，中医学文献很早就有记载。近几十年来，许多医家在传统痤疮病机理论的基础上提出了血瘀、湿热、痰结、肾阴不足、肝郁等新观点。在女性痤疮方面，临床中患者的病情往往与月经有关，我们认为女性痤疮的发生、发展与肝失疏泄，冲任不调密切相关，并且与肝经郁热也关系密切。据此我们根据多年的临床经验，拟定了滋阴清肝消痤方(女贞子、旱莲草、柴胡、郁金、丹参、鱼腥草等)，临床上用于阴虚火旺、肝经郁热型女性痤疮的治疗，取得了满意的临床疗效。
痤疮常反复发作，影响美容，会对青少年的身心健康都带来不良影响，容易导致焦虑、抑郁、情绪低落，这些情况在女性中更为多见，甚至影响到他们的生存质量，而上述因素又会反过来影响痤疮的病情。因此，有关痤疮患者的生存质量研究也是一个研究热点。
二、目的
1．为寻求一种服用方便且疗效确切的中药制剂，本临床研究采用单味中药免煎颗粒，配成滋阴清肝消痤方颗粒，以观察滋阴清肝消痤方治疗女性痤疮的临床疗效。
2．探讨中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)在国内的适用性，以方便今后痤疮的生存质量调查。
三、方法
1．将列入观察的120例女性痤疮患者按随机分组原则分为滋阴清肝消痤方颗粒组60例，美满霉素组60例，分别治疗4周，两组均使用痤灵酊外搽。
2．120例成年女性痤疮患者在4周治疗的前后均填写中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)两种量表，然后分析量表的信度、效度和反应度。
四、结果
1．滋阴清肝消痤方颗粒治疗组治愈4例，显效14例，有效26例，无效8例，总有效率为84.6％；美满霉素对照组治愈5例，显效13例，有效25例，无效5例，总有效率为89.6％，两组疗效相仿(P＞0.05)。但治疗组发生药物不良反应事件7例，对照组发生不良反应事件9例，治疗组较对照组少。
2．中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)两量表的信度、效度均较好，而反应度均无统计学意义。
五、结论
1．滋阴清肝消痤方对成年女性痤疮患者的疗效好，与美满霉素的疗效相当，而且发生不良事件少，症状轻。
2．皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)中文版量表具有较好的信度及效度，进行部分修改后，能作为我国痤疮患者生存质量的测评工具，但是量表的反应度有待进一步研究。
Background: Ache vulgaris is a chronic and inflammatory skin disease involving in hair follicle and sebaceous gland that commonly occurs in adolescence and in young adulthood. It.is.commonly seen at department of dermatology, the major pathogenic factors involved are hyperkeratinization, obstruction of sebaceous follicles resulting from abnormal keratinization of the infundibular epithelium, stimulation of sebaceous gland secretion by androgens, and microbial colonization of pilosebaceous units by Propionibacterium aches, which promotes perifollicular inflammation. The lesions are often seen on the face, back and chest because the sebaceous glands in these regions are particularly active. It is characteristic of papules, pustule, node, cyst, and so on, with occurring repeatedly. Ache often appears on the surface of the facial skin, which has an effect on the beauty. With the improvement of the living conditions, people attach more and more importance to the treatment of the ache.
Being founded from many researches, a majority of adult ache patients are female, and is durative. In western medicine, the main drugs for treating ache include the drugs of anti-androgen, the drugs that can restrict the secretionof sebaceous gland and anti-keratinization, antibiotics, vitamin and so on. In spite of numerous treatments available, they have some side-effect, no achetherapeutics has been found that is security, valid and ideal for women up to now.
In traditional Chinese medicine, acne vulgaris is generally called as "lung-wind acne", it was recorded very early in Chinese literature. After systematically arranging historical records related to the pathogeny and mechanism of ache vulgaris, and carrying out an overview on literature in recent years, great advancement has been made in the understanding the pathogeny and mechanism of ache vulgaris in Traditional Chinese Medicine(TCM). The doctor of TCM form some new point of view that "Blood Deficiency", "Dampness and Heat", "Phlegm Accumulation", "Yin Deficiency of Kidney", "Liver Depression" and so on. For women, acne often outbreaks associated with menstruation, which is related to "Failure of the Liver to Dredge and Regulate" and "Dysfunction of Thoroughfare Vessel and Conception Vessel". The occurrence of ache vulgaris is closely associated with "Heat in Liver Meridian" besides "in Deficiency of Kidney" and "Yin Deficiency and Blood Heat". Based on the theory of above, we use Ziyin Qinggan Xiaocuo prescription (ZQXP, mainly composed of Fructus Ligustri Lucidi, Herba Ecliptae, Radix Bupleuri, Radix Curcumae, Radix Salviae Miltiorrhizae, Herba Houttuyniae, etc.) to treat ache of women. The therapeutic effect is satisfaction.
Purpose: 1. In order to find a preparation of TCM, which has definite clinical effect and be convenience for taking, we use Single TCM concentrated Granules, of which Ziyin Qinggan Xiaocuo prescription Granules is composed. We study the clinical therapeutic effect of Ziyin Qinggan Xiaocuo prescription in treating female ache. 2. To research the applicability of Dermatology of Life Scales (DQOLS) and the Cardiff Ache Disability Index (CADI) in China, to convenient for the follow research about ache patients' life quality.
Method: 1. One hundred and twenty about female ache vulgaris patients were randomized into two groups by random number table. The two groups received external application of Cuo Ling Tincture (CLT, mainly composed of Radix Salviae Miltiorrhizae, Radix Angelicae Dahuricae, Radix Astragali, etc.), and group A was treated with Ziyin Qinggan Xiaocuo prescription and group B with minocyclin additionally. The treatment lasted 28 days. 2. 120 female adult ache patients fill the forms before and after four weeks. Than analyze the reliability, validity and responsivity.
Results: 1. In group A, 4 were cured, 14 markedly effective, 26 effective and 8 ineffective, the total effective rate being 84.6%. In group B, 5 were cured, 13 markedly effective, 25 effective and 5 ineffective, the total effective rate being 89.6%, which is similar to that in group A (P＞0.05). Adverse action was found in 7 patients of group A and in 9 of group B. 2. The quality of two life forms have well reliability and validity. But the responsivities have no statistical meaning.
Conclusion: 1. Ziyin Qinggan Xiaocuo prescription has a good therapeutic effect for adult female acne vulgaris, which is similar to minocyclin. Meanwhile, ZQXP has less and slight adverse actions. 2. Both DQOLS and CADI have well reliability and validity, and they can be used to measure the quality of life for Chinese acne patients after amended. But the responsivity needs more studies.
是皮肤科门诊的常见病、多发病。国内外的研究资料显示，青春期人群中80-90％的人都患过痤疮。其发病率逐年上升，且年龄跨度变大。痤疮的防治日益受到关注。
国内外的流行病学资料提示，成年人痤疮以女性为主，且多为持续性。所以女性痤疮的治疗成为了目前痤疮研究的热点。西医治疗寻常痤疮的药物主要有抗雄性激素药、抑制皮脂腺分泌和抗角化药、抗生素和维生素等，另外，还有许多激光等物理治疗方法。但这些药物有着较大的副作用，激光治疗的费用昂贵，对于女性痤疮患者，目前仍需探讨一个可以长期使用又有效的理想治疗方案。
痤疮在中医学中称为“肺风粉刺”，中医学文献很早就有记载。近几十年来，许多医家在传统痤疮病机理论的基础上提出了血瘀、湿热、痰结、肾阴不足、肝郁等新观点。在女性痤疮方面，临床中患者的病情往往与月经有关，我们认为女性痤疮的发生、发展与肝失疏泄，冲任不调密切相关，并且与肝经郁热也关系密切。据此我们根据多年的临床经验，拟定了滋阴清肝消痤方(女贞子、旱莲草、柴胡、郁金、丹参、鱼腥草等)，临床上用于阴虚火旺、肝经郁热型女性痤疮的治疗，取得了满意的临床疗效。
痤疮常反复发作，影响美容，会对青少年的身心健康都带来不良影响，容易导致焦虑、抑郁、情绪低落，这些情况在女性中更为多见，甚至影响到他们的生存质量，而上述因素又会反过来影响痤疮的病情。因此，有关痤疮患者的生存质量研究也是一个研究热点。
二、目的
1．为寻求一种服用方便且疗效确切的中药制剂，本临床研究采用单味中药免煎颗粒，配成滋阴清肝消痤方颗粒，以观察滋阴清肝消痤方治疗女性痤疮的临床疗效。
2．探讨中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)在国内的适用性，以方便今后痤疮的生存质量调查。
三、方法
1．将列入观察的120例女性痤疮患者按随机分组原则分为滋阴清肝消痤方颗粒组60例，美满霉素组60例，分别治疗4周，两组均使用痤灵酊外搽。
2．120例成年女性痤疮患者在4周治疗的前后均填写中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)两种量表，然后分析量表的信度、效度和反应度。
四、结果
1．滋阴清肝消痤方颗粒治疗组治愈4例，显效14例，有效26例，无效8例，总有效率为84.6％；美满霉素对照组治愈5例，显效13例，有效25例，无效5例，总有效率为89.6％，两组疗效相仿(P＞0.05)。但治疗组发生药物不良反应事件7例，对照组发生不良反应事件9例，治疗组较对照组少。
2．中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)两量表的信度、效度均较好，而反应度均无统计学意义。
五、结论
1．滋阴清肝消痤方对成年女性痤疮患者的疗效好，与美满霉素的疗效相当，而且发生不良事件少，症状轻。
2．皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)中文版量表具有较好的信度及效度，进行部分修改后，能作为我国痤疮患者生存质量的测评工具，但是量表的反应度有待进一步研究。
Background: Ache vulgaris is a chronic and inflammatory skin disease involving in hair follicle and sebaceous gland that commonly occurs in adolescence and in young adulthood. It.is.commonly seen at department of dermatology, the major pathogenic factors involved are hyperkeratinization, obstruction of sebaceous follicles resulting from abnormal keratinization of the infundibular epithelium, stimulation of sebaceous gland secretion by androgens, and microbial colonization of pilosebaceous units by Propionibacterium aches, which promotes perifollicular inflammation. The lesions are often seen on the face, back and chest because the sebaceous glands in these regions are particularly active. It is characteristic of papules, pustule, node, cyst, and so on, with occurring repeatedly. Ache often appears on the surface of the facial skin, which has an effect on the beauty. With the improvement of the living conditions, people attach more and more importance to the treatment of the ache.
Being founded from many researches, a majority of adult ache patients are female, and is durative. In western medicine, the main drugs for treating ache include the drugs of anti-androgen, the drugs that can restrict the secretionof sebaceous gland and anti-keratinization, antibiotics, vitamin and so on. In spite of numerous treatments available, they have some side-effect, no achetherapeutics has been found that is security, valid and ideal for women up to now.
In traditional Chinese medicine, acne vulgaris is generally called as "lung-wind acne", it was recorded very early in Chinese literature. After systematically arranging historical records related to the pathogeny and mechanism of ache vulgaris, and carrying out an overview on literature in recent years, great advancement has been made in the understanding the pathogeny and mechanism of ache vulgaris in Traditional Chinese Medicine(TCM). The doctor of TCM form some new point of view that "Blood Deficiency", "Dampness and Heat", "Phlegm Accumulation", "Yin Deficiency of Kidney", "Liver Depression" and so on. For women, acne often outbreaks associated with menstruation, which is related to "Failure of the Liver to Dredge and Regulate" and "Dysfunction of Thoroughfare Vessel and Conception Vessel". The occurrence of ache vulgaris is closely associated with "Heat in Liver Meridian" besides "in Deficiency of Kidney" and "Yin Deficiency and Blood Heat". Based on the theory of above, we use Ziyin Qinggan Xiaocuo prescription (ZQXP, mainly composed of Fructus Ligustri Lucidi, Herba Ecliptae, Radix Bupleuri, Radix Curcumae, Radix Salviae Miltiorrhizae, Herba Houttuyniae, etc.) to treat ache of women. The therapeutic effect is satisfaction.
Purpose: 1. In order to find a preparation of TCM, which has definite clinical effect and be convenience for taking, we use Single TCM concentrated Granules, of which Ziyin Qinggan Xiaocuo prescription Granules is composed. We study the clinical therapeutic effect of Ziyin Qinggan Xiaocuo prescription in treating female ache. 2. To research the applicability of Dermatology of Life Scales (DQOLS) and the Cardiff Ache Disability Index (CADI) in China, to convenient for the follow research about ache patients' life quality.
Method: 1. One hundred and twenty about female ache vulgaris patients were randomized into two groups by random number table. The two groups received external application of Cuo Ling Tincture (CLT, mainly composed of Radix Salviae Miltiorrhizae, Radix Angelicae Dahuricae, Radix Astragali, etc.), and group A was treated with Ziyin Qinggan Xiaocuo prescription and group B with minocyclin additionally. The treatment lasted 28 days. 2. 120 female adult ache patients fill the forms before and after four weeks. Than analyze the reliability, validity and responsivity.
Results: 1. In group A, 4 were cured, 14 markedly effective, 26 effective and 8 ineffective, the total effective rate being 84.6%. In group B, 5 were cured, 13 markedly effective, 25 effective and 5 ineffective, the total effective rate being 89.6%, which is similar to that in group A (P＞0.05). Adverse action was found in 7 patients of group A and in 9 of group B. 2. The quality of two life forms have well reliability and validity. But the responsivities have no statistical meaning.
Conclusion: 1. Ziyin Qinggan Xiaocuo prescription has a good therapeutic effect for adult female acne vulgaris, which is similar to minocyclin. Meanwhile, ZQXP has less and slight adverse actions. 2. Both DQOLS and CADI have well reliability and validity, and they can be used to measure the quality of life for Chinese acne patients after amended. But the responsivity needs more studies.
引文
[1] Gary M. White MD San Diego, California. Recent findings in the epidemiologic evidence classification and subtybes of acne vulgaris. J Am Acad Dermatol 1998; 39(S): 34-37.
[2] Shaw CJ. Persistent ache in adult women. Arch dermatl, 2001; 137: 1252-1255.
[3] 李利．成年女性痤疮与相关因素的探讨．中国麻风皮肤病杂志，2004；12：515-517．
[4] 靳培英．痤疮的分型论治．中华皮肤科杂志，2002；35[1]：67—69．
[5] 吴剑波．微生物学检查对寻常痤疮治疗的指导意义．中国皮肤病学杂志，1999；5：149．
[6] 王建琴．迟发性或持久性女性痤疮患者血清性激素水平的研究．中国皮肤性病学杂志，2000；1：8-9．
[7] 王建琴．女性寻常痤疮患者甲状腺激素与性激素的测定及其相互关系的研究．岭南皮肤病科杂志，2001；12：199-200．
[8] 张素芳，曾燕，张秋燕．口服异维A酸治疗痤疮的临床疗效及实验室研究．中国麻风皮肤病杂志，2002；18(3)：228-230．
[9] 吴论，刘志群，欧赋斌．星状神经节阻滞治疗寻常痤疮．临床麻醉学杂志，2002；18(10)：530-530．
[10] 王昌媛，张福仁．光与寻常性痤疮的治疗．国外医学皮肤性病学分册，2004；11(6)：348-349．
[11] Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue(415 nm) and red (660 nm) light in the treatment of ache vulgaris. Br J Dermatol, 2000; 142: 973-978.
[12] Ashkenazi H, Malik Z, Harth Y, etal. Eradication of Propionibacterium aches by its endogenic porphyrins after illumination with high intensity blue light. FEMS Immunol Med Microbiol, 2003: 35: 17.
[13] Hongcharu W, Taylor CR, Chang Y, et al. Topical ALA2photody2namic therapy for the treatment of ache vulgaris. J Invest Dermatol, 2000; 115: 183-192.
[14] 陈平，黎咏璇，刘必来等．光子照射加中药痤疮膏联合治疗痤疮的临床观察．实用美容整形外科杂志，2003；14(3)：129-130．
[15] 吴余乐，燕淑美，厉建鸣等．高能量脉冲CO2激光修复面部凹陷性痤疮瘢痕的疗效与汽化深度．中华医学美学美容杂志，2005；11(1)：25-26．
[16] 吴成山．浅谈痤疮的中医诊治．甘肃中医，1997：10(5)：30．
[17] 顾松杰．痤疮从三焦论治刍议．安徽中医临床杂志，1999；11(4)：275．
[18] 钱江，杨柳．寻常痤疮辩证论治刍议．时珍国医国药，2004；15(12)：867-868．
[19] 王海鹰，周聪和，陈国勤．女性痤疮患者中医证型与性激素水平关系研究．新中医，2005；5：24-25．
[20] 刘矗．青年女性痤疮中医分型与血清性激素水平相关性研究．中国中医药信息杂志，2003；11：82-83．
[21] 黄炜．针刺治疗痤疮的临床研究．甘肃中医，2005；18(4)：6-7．
[22] 魏玉龙．自血疗法配合中药外涂治疗痤疮65例．河南中医药学刊，2000；15(1)：25-26．
[23] Stoll S, Shaltia AR, Webster GF. The effect of the menstrual cycle on ache. J Am Acad Dermatol, 2001 Dec: 45(6): 957-60.
[24] Lucky AW. Quantitative documentation of a premenstrual flare of facial ache in adult women. Arch Dermatol, 2OO4 Apr; 140(4): 423-424.
[25] 胡晓莉，张书梅，赵广碧等．女性迟发性痤疮与性激素关系的研究．中华皮肤科杂志，2000：33(6)：417．
[26] Goulden V, Clark SM, Cunliffe WJ. Postadolescent ache: a review of clinical features. Br J Dermatol, 1997; 136: 66-70.
[27] Ito A, Kitamura K, Sato K, Akamatsu H. A novel enzymatic assay for the quantification of skin surface lipids. J Int Med Res, 1996 Jan-Feb: 24(1): 69-83.
[28] Fisner DA. Desideratum dermatologicum—cause and control of premenstrual ache flare. Int J Dermatol. 2000 May; 39(5): 334-6.
[29] 王建琴，曾仁山．女性寻常型痤疮患者黄体期八项性激素和皮质醇水平的检测．中华皮肤科杂志，2000；33(4)：264-265．
[30] 虞瑞尧编著．痤疮诊治彩色图谱[M]，北京：北京北京科学技术出版社，2002，第一版：7．
[31] Tan AW, Tan HH. Ache vulgaris: a review of antibiotic therapy. Expert Opin Pharmacother, 2005 Mar: 6(3): 409-18.
[32] 尹兴平，夏隆庆．痤疮患者痤疮丙酸杆菌耐药性的研究进展．国外医学皮肤性病学分册，2004；30(3)：152-154．
[33] 魏雅川，卢贺起．115例女性寻常性痤疮的治疗探讨．实用中医药杂志，1994；10(5)：15-16．
[34] 冯桂丽．女性痤疮的中医治疗．天津中医学院学报，2000；19(2)：11．
[35] 陈英．女子面部痤疮从肝论治．河北中医，2003；25(2)：110-111．
[36] 张芃，张志礼．金菊香煎剂治疗女性寻常性痤疮临床观察及血清睾酮检测．中国 皮肤性病学杂志，2001；15(1)：48-49．
[37] 高山凤，赖慧红，徐成康．赖慧红辨证论治女性痤疮经验撷要．山西中医，2002；18(2)：8-9．
[38] 邓伟民．按月经周期辨证用药治疗面部痤疮78例．浙江中医杂志，1998；33(10)：454．
[39] 赵辨．临床皮肤病学[M]．江苏：江苏科学技术出版社，2003，第三版：936．
[40] 杨磊等．痤疮严重度分级及其治疗研究进展．滨州医学院学报，2005；2：41-42．
[41] 张晓梅．范瑞强教授治疗女性痤疮经验撷菁．中医药学刊，2004；4：588．
[42] 秦万章主编．皮肤病研究．上海：上海科学技术出版社，1990，第一版：130．
[43] 万崇华．生命质量的测定与评价方法[M]．昆明：云南大学出版社，1999，第一版：71-73．
[44] 倪宗瓒．医学统计学[M]．北京：高等教育出版社，2003，第一版：8．
[2] Shaw CJ. Persistent ache in adult women. Arch dermatl, 2001; 137: 1252-1255.
[3] 李利．成年女性痤疮与相关因素的探讨．中国麻风皮肤病杂志，2004；12：515-517．
[4] 靳培英．痤疮的分型论治．中华皮肤科杂志，2002；35[1]：67—69．
[5] 吴剑波．微生物学检查对寻常痤疮治疗的指导意义．中国皮肤病学杂志，1999；5：149．
[6] 王建琴．迟发性或持久性女性痤疮患者血清性激素水平的研究．中国皮肤性病学杂志，2000；1：8-9．
[7] 王建琴．女性寻常痤疮患者甲状腺激素与性激素的测定及其相互关系的研究．岭南皮肤病科杂志，2001；12：199-200．
[8] 张素芳，曾燕，张秋燕．口服异维A酸治疗痤疮的临床疗效及实验室研究．中国麻风皮肤病杂志，2002；18(3)：228-230．
[9] 吴论，刘志群，欧赋斌．星状神经节阻滞治疗寻常痤疮．临床麻醉学杂志，2002；18(10)：530-530．
[10] 王昌媛，张福仁．光与寻常性痤疮的治疗．国外医学皮肤性病学分册，2004；11(6)：348-349．
[11] Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue(415 nm) and red (660 nm) light in the treatment of ache vulgaris. Br J Dermatol, 2000; 142: 973-978.
[12] Ashkenazi H, Malik Z, Harth Y, etal. Eradication of Propionibacterium aches by its endogenic porphyrins after illumination with high intensity blue light. FEMS Immunol Med Microbiol, 2003: 35: 17.
[13] Hongcharu W, Taylor CR, Chang Y, et al. Topical ALA2photody2namic therapy for the treatment of ache vulgaris. J Invest Dermatol, 2000; 115: 183-192.
[14] 陈平，黎咏璇，刘必来等．光子照射加中药痤疮膏联合治疗痤疮的临床观察．实用美容整形外科杂志，2003；14(3)：129-130．
[15] 吴余乐，燕淑美，厉建鸣等．高能量脉冲CO2激光修复面部凹陷性痤疮瘢痕的疗效与汽化深度．中华医学美学美容杂志，2005；11(1)：25-26．
[16] 吴成山．浅谈痤疮的中医诊治．甘肃中医，1997：10(5)：30．
[17] 顾松杰．痤疮从三焦论治刍议．安徽中医临床杂志，1999；11(4)：275．
[18] 钱江，杨柳．寻常痤疮辩证论治刍议．时珍国医国药，2004；15(12)：867-868．
[19] 王海鹰，周聪和，陈国勤．女性痤疮患者中医证型与性激素水平关系研究．新中医，2005；5：24-25．
[20] 刘矗．青年女性痤疮中医分型与血清性激素水平相关性研究．中国中医药信息杂志，2003；11：82-83．
[21] 黄炜．针刺治疗痤疮的临床研究．甘肃中医，2005；18(4)：6-7．
[22] 魏玉龙．自血疗法配合中药外涂治疗痤疮65例．河南中医药学刊，2000；15(1)：25-26．
[23] Stoll S, Shaltia AR, Webster GF. The effect of the menstrual cycle on ache. J Am Acad Dermatol, 2001 Dec: 45(6): 957-60.
[24] Lucky AW. Quantitative documentation of a premenstrual flare of facial ache in adult women. Arch Dermatol, 2OO4 Apr; 140(4): 423-424.
[25] 胡晓莉，张书梅，赵广碧等．女性迟发性痤疮与性激素关系的研究．中华皮肤科杂志，2000：33(6)：417．
[26] Goulden V, Clark SM, Cunliffe WJ. Postadolescent ache: a review of clinical features. Br J Dermatol, 1997; 136: 66-70.
[27] Ito A, Kitamura K, Sato K, Akamatsu H. A novel enzymatic assay for the quantification of skin surface lipids. J Int Med Res, 1996 Jan-Feb: 24(1): 69-83.
[28] Fisner DA. Desideratum dermatologicum—cause and control of premenstrual ache flare. Int J Dermatol. 2000 May; 39(5): 334-6.
[29] 王建琴，曾仁山．女性寻常型痤疮患者黄体期八项性激素和皮质醇水平的检测．中华皮肤科杂志，2000；33(4)：264-265．
[30] 虞瑞尧编著．痤疮诊治彩色图谱[M]，北京：北京北京科学技术出版社，2002，第一版：7．
[31] Tan AW, Tan HH. Ache vulgaris: a review of antibiotic therapy. Expert Opin Pharmacother, 2005 Mar: 6(3): 409-18.
[32] 尹兴平，夏隆庆．痤疮患者痤疮丙酸杆菌耐药性的研究进展．国外医学皮肤性病学分册，2004；30(3)：152-154．
[33] 魏雅川，卢贺起．115例女性寻常性痤疮的治疗探讨．实用中医药杂志，1994；10(5)：15-16．
[34] 冯桂丽．女性痤疮的中医治疗．天津中医学院学报，2000；19(2)：11．
[35] 陈英．女子面部痤疮从肝论治．河北中医，2003；25(2)：110-111．
[36] 张芃，张志礼．金菊香煎剂治疗女性寻常性痤疮临床观察及血清睾酮检测．中国 皮肤性病学杂志，2001；15(1)：48-49．
[37] 高山凤，赖慧红，徐成康．赖慧红辨证论治女性痤疮经验撷要．山西中医，2002；18(2)：8-9．
[38] 邓伟民．按月经周期辨证用药治疗面部痤疮78例．浙江中医杂志，1998；33(10)：454．
[39] 赵辨．临床皮肤病学[M]．江苏：江苏科学技术出版社，2003，第三版：936．
[40] 杨磊等．痤疮严重度分级及其治疗研究进展．滨州医学院学报，2005；2：41-42．
[41] 张晓梅．范瑞强教授治疗女性痤疮经验撷菁．中医药学刊，2004；4：588．
[42] 秦万章主编．皮肤病研究．上海：上海科学技术出版社，1990，第一版：130．
[43] 万崇华．生命质量的测定与评价方法[M]．昆明：云南大学出版社，1999，第一版：71-73．
[44] 倪宗瓒．医学统计学[M]．北京：高等教育出版社，2003，第一版：8．
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