康斯特联合非那雄胺治疗男性雄激素源性脱发临床疗效观察
摘要
雄激素源性脱发(androgenetic alopecia,AGA),又称脂溢性脱发、男性型脱发。青年男性多见,主要由雄激素引起,呈进行性头发密度减少,从前额开始渐向头顶部延伸,发展至仅枕部及双颞剩余头发。近年来由于社会竞争压力,精神长期处于紧张状态,刺激机体增加分泌雄激素,使毛囊萎缩,致雄激素源性脱发患者逐渐增多。内治普遍口服雄激素抑制剂,然外治副作用相对较小,且大量临床报导显示其疗效显著。临床上已广泛应用外治法治疗雄激素性脱发,而制剂外洗及外涂较为便捷,操作技术性不高,较多患者接受。目前蔓迪与康斯特两种外用制剂已广泛用于我院临床。
目的：本研究旨在通过两种外用制剂对雄激素源性脱发临床疗效进行比较,为临床用药选择性提供理论依据及指导,为该病外治制剂选择提供一定指导方向。
方法：本研究采用随机对照的方法,共纳入男性雄激素源性脱发病例60例,按照随机原则分为治疗组30例,对照组30例,两组均口服非那雄胺片lmg qd,复方维生素B片3片tid,治疗组联合外用康斯特与对照组外用蔓迪比较,在治疗前及治疗后第1月、第2月、第3月和第6月各随访1次并填写相应观察量表,记录不良反应,监测血液、尿液常规及肝肾功能,探讨外用治疗雄激素性脱发的临床疗效。
结果：康斯特联合非那雄胺治疗男性雄激素源性脱发与蔓迪对照组疗效相当,治疗组有效率80.00%,对照组有效率73.33%,两组内治疗前后比较均有显著性差异(P<0.05),治疗组与对照组间疗效比较无明显差异。
结论：可见,康斯特联合非那雄胺在治疗雄激素源性脱发上疗效确切,且未发现毒副作用。
The androgenetic alopecia is also known as seborrheic alopecia or male pattern alopecia. It is more common in young men, and mainly caused by androgen.It showes a progressive hair density reduction, which extends gradually from the forehead to the top of the head and develops to the remaining hair of occipital and temporal. In recent years, due to the social pressure of competition, people are always in a state of tension, and this stimulates the body to increase the secretion of androgens which make the hair follicle atrophy, and cause the androgenetic alopecia patients increase gradually. The internal treatment is generally to take the androgen inhibitors, but the external treatment relatively has a gentler side effect and a large number of clinical reports shows that its effect is significant. The external treatment is widely used to cure androgenetic alopecia in clinic, and the preparations is more convenient to wash and coat, besides, it doesn't need high skill to manipulate, so more patients recept this treatment. Currently, the topical formulations Mandy and Kangsite has been widely used in our hospital.
Objective:This study aimed to compare the clinical effect of androgenetic alopecia in two topical formulations, to provide theoretical basis and guidance for clinical medicine selection. Furthermore, provide some direction for this disease at choosing topical formulations.
Method:This reserch used a stochastic and controled method. Brought in60cases of men with androgenetic alopecia, then divided them randomly to treatment group30cases and control group30cases. Both of two groups oral finasteride tablet lmg qd, and compound vitamin B tablet3pieces tid, the treatment group combine with Kangsite external use, compare to the control group combine with Mandy external use. Followed up once and filled in the corresponding observation scale before the treatment and the first month, the second month, the third month and the sixth month after the treatment, meanwhile recorded the adverse events, monitored the blood routine examination, the urine routine examination, the liver function and the renal function, in order to explore the clinical efficacy of topical treatment on androgenetic alopecia.
Result:The results showed that the treatment of Kangsite combining finasteride for androgenetic alopecia had a equal efficiency with the control group, The effective rate was80.00%in treatment group, and was73.33%in treatment group. The comparation before and after the treatment in two groups had significant differences(P<0.05), and the curative effect between the two groups has no significant differences.
Conclusion:We can see that Kangsite combining finasteride had a definite efficacy in the treatment of androgenetic alopecia, the toxic and side effects is not found.
目的：本研究旨在通过两种外用制剂对雄激素源性脱发临床疗效进行比较,为临床用药选择性提供理论依据及指导,为该病外治制剂选择提供一定指导方向。
方法：本研究采用随机对照的方法,共纳入男性雄激素源性脱发病例60例,按照随机原则分为治疗组30例,对照组30例,两组均口服非那雄胺片lmg qd,复方维生素B片3片tid,治疗组联合外用康斯特与对照组外用蔓迪比较,在治疗前及治疗后第1月、第2月、第3月和第6月各随访1次并填写相应观察量表,记录不良反应,监测血液、尿液常规及肝肾功能,探讨外用治疗雄激素性脱发的临床疗效。
结果：康斯特联合非那雄胺治疗男性雄激素源性脱发与蔓迪对照组疗效相当,治疗组有效率80.00%,对照组有效率73.33%,两组内治疗前后比较均有显著性差异(P<0.05),治疗组与对照组间疗效比较无明显差异。
结论：可见,康斯特联合非那雄胺在治疗雄激素源性脱发上疗效确切,且未发现毒副作用。
The androgenetic alopecia is also known as seborrheic alopecia or male pattern alopecia. It is more common in young men, and mainly caused by androgen.It showes a progressive hair density reduction, which extends gradually from the forehead to the top of the head and develops to the remaining hair of occipital and temporal. In recent years, due to the social pressure of competition, people are always in a state of tension, and this stimulates the body to increase the secretion of androgens which make the hair follicle atrophy, and cause the androgenetic alopecia patients increase gradually. The internal treatment is generally to take the androgen inhibitors, but the external treatment relatively has a gentler side effect and a large number of clinical reports shows that its effect is significant. The external treatment is widely used to cure androgenetic alopecia in clinic, and the preparations is more convenient to wash and coat, besides, it doesn't need high skill to manipulate, so more patients recept this treatment. Currently, the topical formulations Mandy and Kangsite has been widely used in our hospital.
Objective:This study aimed to compare the clinical effect of androgenetic alopecia in two topical formulations, to provide theoretical basis and guidance for clinical medicine selection. Furthermore, provide some direction for this disease at choosing topical formulations.
Method:This reserch used a stochastic and controled method. Brought in60cases of men with androgenetic alopecia, then divided them randomly to treatment group30cases and control group30cases. Both of two groups oral finasteride tablet lmg qd, and compound vitamin B tablet3pieces tid, the treatment group combine with Kangsite external use, compare to the control group combine with Mandy external use. Followed up once and filled in the corresponding observation scale before the treatment and the first month, the second month, the third month and the sixth month after the treatment, meanwhile recorded the adverse events, monitored the blood routine examination, the urine routine examination, the liver function and the renal function, in order to explore the clinical efficacy of topical treatment on androgenetic alopecia.
Result:The results showed that the treatment of Kangsite combining finasteride for androgenetic alopecia had a equal efficiency with the control group, The effective rate was80.00%in treatment group, and was73.33%in treatment group. The comparation before and after the treatment in two groups had significant differences(P<0.05), and the curative effect between the two groups has no significant differences.
Conclusion:We can see that Kangsite combining finasteride had a definite efficacy in the treatment of androgenetic alopecia, the toxic and side effects is not found.
引文
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[3]江光明,范瑞强,池凤好.榻国维教授治疗脂溢性皮肤病良方例析[J].中医药学刊2001,19(3)：203.
[4]杨建宏.六味地黄汤合二至丸加减治疗脱发120例[J].实用中医内科杂志,2009,23(1)：70.
[5]张苍,陶洋,陈凯.天麻钩藤饮治疗脂溢性脱发经验[J].中国中西医结合皮肤性病学杂志,2003,2(2)：120.
[6]方炳福.小柴胡汤治疗脱发34例[J].安徽中医临床杂志.1997.9(1)：7.
[7]徐云生.龙胆泻肝汤新用[J].新中医.1997,29(6)：54.
[8]程德华.健脾养血生发汤治疗脂溢性脱发36例[J].安徽中医学院学报.1998,17(5)：34.
[9]何养宁.论痰瘀在早秃发中的机制及其临床意义[J].陕西中医,1998,18(2)：66.
[10]柏彩宝,艾儒棣.楂曲平胃散治疗脂溢性脱发[J].山西中医,2007,23(3)：73.
[11]左安龙.脱发治肺验案3则[J].医案医话,2010,42(1)：46.
[12]张喜奎.陈亦人教授医话[J].国医论坛.1999,14(1)：17-18.
[13]马淑然,张宝春,刘晓燕.刘燕池教授治疗脂溢性脱发经验[J].安徽中医学院学报,2006,25(6)：12.
[14]郭晓洁,郭延林.从“源”、“流”论治脱发[J].河南中医,2009,29(6)：544.
[15]张洁,侯红丽,邓为.崔应珉教授治疗脂溢性脱发经验[J].河南中医,2008,28(6)：21.
[16]李东海,王丽,林少健,等.脱发与五脏相关性探讨[J].河南中医,2010,30(1)：20.
[17]Hanneken S, Ritzmann, Nothen MM, et al. Androgenetische Alopezie Aktuelle Aspekte eines yertrauten Phanotyps[J]. Hautarzt,2003;54(8):703-712.
[18]刘维,陈达灿,韩凌.雄激素性脱发患者血清雄激素水平测定[J].中国麻风皮肤病杂志,2007,23(2)：136.
[19]Inui S, Fukuzato Y, Nakajima T, et al. Androgen-inducible TGF-betal from balding dermal papilla cells inhibits epithelial cell growth:a clue to understand paradoxical effects of androgen on human hair growth. FASEB J 2002;16(14):1967-1969.
[20]Yoo HG, Kim JS, Lee SR et al. Perifollicular fibrosis:pathogenetic role in androgenetic alopecia. Biol Pharm Bull 2006;29(6):1246-1250.
[21]Singh SM, Gauthier S, Labrie F. Androgen receptor antagonists(antiandro-gens):structure-activity relationships. Curr Meb Chem 2000;7:211-247.
[22]Kaufman K. Androgen metabolism as it affects hair growth in androgenetic alopecia. Clin Dermatol,1996;14:697-711.
[23]KaufmanKD. Androgens and alopecia. Mol Cell Endocrinok[J],2002; 198(1-2):89-95.
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