阴三针治疗女性痤疮临床研究
摘要
目的：痤疮是一种常见的损美性疾病,表现为面部、胸部和背部的粉刺、丘疹、脓疱、结节及囊肿,是一种毛囊及皮脂腺的慢性炎症。本研究通过比较两组女性痤疮患者治疗前、第1疗程后、第2疗程后及随访1个月的皮损积分,客观评价阴三针对女性痤疮的临床疗效,以及疗效与中医证型和月经不调间的关系,初步探讨阴三针治疗女性痤疮的机制,为针刺治疗女性痤疮提供临床依据。
方法：将门诊女性痤疮患者随机分为治疗组和对照组,共60例。根据中医辨证分型为四型：冲任失调型18例,肺经风热型17例,湿热蕴结型18例,痰湿凝滞型7例。通过调查患者的月经情况发现,月经不调患者27例,占45%；经前皮损加重患者18例,占30%0。根据皮损严重程度分为四级：轻度8例,中度23例,重度26例,特重3例。治疗组针刺阴三针和手三针,对照组仅针刺手三针。隔日治疗一次,6次为1疗程,治疗2个疗程后结束,适逢行经期者当周休息1周。1个月后随访。采用痤疮综合分级系统(GAGS)对患者皮损进行评分,计算每个疗程后及随访时的皮损积分和临床疗效指数。采用SPSS18.0软件包进行统计学分析。
结果：治疗组30例总有效率为93.33%,对照组总有效率为86.67%,经比较差异有统计学意义(P<0.05)。随访1个月,治疗组复发1例,对照组复发3例,皮损积分比较差异有统计学意义(P<0.05),中医各证型治疗后总有效率比较,治疗组冲任失调型100%,肺经风热型100%,湿热蕴结型87%,痰湿凝滞型20%；对照组冲任失调型100%,肺经风热型100%,湿热蕴结型90%,痰湿凝滞型25%。比较临床疗效各级别例数后发现,冲任不调型两组间有显著性差异,余证型在两组间差异无统计学意义。组内证型两两比较显示治疗组冲任失调型和肺经风热型疗效与其余证型相比有显著性差异,而对照组仅对肺经风热型差异有统计学意义。治疗组月经不调患者总有效率85.71%,对照组月经不调患者总有效率76.92%,差异有统计学意义(P<0.05)；普通患者间疗效无显著性差异。
结论：两组患者经治疗后皮损均有改善。从第一疗程开始,治疗组的积分便明显低于对照组,提示治疗组可缩短治疗周期。治疗组对月经不调患者或冲任失调型患者疗效均高于对照组,随访情况也优于对照组。提示阴三针治疗女性痤疮具有起效快、治愈率高、复发率低的优势。无论患者是否伴随月经不调,均能取得较好疗效。
Objective:To observe the clinical effect of Yin-Three-Needle Technique on female acne, and preliminary estimate the possible mechanism by studying the comparisons of acne lesions and effective rates from two groups.
Methods:Randomized 60 female acne patients into Yin-Three-Needle group and control group. According to the differentiation standards of Chinese Medicine: there were 18 cases on Chong-Ren disorders,17 on Wind-Heat of Lung Channel, 18 on damp-heat syndrome,7 on dampness in total.27 cases complained of irregular menstruation, constituted 45% of 60 cases. Acne lesions were graded by GAGS (The Globe Acne Grading System), which is a quantitative scoring system in which the total severity score is derived from summation of six regional sub scores. The Yin-Three-Needle group received Yin-Three-Needle and Hand-three-Needle; while the control group received only Hand-three-Needle every other day, avoiding the menstruation week, collected severity scores of lesions after the 6th visit and the 12th visit. The follow-up visit was set on one month later. All data were analyzed under PASW Statistics 18.0. Results:Yin-Three-Needle group ended with effective of 93.33%, while control group was of 86.67%, indicating statistical significance (P<0.05). During follow-up visit, there were one recurrent patient in Yin-Three-Needle group, and 3 in control group. Their lesion scores showed a statistical significance (P<0.05). Compared the effective among the 4 differentiation types, Chong-Ren disorders and Wind-Heat of Lung Channel were 100%, while damp-heat syndrome was 87%, and dampness was 20% in. Yin-Three-Needle group; Chong-Ren disorders and Wind-Heat of Lung Channel were 100%, while damp-heat syndrome was 90%, and dampness was 25% in control group. Statistics showed only Chong-Ren disorders indicated statistical significance between two groups. Intra-class comparison of the Yin-Three-Needle group showed Chong-Ren disorders and Wind-Heat of Lung Channel were superior to other syndromes on effective rates, while control group only displayed a superiority in Wind-Heat of Lung Channel. Among cases complained with irregular cycles, their effective was 85.71% in Yin-Three-Needle group, and 76.92% in control group. This difference were proven statistical significance by PASW Statistics 18.0. The effective among regular cycle patients were almost the same.
Conclusion:Two groups were both effective in lowering lesion scores, while the Yin-Three-Needle group lowered the scores more quickly, with less recurrence cases, indicating the Yin-Three-Needle group are capable in shorten the treatment cycle with a more lower lesion scores. What's more, Yin-Three-Needle group achieved even better effective in irregular menstruation female than the control group. Yin-Three-Needle is an efficient, time-saving, and safe therapy in treating female acne.
方法：将门诊女性痤疮患者随机分为治疗组和对照组,共60例。根据中医辨证分型为四型：冲任失调型18例,肺经风热型17例,湿热蕴结型18例,痰湿凝滞型7例。通过调查患者的月经情况发现,月经不调患者27例,占45%；经前皮损加重患者18例,占30%0。根据皮损严重程度分为四级：轻度8例,中度23例,重度26例,特重3例。治疗组针刺阴三针和手三针,对照组仅针刺手三针。隔日治疗一次,6次为1疗程,治疗2个疗程后结束,适逢行经期者当周休息1周。1个月后随访。采用痤疮综合分级系统(GAGS)对患者皮损进行评分,计算每个疗程后及随访时的皮损积分和临床疗效指数。采用SPSS18.0软件包进行统计学分析。
结果：治疗组30例总有效率为93.33%,对照组总有效率为86.67%,经比较差异有统计学意义(P<0.05)。随访1个月,治疗组复发1例,对照组复发3例,皮损积分比较差异有统计学意义(P<0.05),中医各证型治疗后总有效率比较,治疗组冲任失调型100%,肺经风热型100%,湿热蕴结型87%,痰湿凝滞型20%；对照组冲任失调型100%,肺经风热型100%,湿热蕴结型90%,痰湿凝滞型25%。比较临床疗效各级别例数后发现,冲任不调型两组间有显著性差异,余证型在两组间差异无统计学意义。组内证型两两比较显示治疗组冲任失调型和肺经风热型疗效与其余证型相比有显著性差异,而对照组仅对肺经风热型差异有统计学意义。治疗组月经不调患者总有效率85.71%,对照组月经不调患者总有效率76.92%,差异有统计学意义(P<0.05)；普通患者间疗效无显著性差异。
结论：两组患者经治疗后皮损均有改善。从第一疗程开始,治疗组的积分便明显低于对照组,提示治疗组可缩短治疗周期。治疗组对月经不调患者或冲任失调型患者疗效均高于对照组,随访情况也优于对照组。提示阴三针治疗女性痤疮具有起效快、治愈率高、复发率低的优势。无论患者是否伴随月经不调,均能取得较好疗效。
Objective:To observe the clinical effect of Yin-Three-Needle Technique on female acne, and preliminary estimate the possible mechanism by studying the comparisons of acne lesions and effective rates from two groups.
Methods:Randomized 60 female acne patients into Yin-Three-Needle group and control group. According to the differentiation standards of Chinese Medicine: there were 18 cases on Chong-Ren disorders,17 on Wind-Heat of Lung Channel, 18 on damp-heat syndrome,7 on dampness in total.27 cases complained of irregular menstruation, constituted 45% of 60 cases. Acne lesions were graded by GAGS (The Globe Acne Grading System), which is a quantitative scoring system in which the total severity score is derived from summation of six regional sub scores. The Yin-Three-Needle group received Yin-Three-Needle and Hand-three-Needle; while the control group received only Hand-three-Needle every other day, avoiding the menstruation week, collected severity scores of lesions after the 6th visit and the 12th visit. The follow-up visit was set on one month later. All data were analyzed under PASW Statistics 18.0. Results:Yin-Three-Needle group ended with effective of 93.33%, while control group was of 86.67%, indicating statistical significance (P<0.05). During follow-up visit, there were one recurrent patient in Yin-Three-Needle group, and 3 in control group. Their lesion scores showed a statistical significance (P<0.05). Compared the effective among the 4 differentiation types, Chong-Ren disorders and Wind-Heat of Lung Channel were 100%, while damp-heat syndrome was 87%, and dampness was 20% in. Yin-Three-Needle group; Chong-Ren disorders and Wind-Heat of Lung Channel were 100%, while damp-heat syndrome was 90%, and dampness was 25% in control group. Statistics showed only Chong-Ren disorders indicated statistical significance between two groups. Intra-class comparison of the Yin-Three-Needle group showed Chong-Ren disorders and Wind-Heat of Lung Channel were superior to other syndromes on effective rates, while control group only displayed a superiority in Wind-Heat of Lung Channel. Among cases complained with irregular cycles, their effective was 85.71% in Yin-Three-Needle group, and 76.92% in control group. This difference were proven statistical significance by PASW Statistics 18.0. The effective among regular cycle patients were almost the same.
Conclusion:Two groups were both effective in lowering lesion scores, while the Yin-Three-Needle group lowered the scores more quickly, with less recurrence cases, indicating the Yin-Three-Needle group are capable in shorten the treatment cycle with a more lower lesion scores. What's more, Yin-Three-Needle group achieved even better effective in irregular menstruation female than the control group. Yin-Three-Needle is an efficient, time-saving, and safe therapy in treating female acne.
引文
[1]闵莉,李灿东,蔡东华.不同年龄青少年痤疮发病流行病学调查[J].甘肃中医学院学报,2008,25(1)：27-29.
[2]高爱莉,张宏,曾翰翔,等.广州市天河区青少年痤疮患病情况及危险因素分析[J].中国麻风皮肤病杂志,2007,23(12):1052-1053.
[3]李红毅,冯洁莹,范瑞强,等.女性痤疮与月经的关系(附339例分析)[J].中华现代皮肤科学杂志,2005,2(2)：138-139.
[4]张又仁,徐祖森.女性痤疮患者血清中性激素水平的研究[J].中国医师杂志,2004,(6)4：449-450.
[5]王建琴,曾仁山,唐绍生,等.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[J].中华皮肤科杂志,2000,33(4)：264-265.
[6]马骏,周星慧.痤疮与性激素的关系[J].中国医疗前沿,2008,3(20)：88.
[7]王建琴,曾仁山,唐绍生,等.迟发性或持久性女性痤疮患者血清性激素水平的研究[J].中国皮肤病学杂志,2000,14(1)：8-9.
[8]于中蛟,陆洁,段听所,等.女性痤疮患者卵泡期血清六项性激素水平的测定[J].皮肤与性病,2006,26(1)：9-11.
[9]盛文婷,陈建浩.女性迟发性痤疮血清性激素及皮质醇水平的研究[J].岭南皮肤性病科杂志,2003,10(4)：241-242.
[10]苏庆军,唐茂林,王一男,等.女性痤疮患者血清性激素水平的变化[J].华北国防医药,2006,18(3)：212-213.
[11]赵晓秋,康立久,张雁来.青春期后女性痤疮患者血清性激素水平的研究[J].中国麻风皮肤病学杂志,2001,17(4)：253-254.
[12]Iurassich S, Trotta C, Palagiano A, etal. Correlations between acne and Polycystic ovary:a study of 60 cases[J]. MinervaGineeol,2001,53(2):107.
[13]武峰,李宇欣.魏品康治疗痤疮经验举隅[J].山东中医药大学学报,2008,3(3)：217-218.
[14]陈文曾,刘建新,陈汉章.陈汉章教授治疗痤疮临床经验撷著[J].中医药学刊,2006,24(2)：213-214.
[15]张军领.烟建华教授治疗青春期痤疮经验[J].河南中医,2008,28(4)：23-24.
[16]郭琴.艾儒棣教授治疗寻常痤疮临床经验[J].中国中西医结合皮肤性病学杂志,2007,6(2)：91-92.
[17]刘爱军,唐宋教授临证治验[J].现代中医药,2009,29(1)：32-33.
[18]简小兵.李赛美论治女性痤疮经验[J].辽宁中医杂志,2007,34(4)：398-399.
[19]陈英.女子面部痤疮从肝论治[J].河北中医,2003,25(2)：110-111.
[20]杨慧敏,张景龙,张广中.育龄女性痤疮的内分泌水平测定及中医辨证治疗分析[J].中国中西医结合皮肤性病学杂志,2004,3(3)：149-151.
[21]田黎明.王玮蓁教授中西医结合治疗痤疮经验[J].湖南中医杂志,2006,22(1)：19-20.
[22]周佳.女性痤疮流行病学调查及中医证候临床研究[D].南京：南京中医药大学,2008.
[23]陈丽.女性痤疮的流行病学及与中医证型的相关研究[D].南京：南京中医药大学,2009.
[24]代淑芳,张步鑫,王延乾.刘爱民教授运用丹栀逍遥散治疗皮肤病验案5则[J].中国中西医结合皮肤性病杂志,2009,8(5)：297-298.
[25]刘丰兰,谢慧明.丹栀逍遥散加减治疗经前期痤疮52例[J].实用中西医结合临床,2005,5(5)：55.
[26]孙维峰,刘毅.丹栀逍遥散加减治疗面部痤疮伴月经不调36例[J].贵州中医学院学报,2005,21(1)：35.
[27]朱宜德.丹栀逍遥散治疗女性痤疮36例[J].暨南大学学报(医学版),2000,21(6)：43.
[28]柯友辉,陈浩波,杜晓靖,等.中西药联用治疗经前痤疮96例[J].浙江中西医结合杂志,2006,16(3)：168-169.
[29]刘丽琴,余土根.试述余土根分型辨治痤疮的经验[J].浙江中医杂志,2008,43(4)：228-229.
[30]姜永珊.龙胆泻肝汤加减治疗经前期痤疮84例[J].新中医,2003,35(9)：55.
[31]韦朝霞.用仙蓉逍遥饮合银红酒精外涂治疗经前痤疮43例[J].辽宁中医杂志,2000,27(10)：53-54.
[32]向丽萍.从肝肾论治经前期痤疮的临床观察[J].中国中医药信息杂志,2006,13(6)：61.
[33]刘德彬,宋传云.除痤汤治疗经前面部痤疮32例[J].山东中医杂志,2002,21(3)：145-146.
[34]郭红,李达,吴军.消痤饮治疗经前期痤疮[J].新中医,2008,40(3)：21.
[35]吕海香.养阴清热调冲任治疗经前期痤疮36例[J].广西中医药,2004,27(1)：38.
[36]王静.夏桂成教授运用调周法治疗面部痤疮的经验[J].吉林中医药,2007,27(6)：5-6.
[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[J].山西中医,2002,18(2)：8-9.
[38]江光明,吴元胜.消痤方配合辨证调经法治女性迟发性痤疮60例[J].江西中医药, 2008,39(306)：40-41.
[39]梁俊芳,段渠,李聪颖.中药结合调周法配合净面方治疗痤疮样月经疹60例[J].中国美容医学,2009,18(4)：542-543.
[40]于妍妍,赵成国.调周序贯疗法治疗面部痤疮伴月经后期40例[J].新中医,2005,5(37)：71.
[41]何玉伟,李晓泓,翟景慧,等.“逆针灸”对去卵巢大鼠生殖内分泌影响的研究[J].中华中医药学刊,2008,26(9)：1918-1920.
[42]秦正玉,胡玲,夏晓红,等.电针三阴交对围绝经期综合征患者生殖内分泌影响的随机对照研究[J].针刺研究,2007,32(4)：255-258.
[43]兰东,司天润,赵树玲.针药结合治疗不同证型女性迟发性与持久性痤疮的临床与实验研究[J].中国针灸,2004,24(6)：379-382.
[44]周华青.针刺配合穴位埋线治疗女性痤疮55例[J].浙江中医杂志,2009,44(11)：818.
[45]曹金梅.穴位埋线配合中药治疗经前期痤疮46例[J].吉林中医药,2003,23(8)：38-39.
[46]陈国勤,周聪和,王海鹰.从肝肾论治配合耳穴贴压治疗成年女性痤疮62例[J].中国中医药信息杂志,2009,16(10)：66.
[47]高静敏,相永梅,史正修.电针配合耳穴贴压治疗中年女性痤疮76例[J].中国针灸,2004,24(7)：474.
[48]丁敏,蒋亚秋.耳针治疗女性迟发性痤疮41例[J].中国针灸,2008,28(11)：833-834.
[49]徐佳,方海宁,杨淑娟.针刺加梅花针对女性痤疮患者血清睾酮含量的影响[J].南京中医药大学学报,2009,25(3)：223-224.
[50]黄碧玉,林丽莉,陈韵竹.针刺对女性迟发性痤疮患者性激素的影响[J].福建中医学院学报,2004,14(4)：16-18.
[51]樊星,刘晓华.中药结合刺络拔罐治疗女性痤疮68例疗效分析[J].中国美容医学,2008,15(1)：87-88.
[52]赵辨.临床皮肤病学[M].第3版,南京：江苏科学技术出版社,2001,3：935.
[53]Mango D, Ricci S, Manna P, et al. Clinical and hormonal effects of ethinylestradiol combined with gestodene and desogestrel in young women with acne vulgaris[J]. Contraception,1996,53(3):163-170.
[54]lto A, Kitamura K, Sato K, et al. A novel enzymatic assay for the quantification of skin surface lipids[J]. J Int Med Res,1996,24(1):69-83.
[55]周华.寻常痤疮和免疫[J].国外医学·皮肤性病学分册,1990,17(1)：14-17.
[56]鞠强,石继海,夏隆庆.白介素-1与痤疮[J].国外医学·皮肤性病学分册, 2001,27(1)：24-26.
[57]刘巧.中西医结合皮肤病治疗学[M].人民军医出版社,2001,1：379.
[58]冀慧霞,谷义蓉.安体舒通与阿达帕林凝胶联用治疗月经前痤疮[J].国际医药卫生导报,2002,7：57-58.
[59]杨克力,陆沪扬,姜燕.罗红霉素缓释片联合丹参酮治疗经期痤疮的疗效观察[J].中国麻风皮肤病杂志,2007,27(12)：1039.
[60]孙爱军,孔桂英,邓弘,等.妈富隆用于治疗女性痤疮的临床观察[J].世界医学杂志,2001,5(11)：42-43.
[61]孟繁俊.泼尼松联合维A酸乳膏治疗月经前痤疮疗效观察[J].中华皮肤科杂志,2004,37(7)：433-434.
[62]徐刚,余开梅,刘关玲.泼尼松内服治疗月经前痤疮[J].中国麻风皮肤病杂志,2002,18(4)：332.
[63]黄联继,易建平,梁利球.青年学生痤疮诱发及加重的相关因素分析[J].中国美容医学,2003,12(5)：537.
[64]张迪展,王广进.89例青春期后痤疮临床分析[J].中国麻风皮肤病杂志,2000,6(1)：26-27.
[65]薛梅.30岁以上的女性寻常痤疮105例分析[J].临床皮肤科杂志,1997,26：271.
[66]曹萍.69例女性青春期后痤疮临床分析[J].中国麻风皮肤病杂志,2005,21(2)：160-161.
[67]Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system[J]. Int J Dermatol,1997,36(6):416-418
[68]郑筱萸.中药新药临床研究指导原则[M].北京：中国医药科技出版社,2002,4：292.
[69]王启才.针灸治疗学[M].北京：中国中医药出版社,2003,1：220-222.
[70]沈雪勇.经络腧穴学[M].北京：中国中医药出版社,2003,1.
[71]张霞芬.靳三针结合辨证分型治疗痤疮的临床研究[D].广州：广州中医药大学,2010.
[72]袁青.靳瑞针灸传真[M].北京：人民卫生出版社,2006,1：249.
[73]胡玲,汪惠丽.电针关元与三阴交对围绝经期模型大鼠性激素及下丘脑β-EP调整作用的比较[J].中国针灸,2004,9(24)：651.
[74]刘宏艳,吴高媛,王滨,等.针刺治疗更年期综合征的实验研究[J].天津中医学院学报,2002,21(1)：46.
[75]李沛,安晓英.针刺不同穴位对雌性恒河猴生殖内分泌影响的实验研究[J].中医药学报,2000,(3)：51-53.
[76]李沛,徐文倩,安晓英,等.不同时间针刺对雌性恒河猴生殖内分泌影响的实验 研究[J].中国针灸,2002,22(3)：189-192.
[77]秦其兴.针刺归来穴治经迟[J].山西中医,1992,(05)：49.
[78]梁楚京,赖新生,李万瑶,等.针灸治疗闭经-溢乳综合征的临床观察[J].广州中医学院学报,1991,8(23)：201-203.
[2]高爱莉,张宏,曾翰翔,等.广州市天河区青少年痤疮患病情况及危险因素分析[J].中国麻风皮肤病杂志,2007,23(12):1052-1053.
[3]李红毅,冯洁莹,范瑞强,等.女性痤疮与月经的关系(附339例分析)[J].中华现代皮肤科学杂志,2005,2(2)：138-139.
[4]张又仁,徐祖森.女性痤疮患者血清中性激素水平的研究[J].中国医师杂志,2004,(6)4：449-450.
[5]王建琴,曾仁山,唐绍生,等.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[J].中华皮肤科杂志,2000,33(4)：264-265.
[6]马骏,周星慧.痤疮与性激素的关系[J].中国医疗前沿,2008,3(20)：88.
[7]王建琴,曾仁山,唐绍生,等.迟发性或持久性女性痤疮患者血清性激素水平的研究[J].中国皮肤病学杂志,2000,14(1)：8-9.
[8]于中蛟,陆洁,段听所,等.女性痤疮患者卵泡期血清六项性激素水平的测定[J].皮肤与性病,2006,26(1)：9-11.
[9]盛文婷,陈建浩.女性迟发性痤疮血清性激素及皮质醇水平的研究[J].岭南皮肤性病科杂志,2003,10(4)：241-242.
[10]苏庆军,唐茂林,王一男,等.女性痤疮患者血清性激素水平的变化[J].华北国防医药,2006,18(3)：212-213.
[11]赵晓秋,康立久,张雁来.青春期后女性痤疮患者血清性激素水平的研究[J].中国麻风皮肤病学杂志,2001,17(4)：253-254.
[12]Iurassich S, Trotta C, Palagiano A, etal. Correlations between acne and Polycystic ovary:a study of 60 cases[J]. MinervaGineeol,2001,53(2):107.
[13]武峰,李宇欣.魏品康治疗痤疮经验举隅[J].山东中医药大学学报,2008,3(3)：217-218.
[14]陈文曾,刘建新,陈汉章.陈汉章教授治疗痤疮临床经验撷著[J].中医药学刊,2006,24(2)：213-214.
[15]张军领.烟建华教授治疗青春期痤疮经验[J].河南中医,2008,28(4)：23-24.
[16]郭琴.艾儒棣教授治疗寻常痤疮临床经验[J].中国中西医结合皮肤性病学杂志,2007,6(2)：91-92.
[17]刘爱军,唐宋教授临证治验[J].现代中医药,2009,29(1)：32-33.
[18]简小兵.李赛美论治女性痤疮经验[J].辽宁中医杂志,2007,34(4)：398-399.
[19]陈英.女子面部痤疮从肝论治[J].河北中医,2003,25(2)：110-111.
[20]杨慧敏,张景龙,张广中.育龄女性痤疮的内分泌水平测定及中医辨证治疗分析[J].中国中西医结合皮肤性病学杂志,2004,3(3)：149-151.
[21]田黎明.王玮蓁教授中西医结合治疗痤疮经验[J].湖南中医杂志,2006,22(1)：19-20.
[22]周佳.女性痤疮流行病学调查及中医证候临床研究[D].南京：南京中医药大学,2008.
[23]陈丽.女性痤疮的流行病学及与中医证型的相关研究[D].南京：南京中医药大学,2009.
[24]代淑芳,张步鑫,王延乾.刘爱民教授运用丹栀逍遥散治疗皮肤病验案5则[J].中国中西医结合皮肤性病杂志,2009,8(5)：297-298.
[25]刘丰兰,谢慧明.丹栀逍遥散加减治疗经前期痤疮52例[J].实用中西医结合临床,2005,5(5)：55.
[26]孙维峰,刘毅.丹栀逍遥散加减治疗面部痤疮伴月经不调36例[J].贵州中医学院学报,2005,21(1)：35.
[27]朱宜德.丹栀逍遥散治疗女性痤疮36例[J].暨南大学学报(医学版),2000,21(6)：43.
[28]柯友辉,陈浩波,杜晓靖,等.中西药联用治疗经前痤疮96例[J].浙江中西医结合杂志,2006,16(3)：168-169.
[29]刘丽琴,余土根.试述余土根分型辨治痤疮的经验[J].浙江中医杂志,2008,43(4)：228-229.
[30]姜永珊.龙胆泻肝汤加减治疗经前期痤疮84例[J].新中医,2003,35(9)：55.
[31]韦朝霞.用仙蓉逍遥饮合银红酒精外涂治疗经前痤疮43例[J].辽宁中医杂志,2000,27(10)：53-54.
[32]向丽萍.从肝肾论治经前期痤疮的临床观察[J].中国中医药信息杂志,2006,13(6)：61.
[33]刘德彬,宋传云.除痤汤治疗经前面部痤疮32例[J].山东中医杂志,2002,21(3)：145-146.
[34]郭红,李达,吴军.消痤饮治疗经前期痤疮[J].新中医,2008,40(3)：21.
[35]吕海香.养阴清热调冲任治疗经前期痤疮36例[J].广西中医药,2004,27(1)：38.
[36]王静.夏桂成教授运用调周法治疗面部痤疮的经验[J].吉林中医药,2007,27(6)：5-6.
[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[J].山西中医,2002,18(2)：8-9.
[38]江光明,吴元胜.消痤方配合辨证调经法治女性迟发性痤疮60例[J].江西中医药, 2008,39(306)：40-41.
[39]梁俊芳,段渠,李聪颖.中药结合调周法配合净面方治疗痤疮样月经疹60例[J].中国美容医学,2009,18(4)：542-543.
[40]于妍妍,赵成国.调周序贯疗法治疗面部痤疮伴月经后期40例[J].新中医,2005,5(37)：71.
[41]何玉伟,李晓泓,翟景慧,等.“逆针灸”对去卵巢大鼠生殖内分泌影响的研究[J].中华中医药学刊,2008,26(9)：1918-1920.
[42]秦正玉,胡玲,夏晓红,等.电针三阴交对围绝经期综合征患者生殖内分泌影响的随机对照研究[J].针刺研究,2007,32(4)：255-258.
[43]兰东,司天润,赵树玲.针药结合治疗不同证型女性迟发性与持久性痤疮的临床与实验研究[J].中国针灸,2004,24(6)：379-382.
[44]周华青.针刺配合穴位埋线治疗女性痤疮55例[J].浙江中医杂志,2009,44(11)：818.
[45]曹金梅.穴位埋线配合中药治疗经前期痤疮46例[J].吉林中医药,2003,23(8)：38-39.
[46]陈国勤,周聪和,王海鹰.从肝肾论治配合耳穴贴压治疗成年女性痤疮62例[J].中国中医药信息杂志,2009,16(10)：66.
[47]高静敏,相永梅,史正修.电针配合耳穴贴压治疗中年女性痤疮76例[J].中国针灸,2004,24(7)：474.
[48]丁敏,蒋亚秋.耳针治疗女性迟发性痤疮41例[J].中国针灸,2008,28(11)：833-834.
[49]徐佳,方海宁,杨淑娟.针刺加梅花针对女性痤疮患者血清睾酮含量的影响[J].南京中医药大学学报,2009,25(3)：223-224.
[50]黄碧玉,林丽莉,陈韵竹.针刺对女性迟发性痤疮患者性激素的影响[J].福建中医学院学报,2004,14(4)：16-18.
[51]樊星,刘晓华.中药结合刺络拔罐治疗女性痤疮68例疗效分析[J].中国美容医学,2008,15(1)：87-88.
[52]赵辨.临床皮肤病学[M].第3版,南京：江苏科学技术出版社,2001,3：935.
[53]Mango D, Ricci S, Manna P, et al. Clinical and hormonal effects of ethinylestradiol combined with gestodene and desogestrel in young women with acne vulgaris[J]. Contraception,1996,53(3):163-170.
[54]lto A, Kitamura K, Sato K, et al. A novel enzymatic assay for the quantification of skin surface lipids[J]. J Int Med Res,1996,24(1):69-83.
[55]周华.寻常痤疮和免疫[J].国外医学·皮肤性病学分册,1990,17(1)：14-17.
[56]鞠强,石继海,夏隆庆.白介素-1与痤疮[J].国外医学·皮肤性病学分册, 2001,27(1)：24-26.
[57]刘巧.中西医结合皮肤病治疗学[M].人民军医出版社,2001,1：379.
[58]冀慧霞,谷义蓉.安体舒通与阿达帕林凝胶联用治疗月经前痤疮[J].国际医药卫生导报,2002,7：57-58.
[59]杨克力,陆沪扬,姜燕.罗红霉素缓释片联合丹参酮治疗经期痤疮的疗效观察[J].中国麻风皮肤病杂志,2007,27(12)：1039.
[60]孙爱军,孔桂英,邓弘,等.妈富隆用于治疗女性痤疮的临床观察[J].世界医学杂志,2001,5(11)：42-43.
[61]孟繁俊.泼尼松联合维A酸乳膏治疗月经前痤疮疗效观察[J].中华皮肤科杂志,2004,37(7)：433-434.
[62]徐刚,余开梅,刘关玲.泼尼松内服治疗月经前痤疮[J].中国麻风皮肤病杂志,2002,18(4)：332.
[63]黄联继,易建平,梁利球.青年学生痤疮诱发及加重的相关因素分析[J].中国美容医学,2003,12(5)：537.
[64]张迪展,王广进.89例青春期后痤疮临床分析[J].中国麻风皮肤病杂志,2000,6(1)：26-27.
[65]薛梅.30岁以上的女性寻常痤疮105例分析[J].临床皮肤科杂志,1997,26：271.
[66]曹萍.69例女性青春期后痤疮临床分析[J].中国麻风皮肤病杂志,2005,21(2)：160-161.
[67]Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system[J]. Int J Dermatol,1997,36(6):416-418
[68]郑筱萸.中药新药临床研究指导原则[M].北京：中国医药科技出版社,2002,4：292.
[69]王启才.针灸治疗学[M].北京：中国中医药出版社,2003,1：220-222.
[70]沈雪勇.经络腧穴学[M].北京：中国中医药出版社,2003,1.
[71]张霞芬.靳三针结合辨证分型治疗痤疮的临床研究[D].广州：广州中医药大学,2010.
[72]袁青.靳瑞针灸传真[M].北京：人民卫生出版社,2006,1：249.
[73]胡玲,汪惠丽.电针关元与三阴交对围绝经期模型大鼠性激素及下丘脑β-EP调整作用的比较[J].中国针灸,2004,9(24)：651.
[74]刘宏艳,吴高媛,王滨,等.针刺治疗更年期综合征的实验研究[J].天津中医学院学报,2002,21(1)：46.
[75]李沛,安晓英.针刺不同穴位对雌性恒河猴生殖内分泌影响的实验研究[J].中医药学报,2000,(3)：51-53.
[76]李沛,徐文倩,安晓英,等.不同时间针刺对雌性恒河猴生殖内分泌影响的实验 研究[J].中国针灸,2002,22(3)：189-192.
[77]秦其兴.针刺归来穴治经迟[J].山西中医,1992,(05)：49.
[78]梁楚京,赖新生,李万瑶,等.针灸治疗闭经-溢乳综合征的临床观察[J].广州中医学院学报,1991,8(23)：201-203.