中药穴位注射治疗女性黄褐斑的临床研究
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摘要
目的：探讨中药穴位注射疗法对女性黄褐斑患者性激素水平的影响及其临床疗效观察。
方法：本研究选择女性黄褐斑患者46例,采用随机分组,治疗组和对照组各23例。患者治疗前进行血清性激素水平检测,治疗组采用中药穴位注射疗法,对照组口服维生素C和维生素E,疗程5周,治疗结束1个月后再次检测血清性激素水平,比较治疗前后血清性激素水平改变是否有差异性；观察治疗前后患者的皮损改善情况,比较两组之间疗效是否有差异性。
结果：本研究结果显示,治疗组1个月后总有效率为86.96%,对照组总有效率为56.52%,两组比较有显著性差异(P<0.05)。治疗组治疗前后血清性激素水平对比有显著性差异(P<0.05),说明中药穴位注射疗法能够降低黄褐斑患者的血清性激素水平。
结论：中药穴位注射疗法治疗黄褐斑疗效确切,能够降低患者血清性激素水平。
Objective:To investigate the influence of the acupoint-injection with Chinese herb on the sex hormone level of female patients with melasma and to reserve the clinical effects.
Methods:46 cases in this series were divided into the research group and the control group randomly with 23 cases in each group. The research group was given acupoint-injection with Chinese herb while the control group took vitamin C and vitamin E orally. The course of treatment was five weeks. The sexual hormone level of all patients were detected before and after the one-month treatment respectively. The two measurements were contrasted to determine whether there was significant variability; The cutaneous lesions'variation before and after the treatment was observed and contrasted to determine whether there was significant variability in the curative effect.
Results:This study shows that the total effective rate of the research group is 86.96% while that of the control group is 56.52%. There exists significant variability between the two groups (P<0.05).The sexual hormone level before and after the treatment has significant variability (P<0.05), which indicates that the acupoint-injection with Chinese herb treatment can decrease patients'sexual hormone level.
Conclusion:The acupoint-injection with Chinese herb on chloasma has definite curative effect and this treatment can decrease the sexual hormone level.
方法：本研究选择女性黄褐斑患者46例,采用随机分组,治疗组和对照组各23例。患者治疗前进行血清性激素水平检测,治疗组采用中药穴位注射疗法,对照组口服维生素C和维生素E,疗程5周,治疗结束1个月后再次检测血清性激素水平,比较治疗前后血清性激素水平改变是否有差异性；观察治疗前后患者的皮损改善情况,比较两组之间疗效是否有差异性。
结果：本研究结果显示,治疗组1个月后总有效率为86.96%,对照组总有效率为56.52%,两组比较有显著性差异(P<0.05)。治疗组治疗前后血清性激素水平对比有显著性差异(P<0.05),说明中药穴位注射疗法能够降低黄褐斑患者的血清性激素水平。
结论：中药穴位注射疗法治疗黄褐斑疗效确切,能够降低患者血清性激素水平。
Objective:To investigate the influence of the acupoint-injection with Chinese herb on the sex hormone level of female patients with melasma and to reserve the clinical effects.
Methods:46 cases in this series were divided into the research group and the control group randomly with 23 cases in each group. The research group was given acupoint-injection with Chinese herb while the control group took vitamin C and vitamin E orally. The course of treatment was five weeks. The sexual hormone level of all patients were detected before and after the one-month treatment respectively. The two measurements were contrasted to determine whether there was significant variability; The cutaneous lesions'variation before and after the treatment was observed and contrasted to determine whether there was significant variability in the curative effect.
Results:This study shows that the total effective rate of the research group is 86.96% while that of the control group is 56.52%. There exists significant variability between the two groups (P<0.05).The sexual hormone level before and after the treatment has significant variability (P<0.05), which indicates that the acupoint-injection with Chinese herb treatment can decrease patients'sexual hormone level.
Conclusion:The acupoint-injection with Chinese herb on chloasma has definite curative effect and this treatment can decrease the sexual hormone level.
引文
[1]中国中西医结合学会皮肤性病专业委员会色素病学组.黄褐斑的临床诊断和疗效标准(2003年修定稿)[J].中华皮肤科杂志,2004,37(7)：440.
[2]王海棠.中医美容[M].北京：中国中医药出版社,1997：39-40.
[3]田绍侠.面部皮肤病自疗与美容护肤[M].北京：昆仑出版社,2004：54-55.
[4]中国中西医结合学会皮肤性病专业委员会色素病学组.黄褐斑的临床诊断和疗效标准(2003年修定稿)[J]中华皮肤科杂志,2004,37(7)：440.
[5]南京中医学院.黄帝内经素问译释[M].上海：上海科学技术出版社,1991,624.
[6]迟华基.《难经》临床学习参考[M].北京：人民卫生出版社,2002：132.
[7]宋·齐仲甫.女科百问[M].天津：天津科学技术出版社,1999：34-35.
[8]明·朱棣.普济方[M].北京：人民卫生出版社,1959：431.
[9]清·吴谦等.医宗金鉴[M].北京：人民卫生出版社,1963：130.
[10]清·吴谦等.医宗金鉴[M].北京：人民卫生出版社,1963：130.
[11]清·许克昌,毕法.外科证治全书[M].北京：人民卫生出版社,1987：23.
[12]清·张璐.张氏医通[M].北京：中国中医药出版社,1995：209.
[13]郭霭春.黄帝内经灵枢校注语译[M].天津：天津科学技术出版社,1989：287.
[14]明·陈实功.外科正宗[M].北京：中国中医药出版社,2002：252.
[15]清·何梦瑶.医偏[M].上海：上海科学技术出版社,1982：202.
[16]Vazquez M,Heor M,Bermaman C etal. Malasma in men:a clinical and histologic sixly[J].Int Dermatal,1988,27:25-26.
[17]Pere Zm, Sanchez, Ahuilo F. Endocrinologic proflile of patierts with idopathic melasma[J].J Invest Dermatol,1983,81:543-545.
[18]朱光斗,周萍英,孙越等.疏肝解郁调理脾肾法治疗黄褐斑探讨[J].中西医结合皮肤性病学杂志,1997,10(试刊号)：3.
[19]刘爱民.关于黄褐斑病因病机及辨证分型的探讨-436例调查分析[J].中医研究,1995,8(4)：27.
[20]万苗坚,蔡瑞康,张其亮,等.男性黄褐斑皮损区微生态及血清性激素水平的研究[J].中华医学美容杂志,1999,5(2)：32-36.
[21]祝小枫,盛志勇,等.黄褐斑生态治疗和菌群改变的研究[J].中国皮肤性病学杂志,1995,9(2)：70-71.
[22]万苗坚,赵广,蔡瑞康,等.黄褐斑患者皮损区微生态改变的探讨[J].临床皮肤科杂志,1998,26(2)：87-89.
[23]小仓良平.紫外线照射の皮肤疾患[J].最新医学,1978,33：686-690.
[24]陈缓,周玫.自由基学[M].北京：人民军医出版社,1999：42-46.
[25]Hai CX. Studies of lipid peroxidation of people living in high Selenium area[J]. China Environmental Science,1993,4(1):8-50.
[26]Grimes PE. Melasama, etiologic and therapeutic considerations[J]. Arch Dematol,1995,13(12):1453.
[27]万苗坚.黄褐斑研究进展[J].国外医学皮肤性病学分册,1996,22(4)：209.
[28]Boloonia J, Murray M, Pawelek J, et al. UVB-induced nlelanogenesis may be mediated through the MSH receptor system[J]. J Invest Dermatol 1989, 92(5):651.
[29]Kadono S, Manaka I, kawashima M, et al. The role of the epidermal endothlin eascade in the hyperpigmentafion mechanism of lengigo sennilis[J]. J Invest Dermatol,2001,116(4):571.
[30]Mizoguehi M,Murakami F,Ito M,et al. Clinical,patholo-gical,and etiologic aspects of acquired demal melanocytosis[J]. Pigment Cell Res,1997, 10(3):176.
[31]张素洁.中医辨证分析治疗黄褐斑与血液流学关系的研究与分析[J].中国中医基础学杂志,1998,4(11)：35.
[32]Javaheri SM, Handa S, Kaur I, et al. Safety and efficacyof glycohc acid facial peel in Indian women with melasma[J]. Int J Dermatol,2001, 40(5):354.
[33]Kauh YC, Zachian TF.Melasma[J]. Adv Exp Med Biol,1999,25(3):491.
[34]杨慧兰,冯穗一,廖元兴.广州地区黄褐斑有关发病因素的流行病学调查[J].临床皮肤科杂志,1996,2：89-90.
[35]Wolf R, Wolf D, Tamir A, et al.Meiasma:a mask of stress[J]. Br J Dermatol, 1991,125(2):192.
[36]朱文元,陈力.美容皮肤医学新进展.北京：化学工业出版社,2009,3：122-123.
[37]Nouri K Bowes L, Chartier T, et al. Combination treatment of melasma with Pulsed CO2 laser followed by Q-Switched Alexandrite laser:a piloy dyudy [J] Dermatol Surg,1999,25:494-497.
[38]Angsuwarangsee S, Polnikorn N.Combined Ultrapulse CO2 laser and Q-Switched Alexandrite laser Compared with Q-Switched Alexandrite laser Alone for Refractory Melasma:Split Face Design[J]Dermatologic Surgery, 2003:1524-1525.
[39]Kunachak S, Leelaudomlipi P, Wongwaisayawan S. Dermabrasion:a curative treatment for melasma. Aesthetic Plast surg,2001,25:114-117.
[40]杨晋红,罗永莉.穴位注射治疗黄褐斑30例.针灸临床杂志,2000,16(6)：16-17.
[41]顾艳明.穴位注射配合按摩治疗黄褐斑56例.针灸临床杂志,2001,17(5)：49.
[42]李忠仁.实验针灸学[M].北京：中国中医药出版社,2003：189.
[43]付海平.穴位注射治疗面部色斑30例[J].中医外治杂志,2007,16(4)：54.
[1]曾衍胜,叶义森.疏肝化瘀消斑汤治疗黄褐斑临床观察[J].甘肃中医,2009,22(4)：24.
[2]张淑娥,杨海珍,薛少薇.桃红四物汤加味治疗黄褐斑45例[J].江苏中医,2000,21(2)：26.
[3]翁丽丽.自拟疏肝祛斑汤治疗肝郁血瘀型黄褐斑30例临床研究[J].中华中医药杂志,2009,24(3)：399.
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[18]杨晋红,罗永莉.穴位注射治疗黄褐斑30例.针灸临床杂志,2000,16(6)：16-17.
[19]顾艳明.穴位注射配合按摩治疗黄褐斑56例.针灸临床杂志,2001,17(5)：49.
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[22]辜大为.内外合治黄褐斑92例总结[J].湖南中医杂志,1998,4(3)：26.
[2]王海棠.中医美容[M].北京：中国中医药出版社,1997：39-40.
[3]田绍侠.面部皮肤病自疗与美容护肤[M].北京：昆仑出版社,2004：54-55.
[4]中国中西医结合学会皮肤性病专业委员会色素病学组.黄褐斑的临床诊断和疗效标准(2003年修定稿)[J]中华皮肤科杂志,2004,37(7)：440.
[5]南京中医学院.黄帝内经素问译释[M].上海：上海科学技术出版社,1991,624.
[6]迟华基.《难经》临床学习参考[M].北京：人民卫生出版社,2002：132.
[7]宋·齐仲甫.女科百问[M].天津：天津科学技术出版社,1999：34-35.
[8]明·朱棣.普济方[M].北京：人民卫生出版社,1959：431.
[9]清·吴谦等.医宗金鉴[M].北京：人民卫生出版社,1963：130.
[10]清·吴谦等.医宗金鉴[M].北京：人民卫生出版社,1963：130.
[11]清·许克昌,毕法.外科证治全书[M].北京：人民卫生出版社,1987：23.
[12]清·张璐.张氏医通[M].北京：中国中医药出版社,1995：209.
[13]郭霭春.黄帝内经灵枢校注语译[M].天津：天津科学技术出版社,1989：287.
[14]明·陈实功.外科正宗[M].北京：中国中医药出版社,2002：252.
[15]清·何梦瑶.医偏[M].上海：上海科学技术出版社,1982：202.
[16]Vazquez M,Heor M,Bermaman C etal. Malasma in men:a clinical and histologic sixly[J].Int Dermatal,1988,27:25-26.
[17]Pere Zm, Sanchez, Ahuilo F. Endocrinologic proflile of patierts with idopathic melasma[J].J Invest Dermatol,1983,81:543-545.
[18]朱光斗,周萍英,孙越等.疏肝解郁调理脾肾法治疗黄褐斑探讨[J].中西医结合皮肤性病学杂志,1997,10(试刊号)：3.
[19]刘爱民.关于黄褐斑病因病机及辨证分型的探讨-436例调查分析[J].中医研究,1995,8(4)：27.
[20]万苗坚,蔡瑞康,张其亮,等.男性黄褐斑皮损区微生态及血清性激素水平的研究[J].中华医学美容杂志,1999,5(2)：32-36.
[21]祝小枫,盛志勇,等.黄褐斑生态治疗和菌群改变的研究[J].中国皮肤性病学杂志,1995,9(2)：70-71.
[22]万苗坚,赵广,蔡瑞康,等.黄褐斑患者皮损区微生态改变的探讨[J].临床皮肤科杂志,1998,26(2)：87-89.
[23]小仓良平.紫外线照射の皮肤疾患[J].最新医学,1978,33：686-690.
[24]陈缓,周玫.自由基学[M].北京：人民军医出版社,1999：42-46.
[25]Hai CX. Studies of lipid peroxidation of people living in high Selenium area[J]. China Environmental Science,1993,4(1):8-50.
[26]Grimes PE. Melasama, etiologic and therapeutic considerations[J]. Arch Dematol,1995,13(12):1453.
[27]万苗坚.黄褐斑研究进展[J].国外医学皮肤性病学分册,1996,22(4)：209.
[28]Boloonia J, Murray M, Pawelek J, et al. UVB-induced nlelanogenesis may be mediated through the MSH receptor system[J]. J Invest Dermatol 1989, 92(5):651.
[29]Kadono S, Manaka I, kawashima M, et al. The role of the epidermal endothlin eascade in the hyperpigmentafion mechanism of lengigo sennilis[J]. J Invest Dermatol,2001,116(4):571.
[30]Mizoguehi M,Murakami F,Ito M,et al. Clinical,patholo-gical,and etiologic aspects of acquired demal melanocytosis[J]. Pigment Cell Res,1997, 10(3):176.
[31]张素洁.中医辨证分析治疗黄褐斑与血液流学关系的研究与分析[J].中国中医基础学杂志,1998,4(11)：35.
[32]Javaheri SM, Handa S, Kaur I, et al. Safety and efficacyof glycohc acid facial peel in Indian women with melasma[J]. Int J Dermatol,2001, 40(5):354.
[33]Kauh YC, Zachian TF.Melasma[J]. Adv Exp Med Biol,1999,25(3):491.
[34]杨慧兰,冯穗一,廖元兴.广州地区黄褐斑有关发病因素的流行病学调查[J].临床皮肤科杂志,1996,2：89-90.
[35]Wolf R, Wolf D, Tamir A, et al.Meiasma:a mask of stress[J]. Br J Dermatol, 1991,125(2):192.
[36]朱文元,陈力.美容皮肤医学新进展.北京：化学工业出版社,2009,3：122-123.
[37]Nouri K Bowes L, Chartier T, et al. Combination treatment of melasma with Pulsed CO2 laser followed by Q-Switched Alexandrite laser:a piloy dyudy [J] Dermatol Surg,1999,25:494-497.
[38]Angsuwarangsee S, Polnikorn N.Combined Ultrapulse CO2 laser and Q-Switched Alexandrite laser Compared with Q-Switched Alexandrite laser Alone for Refractory Melasma:Split Face Design[J]Dermatologic Surgery, 2003:1524-1525.
[39]Kunachak S, Leelaudomlipi P, Wongwaisayawan S. Dermabrasion:a curative treatment for melasma. Aesthetic Plast surg,2001,25:114-117.
[40]杨晋红,罗永莉.穴位注射治疗黄褐斑30例.针灸临床杂志,2000,16(6)：16-17.
[41]顾艳明.穴位注射配合按摩治疗黄褐斑56例.针灸临床杂志,2001,17(5)：49.
[42]李忠仁.实验针灸学[M].北京：中国中医药出版社,2003：189.
[43]付海平.穴位注射治疗面部色斑30例[J].中医外治杂志,2007,16(4)：54.
[1]曾衍胜,叶义森.疏肝化瘀消斑汤治疗黄褐斑临床观察[J].甘肃中医,2009,22(4)：24.
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