改良中药祛斑汤治疗黄褐斑的疗效观察及初步研究

发布时间：2018-05-01 14:26

本文选题：黄褐斑 + 姜黄素　；参考：《大连医科大学》2017年硕士论文

【摘要】：黄褐斑是多发于颜面部的后天获得的色素沉着性难治性的一种皮肤病,临床常见,多见于女性,尤其以育龄期妇女为多发。主要症状为颜面部等曝光部位的深或浅的褐色斑片。本病几乎无自觉症状亦不影响身体健康,但可严重影响患者的容貌及心理健康,能令患者情感和精神方面产生巨大痛苦,甚至对其生活质量造成严重影响。根据2015年制定的黄褐斑治疗专家共识,本病治疗的目的是促使色斑变淡或恢复正常、面积缩小或消失。虽然目前已证实有多种方法可以治疗黄褐斑,但仍然缺乏特别有效的治疗手段。近年来,随着黄褐斑发病率的逐年升高,且它作为女性常见损容性皮肤病越来越受到重视,对其治疗的研究亦随之大量涌现。本研究采用含有效成分为姜黄素的中药---姜黄和郁金入方组成的祛斑汤来治疗女性肝郁气滞型黄褐斑,然后分别用皮肤色度仪、Wood灯的方法观察治疗组和对照组治疗后的疗效并做初步分析,以期能为黄褐斑的治疗提供新思路。目的:探讨含有效成分姜黄素的中药祛斑汤治疗黄褐斑的疗效并做初步分析。方法:将67例辩证为肝郁气滞型的黄褐斑患者随机分为治疗组(35例)和空白对照组(32例)。予以治疗组12周含有效成分姜黄素的中药祛斑汤(柴胡10g郁金20g姜黄10g当归15g芍药15g茯苓15g白术15g益母草15g丹参15g甘草10g)治疗。1.分别于治疗前、疗中、疗后使用皮肤色度仪监测及记录两组患者面部黄褐斑的色度值(皮肤亮度L*、皮肤红绿色度a*、皮肤黄蓝色度b*)的变化并做统计分析。2.观察两组治疗前后自然光下和Wood灯下皮肤色斑的变化,做标准图像采集,根据治疗后色斑残留的情况进行PGA评分及对比。3.采集黄褐斑皮损做免疫组化染色,观察镜下黑色素细胞在治疗前后的变化。结果:1.经过3个月的治疗,治疗组的皮肤亮度(L*)在治疗后明显升高、皮肤红绿色度(a*)在治疗后明显下降,且治疗组与对照组相比,色度L*值和a*值的变化差异有统计学意义(P0.05);皮肤黄蓝色度(b*)在治疗后变化不明显,治疗组与对照组相比,b*值的变化差异无统计学意义。2.经过3个月的治疗,自然光下和Wood灯下观察色斑治疗前后的变化,PGA评分显示治疗组治疗后色斑的变化明显优于对照组,两组差异有显著统计学意义(P0.05)。3.经过3个月的治疗,治疗组黄褐斑皮损治疗前后经Bcl-2染色后观察镜下黑色素细胞,治疗后阳性比例较治疗前明显减小,治疗后黑色素细胞数量发生了变化,较治疗前有所减少。结论:含有效成分姜黄素的改良中药祛斑汤能淡化肝郁气滞型黄褐斑患者的面部色斑。
[Abstract]:Chloasma is a difficult skin disease with pigmentation acquired in the face. It is commonly seen in women, especially in women of childbearing age. The main symptoms were deep or light brown spots at the same exposure site of the face. This disease has almost no conscious symptoms and does not affect physical health, but can seriously affect the appearance and mental health of patients, can cause great emotional and mental pain, and even seriously affect their quality of life. According to the consensus of experts in the treatment of chloasma in 2015, the aim of the treatment is to cause the color spot to fade or return to normal, and to reduce or disappear the area. Although a variety of treatments for chloasma have been proven, there is still a lack of particularly effective treatment. In recent years, with the increase of chloasma incidence year by year, and it is more and more attention as a common female capacitive dermatosis, the treatment of chloasma has also emerged in large numbers. In this study, the treatment of chloasma in female patients with stagnation of liver-qi was carried out by using the decoction composed of turmeric and turmeric and turmeric decoction with curcumin as an active component. Then the therapeutic effect of the treatment group and the control group were observed by the method of skin colorimeter and Wood lamp respectively and the preliminary analysis was made in order to provide a new idea for the treatment of chloasma. Objective: to study the curative effect of Qubantang containing curcumin on chloasma. Methods: 67 patients with chloasma were randomly divided into treatment group (n = 35) and blank control group (n = 32). The treatment group was treated with Quban decoction with effective ingredient curcumin (Radix Bupleurum 10g, turmeric 20g, turmeric 10g, angelica sinensis 15g, paeoniflorin 15g, Rhizoma Atractylodes macrocephala 15g, Radix Salviae Miltiorrhizae 15g, Radix Salviae Miltiorrhizae 15g, Licorice 15g). Before, during and after treatment, the changes of colority of chloasma on the face of two groups were monitored and recorded by means of skin colorimeter (skin brightness, skin red and green color A, skin yellow and blue color), and statistical analysis was made .2.The results were as follows: (1) before, during and after treatment, the changes of the color of chloasma on the face of the two groups were monitored and recorded. The changes of skin spots under natural light and Wood lamp were observed before and after treatment, and the standard images were collected. The PGA score and contrast were made according to the residual situation of the spots after treatment. The changes of melanocytes before and after treatment were observed by immunohistochemical staining. The result is 1: 1. After 3 months of treatment, the skin brightness of the treatment group increased significantly after treatment, and the skin red and green degree decreased after treatment, and the treatment group was compared with the control group. There was significant difference between the values of colority L * and A * (P 0.05), but there was no significant change after treatment, but there was no significant difference between the treatment group and the control group in the change of the value of B * and B * (P 0.05, P < 0.05), but there was no significant difference between the treatment group and the control group (P < 0.05). After 3 months of treatment, the changes of color spot before and after treatment were observed under natural light and Wood lamp. PGA score showed that the change of color spot in the treatment group was obviously better than that in the control group, and the difference between the two groups was statistically significant. After 3 months of treatment, melanocytes were observed by Bcl-2 staining before and after treatment in the treatment group. After treatment, the positive rate of melanocytes decreased significantly, and the number of melanocytes changed after treatment, which was less than that before treatment. Conclusion: the modified Quban decoction containing curcumin can desalinate the facial spots in patients with chloasma with stagnation of liver and qi.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R275.9

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