桃花煎联合强脉冲光治疗黄褐斑的临床观察

文章信息/Info

• Title:桃花煎联合强脉冲光治疗黄褐斑的临床观察

• 卷期:2024年22卷3期

• 作者:杨斌，曾宪晶，彭月秀，李林育，胡榕

• 井冈山大学附属医院皮肤科 ,江西 吉安 343000

• Author(s):YANG Bin, ZENG xian-jin , PENG Yue-xiu, LI Lin-yu, HU Rong

• Affiliated Hospital ,Jinggangshan University , Ji’an, Jiangxi, 343000，China

• 关键词强脉冲光； 桃花煎；黄褐斑

• Keywords:intense pulsed light; Taohuajian; chloasma

• 摘要:目的 研究桃花煎联合强脉冲光治疗黄褐斑的临床疗效。方法 将本院60例黄褐斑患者随机分为治疗组和观察组（各30例），观察组予每月一次强脉冲光治疗，连续3次；治疗组在观察组基础上口服中药桃花煎，3个月后对两组患者进行临床有效率比较，黄褐斑颜色、靶皮损面积MASI评分比较及血液流变学指标比较。结果 治疗组临床总有效率高于观察组,与治疗前比较，治疗3个月后两组患者MASI评分、VISIA检测各指标值及血液流变学指标均降低（P<0.05），与观察组治疗后比较，治疗组MASI评分、VISIA检测斑点、红色区域、棕色斑值及血液流变学指标明显低于观察组（P<0.05），随访3个月，治疗组复发率明显低于观察组（P<0.05）。结论 桃花煎联合强脉冲光能明显提高黄褐斑的治疗效果。                                                                                                                                                                                

• Abstract:To study the clinical efficacy of Taohuajian with intense pulsed light combined in the treatment of chloasma. Method： sixty patients diagnosed as chloasma admitted to Our hospital were randomly divided into observation group and control group (30 cases each). The control group was treated with intense pulsed light; the treatment group was treated with intense pulsed light combined with oral Taohuajian. The course of treatment of both groups was three month, and the treatment of intense pulsed light was once a month. The color of chloasma, MASI score of target lesion area and hemorheology were observed, and the recurrence rate was followed up for 3 months. Result： The total efficacy of the two groups were compared, the treatment group of Taohuajian with intense pulsed light was better than the observation group, the curative effect was statistically significant (P<0.05). Before and after treatment, the MASI score，the VISIA analysis and hemorheology of the two groups were decreased, and the treatment group was significantly lower than the observation group, with significant difference, with statistical significance (P <0.05). After 3 months of follow-up, the recurrence rate of the treatment group was significantly lower than that of the observation group. Conclusion： The efficacy of Taohuajian with intense pulsed light in the treatment of chloasma is obvious, which is better than that of intense pulsed light alone.

  黄褐斑是发生在面部的常见获得性色素沉着皮肤病，发病率高，多见于深肤色20-50岁女性，临床表现以颧颊部对称分布的皮肤黄褐色或深褐色色素斑片，目前黄褐斑病因不清，易诊难治，且反复发作严重影响患者容貌的一种常见色素性疾病[1-2]。当前黄褐斑的治疗主要是防晒及外用药物，常用药物如氢醌、维甲酸、熊果苷类等长期使用效果并不理想，而化学剥脱换肤治疗黄褐斑疗效持续短，且易使治疗后皮肤出现色素沉着及色素脱失，患者往往难以接受。随着国内外激光发展，强脉冲光治疗黄褐斑的临床报道越来越多，研究证实：强脉冲光治疗能明显改善面部黄褐斑色素增多；中医认为“无瘀不成斑”，临床中常见黄褐斑患者证型为肝郁血瘀，桃花煎为吴雄志教授的经验方，能抑制ACTH激素水平，降低黑素的合成，改善基底膜炎症反应，明显降低黄褐斑的复发率，口服桃花煎联合强脉冲光的应用具有较好临床疗效。