女性黄褐斑主要中医证型与CLSM组织分型及病程的关系

Correlation of Main Syndrome Patterns of TCM between CLSM Histological Classi cation and Course in Female Patients With Melasma

目的:总结分析女性黄褐斑主要中医证型与共聚焦激光扫描显微镜(CLSM)组织分型及病程的关系,为中医辨证与治疗提供一种客观参考依据。方法:从不同病程的女性黄褐斑初诊患者中,筛选出符合黄褐斑主要中医证型辨证分型标准的患者187例,采用非创伤性CLSM技术对其进行组织分型,分析女性黄褐斑主要中医证型与CLSM组织分型及病程的关系。结果:187例女性黄褐斑患者中,CLSM组织分型分别包括表皮型122例(65.24%)和混合型65例(34.76%),无真皮型。表皮型患者以脾虚湿阻型最多(56.56%),显著高于混合型;混合型患者以肾阴不足型为主(38.46%),显著高于表皮型。所有患者平均病程为6.5年,<5年70例(37.43%),以肝气郁结型为主(68.57%);5～10年94例(50.27%),脾虚湿阻型最多(74.47%);>10年23例(12.30%),肾阴不足型最多(86.96%)。结论:女性黄褐斑主要中医证型与CLSM组织分型及病程密切相关,呈一定的规律性分布。

Objective：To analyze the correlation between the main syndrome patterns of TCM and the histological classi cation of confocal laser scanning microscopy（CLSM） and course of disease,and to provide an objective reference for TCM syndrome differentiation and treatment in female patients with melasma.Methods：According to the TCM syndrome differentiation standard,a total of 187 cases were selected for the non-traumatic CLSM detecting from newly diagnosed melasma female patients with different courses.The correlation between the main syndrome patterns of TCM and the CLSM histological classi cation and course of disease were analyzed.Results：Depending on the characteristic imagination of CLSM,187 female patients with melasma were subdivided into 122 cases（65.24%） with epidermal type and 65 cases（34.76%） with mixed type.Typical dermal type could not be found in this study.In patients with epidermal type,syndrome of spleen deficiency and damp obstruction was the largest proportion（56.56%）,and was significantly higher than that in the patients with mixed type.On the contrary,syndrome of kidney yin deficiency was more common in patients with mixed type（38.46%） compared with epidermal type.The course of our patients was from 15 days to 20 years with average 6.5 years.70（37.43%） patients were less than 5 years,with syndrome of liver qi stagnation in cases of 68.57%;94（50.27%） patients were from 5 to 10 years,with syndrome of spleen deficiency and damp obstruction in cases of 74.47%;23（12.30%） patients were more than 10 years,with syndrome of kidney yin deficiency in most cases（86.96%）.Conclusions：The main syndrome patterns of TCM for female patients with melasma are associated with the histological classi cation with CLSM and different course.