调冲消斑汤治疗女性黄褐斑临床研究

Clinical Efficacy of Tiaochong Xiaoban Decoction in Treatment of Women Chloasma

目的：观察调冲消斑汤治疗女性黄褐斑的临床疗效及对激素水平和抗氧化能力的影响。方法：将126例患者随机分为对照组和观察组,每组63例。对照组采用还原型谷胱甘肽片,每次400 mg,每天3次,口服;复方维生素C钠咀嚼片,每次300 mg,每天3次,口服;维生素E软胶囊,每次100 mg,每天3次,口服;氢醌乳膏,适量外涂于皮损,早晚各1次。观察组在对照组治疗基础上加服调冲消斑汤（柴胡10 g,香附10 g,白芷15 g,红花3 g,玫瑰花20 g,菊花20 g,当归10 g,丹参20 g,牡丹皮10 g,桃仁10 g,女贞子20 g,墨旱莲20 g,茯苓20 g,黄芪30 g,益母草20 g,姜黃10 g,甘草6 g）治疗,每天1剂。两组患者均治疗12周。治疗前后各评价1次皮损面积和皮损颜色,并进行色素沉着区域皮肤图像测量;生活质量采用皮肤病生活质量指数（dermatology life quality index,DLQI）,进行肝郁气滞证评分,检测雌激素（estradiol,E2）、孕激素（pregnenolone,P）、超氧化物歧化酶（superoxide dismutase,SOD）、丙二醛（malondialdehyde,MDA）、脂质过氧化物（lipid hydroperoxide,LPO）水平。结果：观察组临床有效率为92.06%,对照组临床有效率为81.48%,差异有统计学意义（χ25.201,P〈0.05）;观察组中医证候有效率为90.48%,对照组中医证候有效率为71.43%,差异有统计学意义（χ27.411,P〈0.01）;治疗后观察组皮损情况、DLQI和肝郁气滞证评分均低于对照组,差异有统计学意义（P〈0.01）;治疗后观察组E2水平低于对照组,P水平高于对照组,差异均有统计学意义（P〈0.01）;治疗后观察组MDA、LPO均低于对照组,SOD水平高于对照组,差异均有统计学意义（P〈0.01）。结论：调冲消斑汤治疗黄褐斑能降低患者皮损情况、肝郁气滞证、DLQI评分,提高临床疗效和中医证候评分疗效,改善患者的生活质量,并能调节患者的内分泌激素水平抗氧化能力。

Objective：To observe the clinical efficacy of Tiaochong Xiaoban Decoction in treatment of women Chloasma and its effect on patients＇ Hormone Levels and the antioxidant capacity. Methods ： 126 cases of patients were randomly divided into control group （63 eases） and observation group （63 cases）. Patients in control group took giutathione tablets ,400 mg/time ,3 times/day; compound sodium chewable of vitamin C,300 mg/time, 3 times/day ; vitamin E soft capsule, 100 mg/time, 3 times/day; hydroqui- none cream applied to the skin every morning and night. Based on the treatment of the control group, patients in the observation group were given Tiaochong Xiaoban Decoction, 1 dose/day. The course of treatment was 12 weeks. Before and after treatment, the area and color of skin lesions, the skin image of pigmented area were detected. Quality of life was evaluated by using the quality of life index （DLQI） of skin disease. Scores of Liver depression and Qi stagnation were graded. And levels of Estrogen （E2 ） ,proges- terone （P）, superoxide dismutase （SOD）, malondialdehyde （MDA） and lipid peroxides （LPO） were detected. Results：The total effective rate （92.06%） of the observation group was significantly higher than that （ 81.48% ） of the control group （χ2= 5. 201,P 〈0.05）. The total effective rate （90.48%） in TCM symptoms of the observation group was significantly higher than that （71.43%） of the control group （χ2= 7. 411, P 〈 0.01 ）. After treatment, scores of skin lesions, DLQI, Liver depression and Qi stagnation, Levels of E2, MDA and LPO of the observation group were all significantly lower than those of the control group（ P 〈 0. 01 ）. The levels of P and SOD were significantly higher than those of the control group （P 〈 0.01 ）. Conclusion ： Tiaochong Xiaoban Decoction can effectively relieve women Chloasma patients＇ skin lesions, patients＇ Liver depression and Qi stagnation, reduce the sores of DLQI,improve patients＇ quality of life, and regulate the hormone levels and antioxidant capacity of patients.