薏苓祛湿生发方联合5%米诺地尔酊对青年男性雄激素源性秃发患者血液流变学、血脂及皮肤镜下征象的影响

Effects of Yiling Qushi Shengfa decoction combined with 5% minoxidil on hemorheology,blood lipids and dermascopic signs in young male androgenetic alopecia patients

目的观察薏苓祛湿生发方联合5%米诺地尔酊治疗湿热蕴结证青年男性雄激素源性秃发患者疗效,探讨其可能作用机制。方法将123例湿热蕴结证青年男性雄激素源性秃发患者随机分为观察组62例和对照组61例,对照组给予非那雄胺片和5%米诺地尔酊治疗,观察组在对照组治疗基础上给予薏苓祛湿生发方剂治疗,疗程均为6个月。比较2组临床疗效,观察2组治疗前后临床症状积分、血液流变学、血脂指标及皮肤镜下征象的变化。结果观察组止脱率、有效率均高于对照组(P均<0.05);2组头发稀疏、头屑、油腻、瘙痒积分及临床症状总积分均较治疗前显著降低(P均<0.05),观察组治疗后以上积分均显著低于对照组(P均<0.05);观察组治疗后全血高切、全血中切、全血低切、血浆黏度、血细胞比容均较治疗前显著降低(P均<0.05),且以上指标均显著高于对照组(P均<0.05),而对照组以上指标治疗前后比较差异均无统计学意义(P均>0.05);2组治疗后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE)、脂蛋白a[Lp(a)]均较治疗前显著改善(P均<0.05),观察组治疗后TC、TG、ApoA1、ApoB改善情况均显著优于对照组(P均<0.05)。2组治疗后> 20%的毛发直径变细、毳毛增多、毛周征、局部无毛征、色素沉着、黄点发生率均明显降低(P均<0.05),1cm2毛发数均明显增多(P均<0.05);观察组> 20%的毛发直径变细、毳毛增多、毛周征、局部无毛征发生率均明显低于对照组(P均<0.05),1 cm2毛发数明显多于对照组(P <0.05)。结论薏苓祛湿生发方联合5%米诺地尔酊能够控制湿热蕴结证青年男性雄激素源性秃发患者秃发的进程,提高止脱率,改善头皮局部症状与镜下征象,其机制可能与调节血液流变学与血脂代谢有关。

Objective It is to observe the curative effect of Yiling Qushi Shengfa decoction combined with 5% minoxidil on hemorheology,blood lipids and dermascopic signs in young male androgenetic alopecia patients with syndrome of dampness and heat accumulation,and to explore its possible mechanism. Methods A total of 123 patients with androgenetic alopecia with syndrome of dampness and heat accumulation were divided into observation group( 62 cases) and control group( 61 cases). The control group was treated with finasteride tablets and 5% minoxidil,the observation group was treated with Yiling Qushi Shengfa decoction on the basis of the control group,both the courses of treatment were 6 months. The clinical efficacy of the two groups was compared. The changes of clinical symptom score,hemorheology,blood lipid index and dermoscopic signs were observed before and after treatment. Results The rate of alopecia stopping and the effective rate of the observation group were higher than those of the control group( P < 0. 05). The scores of hair thinning,dandruff,greasy hair,itching and total score of clinical symptoms were significantly decreased after treatment in the two groups( P <0. 05),and the scores were lower in the observation group than those in the control group( P < 0. 05). The whole blood high cut,whole blood cut,whole blood low cut,plasma viscosity and hematocrit were significantly decreased in the observation groups after treatment( P < 0. 05),the above indexes were higher than the control group( P < 0. 05),but there was no significant difference in the above indicators before and after treatment in the control group( P > 0. 05);total cholesterol( TC),triglyceride( TG),low density lipoprotein cholesterol( LDL-C),high density lipoprotein cholesterol( HDL-C),apolipoprotein A1( Apo A1),apolipoprotein B( Apo B),apolipoprotein E( Apo E),lipoprotein a [Lp( a)] were significantly better than those before treatment in the two groups( P < 0. 05). The improvement of TC,TG,Apo A1 and Apo B in the observation group was significantly better than that in the control group( P < 0. 05). After treatment,> 20% of thinner hairs,pubes increased,hair circumference,local hairlessness,pigmentation,and yellow spot incidence were significantly decreased( P < 0. 05),and the number of hairs in 1 cm2 was increased( P < 0. 05). The incidence of > 20% hair thinning,pubic hair,hair circumference and local hairlessness in the observation group was significantly lower than that in the control group( P < 0. 05),and the number of hairs in 1 cm2 was significantly higher than that in the control group( P <0. 05). Conclusion Yiling Qushisheng Shengfang decoction combined with 5% minoxidil can control the process of alopecia in young male androgenetic alopecia patients with dampness and heat accumulation syndrome,improve the rate of hemostasis,and improve the local symptoms of scalp and microscopic signs. Its mechanisms may be involved in regulating blood rheology and lipid metabolism.