归白祛斑汤结合强脉冲光治疗黄褐斑(肝郁气滞型)临床疗效观察

Clinical Observation of Guibai Quban Decoction(归白祛斑汤)Combined with Intense Pulsed Light in Treatment of Melasma(Liver Depression and Qi Stagnation)

目的观察黄褐斑(肝郁气滞型)患者采取归白祛斑汤结合强脉冲光治疗的临床效果。方法将纳入的78例肝郁气滞型黄褐斑患者以随机数字表法分为观察组和对照组,每组39例,对照组口服维生素C与维生素E治疗,并给予强脉冲光治疗,而观察组在对照组治疗基础上结合归白祛斑汤治疗。数据观察:临床治疗效果、治疗前后中医证候积分(面部黄褐色斑片、胁胀胸痞、性情急躁易怒、乳房作胀或疼痛)变化、皮损面积与皮损颜色评分变化、皮肤病生活质量指数(dermatology life quality index,DLQI评分)变化、皮肤角质层含水量变化、焦虑自评量表(Self-Rating Anxiety Scale,SAS)评分变化、治疗不良反应。结果对照组与观察组患者治疗总有效率比较[82.05%(32/39)vs97.44%(38/39)],观察组更高,P<0.05;治疗前,两组患者中医证候积分(面部黄褐色斑片、胁胀胸痞、性情急躁易怒及乳房作胀或疼痛)、皮损面积及颜色评分、皮肤角质层含水量与DLQI评分、SAS评分等指标比较,P>0.05,治疗后两组患者中医证候积分(面部黄褐色斑片、胁胀胸痞、性情急躁易怒、乳房作胀或疼痛)、皮损面积与皮损颜色评分、DLQI评分、皮肤角质层含水量、SAS评分均改善,治疗后观察组患者的中医证候积分(面部黄褐色斑片、胁胀胸痞、性情急躁易怒、乳房作胀或疼痛)、皮损面积与皮损颜色评分、DLQI评分、皮肤角质层含水量、SAS评分等指标均优于对照组患者,P<0.05;对照组与观察组患者不良反应均较少,P>0.05。结论归白祛斑汤结合强脉冲光治疗黄褐斑(肝郁气滞型)临床疗效显著,患者症状改善,心理状态改善,生活质量明显提升,且不良反应少,治疗较为安全可靠,值得应用。

Objective To observe the clinical effect of Guibai Quban Decoction(归白祛斑汤)combined with intense pulsed light on patients with melasma(liver depression and Qi stagnation).Methods In this study,78 patients with liver depression and Qi stagnation type of melasma were divided into observation group and control group by random number table method,with 39 cases in each group.The patients in the control group were treated with vitamin C and vitamin E orally and given intense pulsed light treatment,while those in the observation group were treated with Guibaiquban Decoction on the basis of the control group.The clinical treatment effect,changes of TCM syndrome scores before and after treatment(facial yellow-brown spots,bulging chest bulges,irritable temper,breast distension or pain),changes of skin area and skin color score,changes of skin quality of Life index(DLQI),changes of skin cuticle water content,changes of Anxiety Self-rating Scale(SAS)scores and adverse reactions were observed and compared.Results The total effective rate of the control group was higher than that of the observation group(82.05%vs 97.44%)(P<0.05).Before treatment,TCM syndrome scores(facial yellow-brown patches,bulging chest bulges,irritability and breast distension or pain),skin lesion area and color scores,skin cuticle water content,DLQI score,SAS score and other indexes were not significant between the two groups(P>0.05).After treatment,TCM syndrome scores(facial yellow-brown spots,bulging chest bulges,irritable disposition,breast distension or pain),skin area and skin color scores,DLQI scores,skin cuticle water content and SAS scores were all improved in each group.And those in the observation group were better than those in control group(P<0.05).There were fewer adverse reactions in the control group and the observation group(P>0.05).Conclusion Guibai Quba Decoction combined with intense pulsed light in the treatment of chloasma(liver depression and Qi stagnation type)has significant clinical efficacy,with improved symptoms,improved mental state,significantly improved quality of life and less adverse reactions.The treatment is relatively safe and reliable,worthy of application.