逍遥散加减联合揿针治疗白癜风伴焦虑抑郁临床观察

Clinical observation on the treatment of vitiligo with anxiety and depression using modified Xiaoyao powder combined with thumbtack needling therapy

目的:探讨逍遥散加减联合揿针治疗肝郁气滞型白癜风患者伴焦虑抑郁的临床疗效。方法:选取肝气郁滞型白癜风患者60例,随机分为对照组30例和观察组30例。对照组予逍遥散加减口服,观察组在此基础上结合揿针治疗和心理疏导。观察两组患者疗效及治疗前后皮损面积、中医症状积分、白斑色素积分、生活质量评分(DLQI)、白癜风面积评分指数(VASI)、焦虑抑郁评分(HAMA-14及HAMD-17)。比较两组血清5-羟色胺(5-HT)、脑源性神经营养因子(BNDF)水平。结果:观察组联合疗法相较于对照组单一治疗总有效率更高(P<0.05)。疗程结束后,观察组患者白斑面积较对照组缩小,中医症状积分、DLQI、VASI、焦虑抑郁量表评分较对照组降低,白斑色素积分及血清5-HT、BNDF水平较对照组有所上升(均P<0.05)。结论:逍遥散加减联合揿针治疗肝郁气滞型白癜风患者的临床疗效较好,可缩小白斑面积,提高生活质量,改善焦虑抑郁状态。

Objective:To explore the clinical efficacy of Xiaoyao powder combined with thumbtack needling in the treatment of anxiety and depression in patients with liver-qi stagnation vitiligo.Methods:A total of 60 patients with liver qi stagnation-type vitiligo were randomly divided into the control group(30 cases)and the observation group(30 cases).Control group was given Xiaoyao powder orally.Observation group was combined with acupuncture treatment and psychological counseling on this basis.The effective rate,skin lesion area,TCM symptom score,vitiligo pigment score,quality of life score(DLQI),vitiligo area scoring index(VASI),anxiety and depression scores(HAMA-14 and HAMD-17)were observed before and after treatment,and serum levels of serotonin(5-HT)and brain-derived neurotrophic factor(BDNF)were compared between the groups.Results:The total effective rate of combined therapy in observation group was higher than that of single therapy in control group(P<0.05).After treatment,the white spot area of observation group was smaller than that of control group,the scores of TCM symptom,DLQI,VASI and anxiety and depression scale were lower than that of control group,and the white spot pigment score and serum 5-HT and BNDF levels were increased compared with control group(all P<0.05).Conclusion:Xiaoyao powder combined with thumbtack needling has good clinical effect in the treatment of patients with liver-qi stagnation vitiligo,which can reduce the white spot area,improve the quality of life,and improve anxiety and depression.