A study on the treatment of chloasma with moxibustion based on the theory of“Yang transforming Qi,and Yin shaping”

Background:“Yang Transforming Qi and Yin shaping”comes from“Plain Question Yin and Yang should be like the theory”.Chinese medicine believes that the imbalance of yin and yang is the cause of human diseases.One of the strengths of TCM in treating diseases is holistic regulation.The theory of“Yang transforming Qi,and Yin shaping”implies a strong holistic view.Chloasma,one of the common skin diseases,seriously affects the physical and mental health of patients due to its unclear etiology,difficult treatment and easy recurrence.The occurrence and development of chloasma are closely related to internal organs.This paper is based on the theory of internal meridian,“Yang transforming Qi,and Yin shaping”which attaches importance to the concept of“Yang Qi”,from a new understanding of the pathogenesis etiology of chloasma.Methods:The author believes that the incidence of the disease is the deficiency of Yang Qi,which can’t promote the movement of Qi and blood to nourish the face,resulting in tangible material condensation,so proposes that this disease needs to be promoted by Yang transforming Qi and warm to dissipate.Moxibustion belongs to the fire,and its warming effect can dissipate the tangible evil.Results:Combined with clinical practice and the theory of internal meridian,the author elaborated that moxibustion is one of the effective methods for treating chloasma,which provides a new way of thinking for the treatment of chloasma.Conclusion:“Yang Transforming Qi and Yin shaping”can be used to guide the treatment of chloasma.

A Double-Blind, Placebo Controlled Clinical Trial Evaluating the Efficacy and Safety of a New Skin Whitening Combination in Patients with Chloasma

Melasma (or chloasma) is a hyperpigmentation disorder predominantly affecting sun-exposed skin in women, and is often refractory to treatment. The objective was to evaluate the efficacy and safety of a new whitening formula for the treatment of chloasma. This?single centre, double-blind, placebo controlled, bilateral (split-face) comparison, was conducted on 44 Chinese subjects with chloasma during the winter season. The test formula was applied twice a day, for 12 weeks on left side of the face and a placebo formula on the right side of the face. Assessments included the use of the hemi-MASI (split-face Melasma Area Severity Index), both ultraviolet and standard photography, together with clinical evaluations of efficacy and safety at T0, T6 and T12 weeks. A significant difference between the 2-hemi-MASI was noticed after 6 and 12 weeks of treatment. This result was confirmed by the clinical evaluation of the dermatologists who recorded a significant improvement in the half-face treated with the new whitening formula compared with that treated with placebo (p = 0.003). The tolerance of the new formula was recorded as excellent by 82% of subjects and found to be cosmetically appealing. In this study, the new whitening formula containing ferulic acid, Ginkgo Biloba, lipohydroxyacid (LHA), niacinamide and thermal spring water was safe and significantly improved chloasma after a 3-month-treatment period compared with placebo.

Fifty Cases of Chloasma Treated by Acupuncture plus Intensive Pulse Light Irradiation

Objective: To observe the clinical therapeutic effect of acupuncture plus intensive pulse light irradiation on chloasma. Methods: Ninety-six cases of chloasma were randomly divided into two groups, the control group of 46 cases treated by simple acupuncture and the treatment group of 50 cases treated by acupuncture and intensive pulse light irradiation. Results: The total effective rate was 89.1% and 98.0% in the control group and treatment group respectively, with a significant difference between the two groups (P<0.05). Conclusion: For chloasma, the effect of treatment with acupuncture plus intensive pulse light irradiation is superior to that with simple acupuncture.

Operation rules of scraping technique

Traditional Chinese medicine scraping is a kind of natural therapy with a long history of simple and safe operation.It is easy to learn and tools are readily available,so that it has a very wide range of practical value.This paper introduces the definition and indications,function and standardization process of scraping technology,the technical operation specifications and matters needing attentions,as well as the application method of scraping technology,with a view to providing reference for clinical use of scraping technology in the treatment of cervical spondylosis,periarthritis of shoulder,lumbar muscle strain,hypertension,chloasma,and other diseases.

CHLOASMA TREATED MAINLY WITH FACIAL ACUPUNCTURE

63 cases of chloasma were divided into two groups, observation group facial acupuncture combined with auricular-plaster therapy of 43 cases and control group auricular-plaster therapy only of 23 cases. The resuls show that marked effective rate in observation group is higher than in control group (P<0. 005). In observation group, there is no distinct relationship between the course of disease and curative effect (P>0. 5), while there is marked difference between the course of treatment and curative effect, the longer the course of treatment, the better the curative effect(P<0. 05).

Effectiveness of a Broad-Spectrum Sunscreen in the Prevention of Melasma in Asian Pregnant Women

Chloasma, or melasma, is a commonly acquired pigmentary disorder among Asian women. It may be considered as a physiological change during pregnancy. The incidence in Asian women is higher than that in other ethnic groups but further epidemiologic data are needed. There are very few studies related to the benefits of sunscreens to prevent this dermatosis. The aim of this study was to assess the effectiveness of a broad-spectrum sunscreen in the prevention of melasma in Korean pregnant women. We tested the effectiveness and tolerance of a sunscreen product (SPF 50+, UVA-PF 30) during a 12-month clinical trial including 220 Korean parturients with skin type III and IV. 217 women completed the study. Only 3 (1%) of the study population developed melasma, which was mild (MASI grade between 1.2 and 2.7). In addition, the clinical effectiveness of the evaluated sunscreen was judged “good to excellent” by the majority of study participants and by the research dermatologists. The “excellent” tolerance of the sunscreen under evaluation was confirmed “good” to “excellent” in 95% and 97% of cases. This study clearly demonstrates that this broad-spectrum sunscreen is well tolerated and effective in the prevention of melasma in Korean pregnant women. Although treatment remains elusive, prevention is possible.

Combination (5% Hydroquinone, 0.1% Tretinoin and 1% Hydrocortisone) Cream in Treating Facial Hyperpigmentation: A Retrospective Patient Satisfaction Survey

Background: Melasma and post-inflammatory hyperpigmentation provide a significant source of psychosocial morbidity, especially in those with Fitzpatrick skin types III-VI. In Europe, a proprietary product aimed at treating these conditions, similar to Kligman’s formula but with a longer expiry date, has become available. Objectives: To assess patient satisfaction with a newly available combination de-pigmenting preparation. Methods: We conducted a small study to see if patients felt that this new product affected their quality of life and skin symptoms from hyperpigmentation. 41 subjects, who had all been prescribed a 15 g tube to use sparingly at night for 90 days within the last 12 months were telephoned to rate the effect the cream had on their quality of life and skin symptom improvement. Each patient also had their Dermatology Life Quality Index (DLQI) score assessed. Results: Out of the 29 patients who responded to the study, 22 had melasma and 7 had post-inflammatory hyperpigmentation from acne. 21 subjects felt that the cream made either a marked or moderate improvement on their quality of life and 23 subjects felt that the cream made either a marked or moderate improvement on their skin symptoms. Conclusion: Patients reported improvement in both hyperpigmentation and quality of life, suggesting a high level of satisfaction with treatment. The long shelf life of the product may also promote compliance and reduce health-care costs.

Etiological analysis of chloasma from view of Western and Chinese traditional medicine

Chloasma is a common and refractory skin disease,which is a discosmetic dermatosis in which pigment is deposited on the face,cheeks,forehead and other parts due to the pigment metabolism disorder.It is manifested as facial yellow-brown patches,with different shades,different shapes,and often symmetrically distributed.The prevalence rate of chloasma is still increasing year by year,which reflects the physical and mental health of women.Because the cause of disease is unknown,and at present there is no uniform treatment.This paper discusses the etiology of chloasma from modern medicine and traditional Chinese medicine to provide reference for clinical therapy.

Effect of Ear-Acupoint Pressing and Ear Apex(HX6,7)Bloodletting on Haemorheology in Chloasma Patients with Gan Depression Pattern

Objective： To explore the therapeutical effect of ear-acupoint pressing combined with Ear Apex （HX6,7） bloodletting on haemorheology in chloasma patients with Gan （Liver） depression pattern. Methods： A total of 180 chloasma patients were randomly assigned to three groups, 60 cases in each. Patients in the ear- acupuncture （EA） group were treated with ear-acupoint pressing combined with Ear Apex（HX6,7） bloodletting; vitamins C and E were put into practice in the Western medicine （WM） group together with 0.025% tretinoin cream for local external application; patients in the placebo group were treated with urea-cream by external use, while 30 healthy volunteers were in the control group. After a treatment course of 2 months, the changes of haemorheology, injury skin area, colour score and symptom score before and after the treatment were observed. Results： There was no significant difference on whole blood reduced viscosity （high shear, medium shear, and low shear）, erythrocyte aggregation index, hematocrit, plasma viscosity among the four groups （F=2.65, P〉0.05）. Compared with those before treatment, the whole blood viscosity （high shear） and whole blood reduced viscosity （high shear） after treatment in the EA group, the WM group and the placebo group were with no statistical significance （P〉0.05）. The injury skin area and colour score after treatment were significantly lower than those before treatment in the EA group and the WM group （P〈0.05）, while there was no significant difference in placebo group （P〉0.05）. Clinical symptoms of the EA group were obviously improved after the 2-month treatment, which was significantly different compared with those before treatment （P〈0.05）, there was significant difference compared with those of WM group and placebo group （P〈0.05）. Conclusion： There was no significant difference on haemorheology index between healthy people and chloasma patients without angionosis, cerebrovascular disease, hematopathy, metabolic disease or any other organic disease. Ear-acupoint pressing combined with Ear Apex （HX6,7） bloodletting can effectively improve concurrent symptoms, lighten chloasma and lower chloasma area in patients accompanied by Gan depression.

Clinical Observation on the Combined Use of Acupuncture and Herbal Medicine for Treatment of Chloasma

Objective:To observe the clinical effects of the combined use of acupuncture and herbal medicine for treatment of chloasma.Methods:Totally 60 patients were randomly divided into a treatment group of 30 cases,treated by acupuncture and herbal medicine,and a control group of 30 cases,administered Vitamin C and Vitamin E.The clinical effects were observed.Results:The total effective rate of the treatment group is 93.3%better than that of the control group(76.7%) ,the difference was significant(P<0.01) .Conclusion:Combined use of acupuncture and herbal medicine may yield definite therapeutic effects in treating chloasma patients.

Clinical Observation on the Treatment of Chloasma by Chinese Herbs Combined with Acupuncture

Objective： To evaluate the clinical effect of Chinese herbs combined with acupuncture （CH-A） in treating chloasma. Methods： Sixty-one patients with chloasma were randomly assigned to two groups： 30 in the control group and 31 in the treated group. Both groups received conventional treatment with oral intake of vitamin C and E, and external application of Quban Powder （祛斑散）. Besides, the treated group also received CH-A, with the therapeutic course for both groups as 3 months. Results： The total effective rate in the treated group and the control group was 100.00% and 46.67% respectively, and the cure-effective rate was 74.19% and 13.33% respectively, all showing significant difference between the two groups （P〈0.01）. The scores of size and color of skin lesion and that of symptoms decreased in both groups, but the decrease in the treated group was more obvious, showing significant difference compared with those before treatment and also compared with those in the control group after treatment （P〈0.05 or P〈0.01）. A follow-up study in 1 year to 2 years and 4 months showed that the long-term effect in the treated group showed an increasing trend compared with the effect immediately after treatment, but it showed a decreasing trend in the control group, though with no any statistical significance （both P〉0.05）. Conclusion： On the basis of conventional treatment, combined use of Chinese herbal medicine and acupuncture in treating chloasma could markedly improve the accompanied symptoms, lighten the color and shrink the size of skin lesions.

Effect of Gan-Pi Regulatory Needling in Treating Chloasma

Objective： To study the effect of Gan （肝）-Pi （脾） regulatory needling （GPRN） in treating chloasma and its influences on female sex hormones, superoxide dismutase （SOD）, lipid peroxide （LPO） and melanocyte-stimulating hormone （MSH）. Methods： Ninety chloasma patients were equally randomized to three groups, the treatment group treated with GPRN, the control group treated with conventional Western medicine and the blank group untreated. Changes in the scores of skin lesion （area and color） and symptom, as well as blood levels of female sex hormones, MSH, SOD and LPO were Observed and compared after 3 months of treatment. Results： In the treatment group, the scores of skin lesion area and color were reduced from 2.76± 0.96 and 2.48 ± 0.78 before treatment to 1.42 ± 0.42 and 1.03± 0.41 after treatment, respectively, while in the control group they were from 2.78 ± 1.06 and 2.53 ± 0.88 to 1.58± 1.23 and 1.28 ± 0.96, respectively, all showing significant changes （P〈0.05）; the scores were insignificantly changed in the blank group （P〉0.05）. At the same time, the score of symptoms in the treatment group significantly improved after treatment （P〈0.05）, significantly different from that of the other two groups. Comparison of female sex hormones among groups showed no significant differences either before or after treatment. The level of LPO decreased and SOD increased in both the treatment group and the control group significantly （all P〈0.05）, but significant lowering of MSH was only seen in the treatment group （P〈0.05）. Conclusions： GPRN can effectively lessen the size and lighten the color of chloasma, improve the accompanying symptoms in patients and decrease LPO and MSH levels and increase the SOD level, but will not affect the level of the female sex hormones.

Effects of Chinese Herbal Medicine Combined with He-Ne Laser on Lipoperoxide and Superoxide Dismutase in Chloasma Patients

Objective: To observe the effects of Chinese decoction and ligustrazin hydrochloride injection combined with He-Ne laser on lipoperoxide (LPO) and Superoxide dismutase (SOD) in patients with chloasma. Methods: 90 cases of chloasma were randomly divided into the following two groups: a treatment group (of 54 cases) treated by a self-prepared prescription for toning the kidneys and relieving the depressed liver to remove blood stasis, ligustrazin hydrochloricde injection and He-Ne laser therapy, and a control group (of 36 cases) treated with oral administration of Vitamin E and Vitamin C plus external application of 20% Azelaic acid cream. Results: The total effective rate in the treatment group was 79.6%, which was significantly higher than that of the control group (P<0.05). After treatment, the LPO level in the treatment group was significantly lowered (P<0.01), and the SOD level was significantly elevated (P<0.05). Conclusion: The therapeutic methods adopted in the treatment group may show the action of antioxidation, providing good clinical effects for treating chloasma.

Clinical observation on the effect of electroacupuncture treatment for chloasma in young and middle-aged women

Objective:To evaluate the clinical effect of electroacupuncture treatment for chloasma in young and middle-aged women.Methods:Sixty young and middle-aged female patients with chloasma were divided into treatment group(n=30)and control group(n=30)according to random number table.In the treatment group,the electroacupuncture was applied to the facial acupoints and"Vagus"in the cavity of concha in the ear.The selection of facial acupoints was relating to the running course of facial nerve trunk:Yifeng(翳风TE17),Shangguan(上关GB3)-Sizhukong(丝竹空TE 23)(Temporal branch),Xiaguan(下关ST7)-Sibai(四白ST2)(Zygomatic branch),Qianzheng(牵正Extra)-Quanliao(颧髎SI18)(Zygomatic branch),Jiache(颊车ST6)-Jiachengjiang(夹承浆Extra)(Buccal branch),Hegu(合谷LI 4).Electro-stimulation was adopted at"Vagus"in the cavity of concha in the ear(two distribution points of the vagus in the cavity of concha of each ear).The control group received conventional acupuncture(surrounding method of needling at the Ashi points in the facial lesion area and 15 acupoints which were selected in the highest frequency in the conventional acupuncture treatment).After 8 weeks of treatment,the clinical effects were compared.The total score of facial skin lesion,score of skin lesion color,score of lesion area,and effective rate of treatment for chloasma were used to evaluate the clinical effect of the two groups before and after treatment.Results:After treatment,the effective rate of the treatment group was 95.00%,that of the control group was 67.50%.The effect of the treatment group was better than that of the control group,and the difference was statistically signifiicant(x2=9.928,P=0.002).Before treatment,there was no difference in the area score,color score,and total score of skin lesions between the two groups(P>0.05).After treatment,the area score,color score,and total score of skin lesions in the treatment group were(1.05±0.64),(1.05±0.64),and(2.10±0.98)points respectively,while those in the control group were(1.38±0.63),(1.28±0.75),and(2.65±1.19)points respectively.The area score,color score,and total score of skin lesions in the treatment group were lower than those in the control group,with statistically significant differences(all P<0.05).Conclusion:electroacupuncture is more effective than conventional acupuncture in treating chloasma in young and middle-aged women.

Electroacupuncture at facial acupoints combined with electrical stimulation on the auricular vagus nerve points for 60 cases of chloasma

Objective： To observe the clinical efficacy of electroacupuncture at facial acupoints combined with electrical stimulation on the auricular vagus nerve points for treatment of chloasma.Methods： Sixty patients with chloasma were selected. According to acupoint selection along facial nerve trunk initially created by professor Gao Wei-bin, Yifeng（翳风TE 17）, Shangguan（上关GB 3） Sizhukong（丝竹空 TE 23）,temporal branches, Xiaguan（下关 ST 7） Sibai（四白 ST 2）,zygomatic branches, Qianzheng（牵正）Quanliao（颧髎 SI 18）,zygomatic branches, Jiache（颊车 ST 6） Chengjiang（承浆 CV 24）,buccal branches, and Hegu（合谷 LI 4）. The auricular vagus nerve acupoints was added additionally（two distribution points in each cavity of auricular concha were selected）. Electroacupuncture was conducted for30 min/time, once a day, and 6 times/week. One day was free from treatment between 2 weeks. Treatment for 4 weeks was 1 course of treatment, and the effect was observed after 1 course.Results： Cured： 39 cases, markedly effective： 13 cases, effective： 6 cases, ineffective： 3 cases. The cure rate was 65%, and the total effective rate was up to 95.0%.Conclusion： The curative effect of electroacupuncture at facial acupoints combined with electrical stimulation on the auricular vagus nerve points for treatment of chloasma was satisfactory.

Treatment of Facial Chloasma by Auricular Pressure in41 Cases

According to differentiating syndrome and dividing patter, 41 cases of Facial Chloasma by Auricular Pressure in Shen (MA-AH), Fei (MA-IC 1), Neifenmi (MA-IC 3), Luanchao (MA-AT), Mianjia (MA-L) and Xia’erbei (MA-IC), the total effective rate was 87.8%. Key Words Skin Pigmentation, Chloasma - Auricular Point Sticking - Syndrome Differ Treatment Author: Liu Guang-xia (1954-), female, associate professorTranslator: Xiao Yuan-chun