中医药内外合治肝郁血滞型黄褐斑的临床疗效观察.doc

中医药内外合治肝郁血滞型黄褐斑的临床疗效观察田何亲，姚震丽，黄九玲(中国中医科学院西苑医院)摘要：目的观察中药内服、外用及耳穴压豆治疗肝郁血滞型黄褐斑的临床疗效。方法中医辨证分型为肝郁血滞型的黄褐斑患者，采用随机数字表进行分组，结果完成84例。治疗组46例，中药阿胶黄精丸口服及中药祛斑膜1号方外用配合耳穴压豆治疗；对照组38例，维生素c片和维生素E胶丸口服，01维A酸乳膏外用治疗，治疗12周后进行疗效判定。结果治疗组有效率为8O43；对照组有效率为6316，2组疗效对比差异有统计学意义(尸005)。结论中医药内外合治肝郁血滞型黄褐斑疗效好，安全性高。关键词：黄褐斑；肝郁血滞；中医疗法 阿胶黄精丸中图分类号：R7584+2 文献标识码：A 文章编号：16720709(2012)05027803Clinical Therapeutic Efect of Traditional Chinese Medicine Therapy on Treating Liver Qi Stagnation and BloodStasis Patients with M elasmaTIANFengyan,YA0 Chunhai，ZHA0 Yiding,SHE Yuanyao，CHIHuiyan,HUANG YaozhouXiyuan Hospital ofChinaAcademy ofChinese Medical Science，Beijing 100091，ChinaAbstract：Objective To observe the clinical therapeutic effects of traditional Chinese medicine therapy on treatingmelasmaMethods 84 Patients with melasma of syndrome of liver Qi stagnation and blood stasis were randomly divided intotwo groups46 patients in the experimental group were treated with the Xiaoban 1 Hao Fang orally and Quban Mol Hao Fangexternally，and they were treated with the ear pressure beans at the same time38 patients in the control group took tablet ofvitamin C and soft capsule of vitamin E orally，and they were treated with 01 dimensional A emulsifiable paste externally atthe same timeEfficacy was evaluated at the baseline and at the end of 12 week S treatmentResults The total effective ratewas 8043 in the experimental group and 6316 in the control group，respectivelyThere was a statistically significantdifference between these two groups O05)Conclusion Treatment of melasma by using internal and external Chinesemedicine iS effective and safeKey words：melasma；syndrome of liver Qi stagnation and blood stasis；traditional Chinese medicine therapy黄褐斑是皮肤科一种常见的多发性疾病，表现为面部呈局限性色素沉着的褐色斑，多见于中青年女性，少数男性也有发病，多数患者无自觉症状。祖国传统医学称之为“黧黑斑”、“肝斑”。现代医学对本病病因认识尚不明确，治疗效果欠佳，而中医运用阿胶黄精丸辨证论治本病多有成效。2010年9月一2011年11月，笔者依托中国中医科学院优势病种项目，采用中药内服联合外用中药倒膜及耳穴压豆治疗肝郁血滞型黄褐斑，取得了较满意的效果，现报道如下。1 资料与方法11 临床资料90例患者均为女性，为本院皮肤科门诊经确诊为黄褐斑的患者，中医辨证分型为肝郁血滞型。采用随机数字表进行分组，结果完成84例，脱落6例(005)。阿胶黄精丸调理肝郁血滞型证候黄褐斑诊断标准(参照中华人民共和国中医药行业标准ZYT0011994中医病证诊断疗效标准，国家中医药管理局发布)：主症为颜面出现黄褐色斑片；次症为急躁易怒，胸协胀痛，舌质暗，苔薄白，脉沉细或细涩。排除标准：其他疾病引起的色素沉着；正在接受其他方法治疗者；妊娠、准备妊娠或哺乳期妇女；近半年内服用影响内分泌的药物以及伴绝经、糖尿病、慢性肝肾功能不全、自身免疫性疾病、1个月内接受过其他治疗的患者；合并有心肝肾和造血系统等严重原发性疾病，精神病患者；不按本方案治疗或中_进而运用阿胶黄精丸对黄褐斑患进行调理，结果临床发现阿胶黄精丸对黑色素细胞的