| The chloasma,which is caused by pigmentation and presents itself into facial symmetry,is a kind of skin disease of face department.Traditional Chinese medicine (TCM) calls it as "Li black spot" or "liver spot".As a damage holding disease,it is one of the most difficult cure dermatitis in clinical treatment.Cholasma,which attacked to young and middle-aged women mainly,is not only influences appearance,but also affects the patient's daily life and work seriously.Besides,it brings a great deal of psychological problems and social stress.Furthermore,these bad effects will accelerate the disease worse. Although both TCM and western medicine have diverse methods and already get some therapeutic effects,they are still not satisfactory.As presenting the medical model of "biology-psychology-society",people begin to focus on the effect of psychological factor to the patients.Based on this,this article will analyze the etiology and lesion mechanism of cholasma from the aspect of social psychology.ObjectiveResearch on Law of syndromes and therapies:We have study and summarize all cases about cholasma in TCM comprehensively by using literature research method,and meantime,build the relevant database.And then,use the method of statistics to dig out the objective law of cholasma relating to emotion which conforms to pharmacology of TCM,in order to reveal the law of syndromes and therapy cholasma.As a result,put forward a new method and an ideal to the TCM clinical scientific research.Research of clinic:Through the introduction of the modern psychology questionnaire measurement,cholasma patients were choose as the object of study,and then in view of the object,make a large sample survey.On the basis of statistics analysis,observe the relevance between Psychology Scale targets and TCM Syndromes.Hereby,explore the role of socio-psychological factors in Cholasma incidence intended to illuminate the lesion mechanism of cholasma.Accordingly,give a new idea in the emotional pathogenic mechanism of TCM,hope that raising therapeutic efficiency of TCM and providing sufficient socio-psychological foundation based on etiology.MethodsResearch of literature:First of all,researching cholasma medicine record information on TCM,Collate and analyze generally the disease history of cholasma,such as the evolution of the disease name,etiology and pathogenesis,treatment of the law and prescription and so on.Simultaneity,consult a number of books and documents about this subject on Western Medicine.Then,make a systemic summary of the cholasma history from both TCM and wester medicine angles.In a word,find out the law of cholasma.Research on law of syndromes and therapies:The medical cholasma database was built up by using Encyclopedia of TCM,the large-scale e-book,as the elementary reference to retrieval all kinds of words which related with chloasma's name in ancient time, selecting the exact amount of prescription drugs as the object of study and regulating the drug's efficacy,indications,measuring unit.Meanwhile,with the help of analysis software SPSS,do data processing and data analysis,including Frequency analysis,Factor analysis, and R-type(target) cluster analysis.Based on this processing result,combined the knowledge of ages of Cholasma and TCM Theory,analyze and check out the statistical and clinical significance.Research of clinic:Choose cholasma patient as the object of study,survey them by questionnaire.These forms consist of Zung self-rating depression scale(SDS),Zung self-rating anxiety scale(SAS),Eysenck Personality Questionnaire(EPQ),Trait Coping Style Questionnaire(TCSQ) and Perceived Social Support Scale(PSSS).By observing the relevance between the target scale and Cholasma TCM Syndrome,explore the role of the socio-psychological factors in the pathogenesis of Cholasma.Aim at explaining cholasma pathogenesis and disease mechanisms from a psychological point.All of the data were processed bySPSS statistics package.Results and Conclusion1.Research on law of syndromes and therapies(1)Selecting cholasma medicine record of TCM information by using philology research,Collect and analyze generally the disease history of cholasma,such as the evolution of the disease name,etiology and pathogenesis,treatment of the law and prescription and so on.To realize the processing law in diagnosis and treatment based on an overall analysis of signs and symptoms about cholasma,and make a systemic summary of culprits.There are a lot of different classifications about chloasma.According to clinical experience,there are 2 kinds of style like butterfly type and surface type.As a type of secondary-type,the disease symptom is that the impaired skin is light brown or dark brown. Obviously,this type is resulted from depression and anxiety.(3)The person's disposition like introversion and extroversion is highly related to emotion like depression and anxiety.Those patients who are introversion are less inclined to be gloomy and anxious,whereas those who are extroversion are more apt to slip into depression and anxiety.(4)Chloasma patients are always prone to adopt passive coping style,so their level of stress reaction is higher than normal person.Thus their level of depression and anxiety is higher accordingly.Coping style,however,is not significant correlation with the level of depression and anxiety.Besides,the questionnaire is related to the traits of social groups.In consideration of this,the result of survey can not stand for general trait.Therefore,it is more suitable for a research subject about all kinds of health problems.(5)The degree of perceived social support has no correlation with the level of depression and anxiety.On account of the sample selection,it is hard to include all kinds of people.Despite of this,we can no ignore social support.(6)It is demonstrated from both overall cases and sub-card-type statistics that most of chloasma patient has serious depression and anxiety.About 80%of those patients are depressive,most of the rest have some anxiety symptom.The results show deafly that chloasma patients suffer prodigious stress and have ill-natured physical and mental health. So it can not be ignored that psychological factors plays a critical role in the chloasma pathogen process.(7)The syndrome's style of the stagnancy of liver-Qi is appeared mostly.A lot of research indicates that the group of stagnancy of liver-Qi has higher level of depression and anxiety than the group of deficiency of spleen and the group insufficiency of kidney-Yin. This means that the emotional disorder is main pathogen of chloasma.The standard of psychological health in the syndrome of stagnancy of liver-Qi is lowest than the others(the syndrome of deficiency of spleen and the syndrome of insufficiency of kidney-Yin])(8)Through quantitative and qualitative analysis,we can discover that there is relativity between the types of chloasma in TCM and socio-psychological factors referred in this dissertation.The sample has been divided into stagnancy of liver-Qi group(group 1), deficiency of spleen group(group2) and insufficiency of kidney-Yin group(group 3).From the diagram of the correlation between stagnancy of liver and anxiety,they show strong positive correlation.The relationship between dampness evidence spleen deficiency and the cholasma association with emotional factors in order to lay the foundations of philology.(2)Combining the method of ancient literature and statistical analysis,research and analyze the law of cholasma' treatment in ancient medical literature.The result shows that the modern and ancient of Chinese medicine have the same medical idea about syndromes and therapy of chloasma.The ancient doctors believe that chloasma is caused by both endopathic and exopathic factor.The endopathic factors are included by emotional injuries, improper diet,maladjustment of work and rest,which led to deficiency of three organs-liver,spleen and kidney.The exopathic factors are included by exogenous wind-heat seemingly,companying by evil of dampness,heat and cold frequently,and pathological producers which are blood stasis,phlegm stains.The chloasma,which pathogenic site is located in liver,spleen and kidney,belongs to syndromes of deficiency of vital qi with excessive pathogenic factors.(3)Abide by TCM theory and method to analysize the medicines of chloasma,accord with the statistic result;it is proved that emotional disorder was considered as an important pathogen.There is a closer relevance between Chloasma and liver.The stagnancy of liver-qi is a main link in the chain of basic pathogenic mechanism of chloasma.(4)It were said that "women are taken blood as body's basis" and "the liver is viewed as congenital of women's life".Liver's function about storing blood and smoothing and regulating the flow of viral energy and blood could play an important role in regulating the reproduction of women.The liver's dysfunction,which could cause the disorder of qi and blood and lose balance of chong-ren,led to facial dark.This illustrates that we should devote much attention to removing stagnancy of vital energy of the liver in order to harmony the blood and adjusts function of chong-ren in clinical diagnosis and treatment for young and middle-aged women especially.(5)Utilizing factor analysis and cluster analysis in statistics,generalize the ancient treatment prescription based on the result of frequency of prescription to dig out and summarize treating recipes about main style of syndromes and signs.2.Research of clinic(1)This dissertation finds that there is a consistency among chloasma patients dominating characteristic,the incidence of the more common factors related to chloasma and the performance of the clinical diagnostic.(2)In the modern word,high-education is the leading element to induce anxiety, simultaneity,high-income gives birth to depression directly.Among those factors referred before,course of the disease,companying diseases and mental factors are the primary anxiety is a clear negative correlation.So does insufficiency of kidney-yin.Overall the result,we can discover that the patient who has blood stasis is more introversion.The patient's response will be more negative with the worse of the illness.According to this, combined psycho-questionnaires with TCM Differential Treatment,give adequate socio-psychological foundations in order to raise the clinical efficiency of chloasma and provide some precautionary methods.This dissertation uses the method of Document Research and Clinical Research to study chloasma from both theoretical and clinical aspects.Furthermore,explores the relevance between chloasma and pathogenic factors of emotion.The results show that the psycho-social factors are closely related to the incidence of chloasma.Depression and anxiety are the major mood problem of chloasma patients and play an important role to the course of the disease.Besides,there is relativity between the types of chloasma in TMC and socio-psychological factors.So,firstly,the doctor should pay more attention on the psycho-social factors while in the course of medical treatment.Secondly,understand the characteristics of emotional disorder and its bad effects.Thirdly,disperse the depressed liver-energy for patient in the treatment.This dissertation tries to combine with psychological results in the questionnaires and TCM treatment in the clinical practice. Finally,give some advice to doctor for chloasma patient who should take full account of the psychological factors,situational factors and the drug's efficacy,while in drug treatment and psychological counseling and psychotherapy.So adjust their emotion in order to reduce pigmentation for spirit factors and improve the prevention and treatment of chloasma the level of Chinese medicine.
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