| Objective:Melasma is an acquired skin pigmentation.It is found mostly in young and middle-aged women.This disease not only affects the face,but also puts a psychological pressure on patients.Therefore,to find a safe and effective method of treatment is very important.Its pathogenesis is very complex,and its cause is still not very clear.Melasma'pathogenesis are usually thought to have relation with many factors,such as endocrine system imbalance,pregnancy,estrogen and progesterone levels,oral contraceptives,uterine and ovarian disease,genetic factors,oxygen free radicals,ultraviolet irradiation,serum copper content,hepatitis,cholecystitis, tyrosinase dysfunction,cosmetics,etc.Among them,endocrine system imbalance is generally considered to be the main reason.It's pointed out that the spirit is also an important factor in some reports.Over the years,modern medical research on the treatment of Melasma has in depth summed up a lot of new treatments,including the use of Dark agent such as Zinc oxide,Peptide Dioxide,the systematic use of Vitamins,Hemostasis acid,Melatonin,the use partially with Hydroquinone,Azelaic acid,Kojic acid,Arbutin,Glutathione,Indomethacin,Victoria acid,cortex steroids inhibit melanin synthesis,chemical stripping cuticle,etc.The patients' symptom can be improved in different degree by these chemical drug treatments,but the results are not very satisfied for its single effect and side-effects.In this regard,traditional Chinese medicine is super to chemical drug treatments for its higher efficiency,persistent effect and lower side-effects.In traditional Chinese medicine,the occurrence of Melasma is generally believed to have relation with the imbalance of liver,kidney,Yin-yang disharmony,and Disharmony of qi and blood.My tutor combined several decades of clinical experience with traditional medicine knowledge of this disease,and thought that the etiology and pathogenesis of Melasma complex.It is a disease caused by multiple factors,including liver,spleen,kidney dysfunction, emotional disorders,the Yin-yang disharmony and Qi-stagnancy and blood-stasis,etc. Among them,Binding depression of liver qi,Liver-kidney yin vacuity,Qi-stagnancy and blood-stasis are common in the clinical,so the treatment should be Relieving the depressed liver,Supplementing the liver and kidney,Harmonizing qi and blood,Activating blood to resolve stagnation.On the basis of the clinical conventional therapy,we study Pathogenesis closely and consider repeatedly increasing or decreasing the herbs according to their nature.After several rounds of screening,we have developed a prescription named CaihuXiaobanTang.The prescription had been used in clinical practice and continued to improve exploration for many years,and achieved satisfactory effect.In this paper,47 cases with Melasma were treated by taking orally Chinese medicine,compered with another 46,treated with Vitamin,and then the effect of taking orally Chinese medicine is evaluated objectively.Thereby we can provide evidence to clinic therapy for Melasma.Material and Methods:93 patients with Melasma were collected from the dermatology department in Hubei hospital of TCM from 2006-3 to 2007-3.All patients were classic Melasma, excluding the pigmentation that was caused by other diseases(For example Naevus fusco-caerulens zygomaticus,Riehl's melanosis,Lichen planus actinicus)and other systemic diseases,without taking VitC and VitE,and the impact of endocrine drugs in recent 1 months.They were divided into two groups randomly.The therapeutic group 47 cases were treated by taking orally CaihuXiaobanTang,basic prescription: Bupleurum 6g,Gill tribulus terrestris 15g,Angelica 20g,Paeonia lactiflora 15g, Ligustrum 15g,Dioscorea opposita 12g,Rehmannia glutinosa 12g,Chuanxiong 10g, Baizhi 10g,Peach seed 10g,Safflower 6g,Licorice 6g,and increase or decrease according to differentiation.The controlled group of 46 cases were treated with VitC 200mg and VitE100mg,tid po.After two months,we recorded itch,the skin lesions'color and area,and SSRI.And then,the therapeutic effects of two groups were compared based on their changes. Results:1 The significant difference about the integral of symptoms was shown statistically before and after treatment in both groups(P＜0.05).2 In the therapeutic group,the totally effective rate was 85.1%;and it was 65.2%in the controlled group.The difference between the two groups were statistically significant(P＜0.05).Conclusion:Taking orally CaihuXiaobanTang and Vitamin are both effective ways of treatment to Melasma.But taking orally Chinese medicine is superior in the clinical efficiency. |
PDF Full Text Request