A Preliminary Study On The Efficacy And Mechanism Of Tongbu Fuluo Decoction Combined With Auricular Acupuncture In The Treatment Of M+V Type Chloasma With Qi Stagnation And Blood Stasis Syndrom

Objective:To observe the curative effect of Tongbu Fuluo Decoction combined with auricular acupuncture on M+V Melasma with qi stagnation and blood stasis syndrome,and to explore its mechanism from the aspect of ROS/HIF-1α/VEGF pathway.Methods:A randomized controlled method was used.From October 2021 to October 2022,patients with M+V Melasma with qi stagnation and blood stasis syndrome who were treated in the Department of Dermatology of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine were randomly divided into ear acupuncture group 24 cases,traditional Chinese medicine group 25 cases and acupuncture combined with medicine group 25 cases.The auricular acupuncture group was only treated with auricular acupuncture,the traditional Chinese medicine group was only treated with Tongbu Fuluo Decoction,and the combined acupuncture and medicine group was treated with auricular acupuncture combined with Tongbu Fuluo Decoction for 12 weeks.Observe the effective rate,clinical efficacy of the three treatment regimens and their effects on mMASI score,dermoscopic vascular number and morphology score,MELASQOL score,ROS,HIF-1α,VEGF levels,and the recurrence of the disease 3 months after the end of treatment and safety.At the same time,35 cases of skin healthy people who were treated in the physical examination center of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine during this period were randomly selected as a normal control group.The levels of ROS,HIF-1α and VEGF in the serum of Melasma patients and normal people were compared.SPSS 25.0 software was used to analyze the collected data.Results:The effective rate of the auricular acupuncture group was 37.50%,the effective rate of the Chinese medicine group was 72.00%,and the effective rate of the combined acupuncture group was 88.00%.The clinical efficacy of the combined group was better than that of the auricular acupuncture group and the traditional Chinese medicine group(P<0.05).3.After treatment,the mMASI scores of the three groups were lower than those before treatment(P<0.01),and the decrease index of mMASI score in the acupuncture combined with medicine group and the traditional Chinese medicine group was greater than that in the auricular acupuncture group(P<0.01),but there was no statistical difference between the two groups(P>0.05).4.After treatment,the number of blood vessels and morphological scores of patients in the traditional Chinese medicine group and the acupuncture combined with medicine group decreased significantly(P<0.01),and the acupuncture combined with medicine group was better than the traditional Chinese medicine group;there was no significant difference in vascular score before and after treatment in auricular acupuncture group.The MELASQOL scores of the three groups before and after treatment were significantly decreased(P<0.01).After treatment,the MELASQOL score of the combined acupuncture and medicine group and the traditional Chinese medicine group was significantly lower than that of the auricular acupuncture group(P<0.01),but there was no statistical difference between the two groups(P>0.05).6.Serum ROS,HIF-1α and VEGF in patients with chloasma were significantly higher than those in normal people(P<0.05).7.After treatment,the serum ROS level in the Chinese medicine group and the acupuncture combined with medicine group was significantly lower than that before treatment(P<0.01),but there was no statistical difference between the two groups(P>0.05);there was no difference in serum ROS before and after treatment in the auricular acupuncture group(P>0.05).8.After treatment,the level of serum HIF-1α in the combined group was lower than that before treatment(P<0.05).9.Acupuncture combined with Chinese medicine group and Chinese medicine group after treatment in patients with serum VEGF levels lower than before treatment(P<0.05).The recurrence rate of the auricular acupuncture group was 44.44%,the recurrence rate of the Chinese medicine group was 38.88%,and the recurrence rate of the combined acupuncture group was 9.09%.There was a significant difference between the combined acupuncture group and the auricular acupuncture group(P<0.05).1.There were no adverse reactions in the three groups after treatment.Conclusion:1.Serum levels of ROS,HIF-1α and VEGF in patients with Melasma were significantly higher than those in normal people,and there may be a high expression of ROS/HIF-1α/VEGF in patients with Melasma.2.The curative effect of Tongbu Fuluo Decoction combined with ear acupuncture needle in the treatment of M+V Melasma with qi stagnation and blood stasis syndrome is significant.Down-regulation of ROS/HIF-1/VEGF may be one of its mechanisms.