Observation Of The Patch Fading Process With Modified Danggui Shaoyao Powder On Liver Depression And Spleen Deficiency Type Of Melasma Via Reflectance Confocal Microscopy

Objective:To observe the clinical effect of Modified Danggui Shaoyao Powder Combined with tranexamic acid oral treatment of liver stagnation and spleen deficiency type on melasma,and observe the patch fading process via Reflectance Confocal Microscopy.Methods:This study included 42 cases of liver and spleen deficiency melasma patients were randomly divided into 2 groups,21 cases in the treatment group,treated with modified Dangguishaoyaosan,tranexamic acid tablets,topical Recombinant Human Epidermal Growth Factor Gel;21 cases in control group were given tranexamic acid tablets,topical Recombinant Human Epidermal Growth Factor Gel.Observe the lesions before treatment,at week 4th,week 8th,week 12th,compaired with skintone guide,record the lesion area scores,skin color and skin color scores,calculate the treatment decreased index and chromaticity of the falling number,determine the curative effect.In the same lesion area,record the pigmentation score,dendritic cell score,melanophores score,solar elarstosis score and vascular proliferation score via RCM.The total score of RCM was calculated,and spss22.0 statistical software was used to analyze the curative effect.Results:1.In the treatment group,1 cases(4.8%)were basically cured,7 cases(33.3%)were markedly improved,12 cases(57.1%)were improved,1 cases(4.8%)were invalid,4.8%cases were effective,19 cases(95.2%)were effective,19 cases(95.2%)were basically cured in the control group,95.2%cases(95.2%)were basically cured,effective cases were improved,cases were improved,and invalid cases were recorded.There was a difference in the curative effect between the treatment group and the control group.(P<0.05)2.1n the treatment group and the control group,compared with the 12 weeks and before treatment,there was a difference in the number of chromaticity in the skin lesions.(P<0.05)3.RCM observation:3.1Among the 42 patients with melasma,there were 16(38.1%)patients with epidermis,and 26(61.9%)patients with mixed type,and no dermis patients were found.3.2The treatment group and control groups,pigmentation score,dendritic cells score was statistically significant in the treatment of 4 weeks and 8 weeks of treatment,after 12 weeks of treatment(P<0.05);melanophores score was statistically significant at 8 weeks of treatment,after 12 weeks of treatment(P<0.05);solar elarstosis score statistically significant differences between the four time loci(P>0.05);vascular proliferation score after 4 weeks of treatment there were significant differences(P<0.05),for 8 weeks,12 weeks of treatment had no significant difference(P>0.05).3.3The treatment group and control the density of pigmentation score in treatment group for 4 weeks and 8 weeks after treatment and before treatment,12 weeks before treatment there was significant difference(P<0.05),the control group for 8 weeks and 12 weeks after treatment and before treatment there was significant difference(P<0.05);dendritic cells score in treatment group for 4 weeks and 8 weeks after treatment and before treatment,12 weeks before treatment there was significant difference(P<0.05),the control group had no statistical difference(P>0.05);the treatment group and the control group were melanophores score,solar elarstosis score for 4 weeks-before treatment,8 weeks and 12 weeks after treatment and before treatment were statistically significant(P<0.05);vascular proliferation score in treatment group 4 weeks before treatment,8 weeks and 12 weeks after treatment and before treatment there was significant difference(P<0.05),There were statistically significant differences(P<0.05)before and after treatment for 8 weeks before treatment and 12 weeks of treatment.Conclusion:Modified Danggui Shaoyao Powder combined tranexamic acid has good curative effect for patients with liver depression and spleen deficiency of melasma,and no obvious adverse reaction.The observation of patch fading process via RCM shows that modified Danggui Shaoyao Powder combined with tranexamic acid on oral lesions of pigmentation,density of dendritic cells,melanocytes and vascular proliferation were significantly improved,suggesting that mechanisms in the treatment of melasma with Danggui Shaoyao Powder may improve the antioxidant capacity,inhibit the generation and proliferation of black prime;promote translocation and degradation of melanosomes.