| Background:Melasma is a pigmented skin disease that is more common in the face symmetry of young and middle-aged women.Traditional Chinese medicine has been called"black spot".It is clinically easy to diagnose but hard to cure,and it affects the physical and mental health of patients.Modern medicine believes that the occurrence of melasma is more than ultraviolet radiation,hormone levels,genetic factors,free radicals,vascular endothelial function and hemorheology.Western medicine treatments are reducing melanin production,chemical skin resurfacing,laser treatment.Traditional Chinese medicine believes that melasma is more closely related to liver,spleen and kidney.It is often treated with dispersing stagnated liver qi for relieving qi stagnation.tonifying and replenishing liver and kidney,Invigorate the spleen to damp elimination,promoting blood circulation for removing blood stasis and other treatments.However,the etiology and pathogenesis of melasma have not yet been fully clarified.The curative effect of Chinese and Western medicine oral medicine is limited.There is no specific treatment plan at present,and it is often necessary to combine various treatments to improve the curative effect.The history of TCM treatment of melasma has been in existence for a long time.The choice of external treatment drugs is based on the theory of TCM syndrome differentiation.TCM oral administration can be a new choice for treating melasma.Postgraduate tutor Zhang Fengchuan,chief physician,has been engaged in the clinical research of melasma for many years.He believes that the main pathogenesis of melasma is kidney deficiency and blood stasis.Self-made Huoxue facial mask granule,Wenjing foot washing granule combined with Meibai Yurong Decoction for treating melasma,after many years Clinical practice has achieved certain effects.In the past,there have been studies on the treatment of melasma with oral Meibai Yurong Decoction,but there is no research to evaluate the efficacy of the combined external treatment.Objective:The purpose of this study was to scientifically evaluate the efficacy of Huoxue facial mask granule,Wenjing foot washing granule combined with Meibai Yurong Decoction in the treatment of melasma with kidney deficiency and blood stasis,and provide a new solution for clinical treatment of melasma.Methods:75 subjects were randomly divided into two groups.The experimental group consisted of 38 patients,which took Meibai Yurong Decoction twice a day,and combined with Huoxue facial mask granule,Wenjing foot washing granule.Control group consisted of 37 patients were only given Meibai Yurong Decoction twice a day.The trial consisted of 12 weeks(84 days)and was divided into 3 stages,each stage being 4 weeks.The patients were evaluated by the trained dermatologist at the 0th,4th,8th,and 12th week for the Melasma Area and Severity Score(MAST)and TCM signs.The difference in efficacy between the combination regimen and the single oral medication was evaluated by comparing the improvement of skin lesions and the improvement of TCM signs in the experimental group and the control group.Results:58 subjects completed the first phase of treatment.The total effective rate of MASI was 20%(6/30)in the experimental group and 7.1%(2/28)in the control group.There was no statistical difference between the two groups(P>0.05),the effective rate of TCM physical signs in the experimental group was 50%(15/30 cases),and the control group was 46.4%(13/28 cases).There was no significant difference between the two groups(P>0.05).51 patients completed the second phase of treatment.The total effective rate of MASI was59.3%(16/27 cases)in the experimental group and 29.2%(7/24 cases)in the control group.The test group was significantly better than the control group(P<0.05),the effective rate of TCM physical signs in the experimental group was 88.9%(24/27 cases),and that in the control group was58.3%(14/24 cases).The efficacy of the experimental group was significantly better than that of the control group(P<0.05).42 subjects completed the third-stage treatment.The total effective rate of MASI was81.8%(18/22 cases)in the experimental group and 45%(9/20 cases)in the control group.The experimental group was significantly better than the control group(P<0.05),the effective rate of TCM physical signs in the experimental group was 95.5%(21/22 cases),and that in the control group was 75%(15/20 cases).The efficacy of the experimental group was significantly better than that of the control group(P<0.05).The decline rates of MASI scores at the 4th,8th,and 12th week of the experimental group were 25.8%,49.7%,and 69.6%,respectively,and that of the control group were 12.3%,22%,and 41.1%.The decline rate of TCM scores in the 4th,8th,and 12th week of the experimental group was 29.3%,55.1%,and 62.2%,and that in the control group was 31.0%.28.8%,and 39.5%.Conclusion:The effect of Huoxue facial mask granule,Wenjing foot washing granule combined with Meibai Yurong Decoction on the 8th and 12th week is better than the oral decoction alone.The long-term effect is better and the effect is faster. |
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