| Objective:Meibai Yurong Decoction,a clinical prescription for melasma established by the instructor,has been used in clinical practice for more than 20 years and has a significant effect,but its treatment mechanism is unknown.Chloasma is closely related to the metabolism of melanin.Studies have found that(MITF)is a key transcription factor for melanin production.Wnt Inhibitory Factor-1(WIF-1)affects MITF production by upregulating typical and atypical Wnt signaling pathways,stimulating melanin production and melanin body transfer.Rab27a,a small GTPase-related protein of the Ras family,regulates the transport of melanosomes in melanocytes.Rab27a expression is regulated by MITF.Therefore,this study intends to explore the mechanism of treatment of chloasma by the traditional Chinese medicine Meibai Yurong Decoction by detecting the content of WIF-1,MITF and Rab27a in the serum of patients before and after treatment and in the peripheral blood of healthy people.Methods:Use clinically controlled experimental research methods.33 healthy volunteers were selected as the control group,and 33 patients with chloasma with kidney deficiency and blood stasis were selected as the test group.The control group was not treated,and the test group was given Meibai Yurong Tang granules orally,1 dose per day,for 8 weeks of continuous treatment.The changes of melasma skin lesion severity score(MASI),TCM symptom score,and melasma quality of life score before and after 8 weeks of treatment were compared.The content of Wnt inhibitory factor protein 1 WIF-1 which inhibits melanin production in peripheral serum of patients and healthy volunteers,MITF,a transcriptional protein associated with small eye malformation related to melanogenesis,and Rab27a,a small GTPase-related protein that promotes melanin metabolism,were measured by ELISA.Compare the changes of the contents of three proteins in the peripheral serum of patients before and after treatment.The relationship between the contents of three proteins in peripheral serum of patients with chloasma before and after treatment and healthy volunteers were compared.Results:After 8 weeks of continuous treatment with Meibai Yurong Decoction:1.MASI score:9 cases were markedly effective,11 cases were improved,and the overall improvement rate reached 66.67%.2.TCM syndromes:1 case was cured clinically,4 cases were markedly effective,25 cases were effective,and the overall effective rate reached 100%.3.Quality of life score for patients with melasma:before treatment was 7.60±4.88 points,after treatment was 3.23±2.75 points,p<0.05,the difference in score before and after treatment was statistically significant.4.Content of WIF-1 in peripheral serum:After treatment,the level of WIF-1 in peripheral serum of patients increased(p<0.05).Compared with healthy people in the control group before and after treatment,the levels of WIF-1 in peripheral serum were different,and the differences were statistically significant(p<0.05).The 95%CI of WIF-1 content in the peripheral serum of healthy people in the control group was(1356.66,1529.26)pg/mL.In the experimental group,24 people were below the lower limit before treatment,3 were above the upper limit,and only 3 People are below the lower limit,and 20 people are above the upper limit.5.Content of MITF in peripheral serum:After treatment,the patient's peripheral serum MITF content increased(p<0.05).Compared with the healthy people in the control group before and after treatment,the MITF content in the peripheral serum was different between the experimental group and the difference was statistically significant(p<0.05).The 95%CI of the MITF content in the peripheral serum of healthy people in the control group was(6.51,7.45)ng/mL,19 patients were below the lower limit before treatment,only 8 were below the lower limit after treatment,and 14 were added Above the upper limit.6.Content of Rab27a in peripheral serum:After treatment,the patient's peripheral serum Rab27a level increased(p<0.05).Compared with healthy people in the control group before and after treatment,the serum levels of Rab27a in the experimental group were different,and the differences were statistically significant(p<0.05).The 95%CI of Rab27a in peripheral blood of healthy people in the control group was(1524.01,1673.99)pg/mL.Before treatment,19 people were below the lower limit,9 were above the upper limit,and only 4 were below the lower limit after treatment Limits,and 1 7 people are higher than the upper limit.Cinclusiong:Meibai Yurong Decoction has advantages in the treatment of chloasma.After 8 weeks of treatment,the patient's MASI score,TCM syndrome,and self-evaluation all improved significantly.Elevating the levels of WIF-1 and Rab27a in peripheral serum may be one of the mechanisms of self-made Meibai Yurong Decoction for the treatment of chloasma.The MITF content does not decrease but rises,and its mechanism of action needs further study. |
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