本文選題：黃褐斑 + 姜黃素��； 參考：《大連醫(yī)科大學》2017年碩士論文

【摘要】：黃褐斑是多發(fā)于顏面部的后天獲得的色素沉著性難治性的一種皮膚病,臨床常見,多見于女性,尤其以育齡期婦女為多發(fā)。主要癥狀為顏面部等曝光部位的深或淺的褐色斑片。本病幾乎無自覺癥狀亦不影響身體健康,但可嚴重影響患者的容貌及心理健康,能令患者情感和精神方面產生巨大痛苦,甚至對其生活質量造成嚴重影響。根據(jù)2015年制定的黃褐斑治療專家共識,本病治療的目的是促使色斑變淡或恢復正常、面積縮小或消失。雖然目前已證實有多種方法可以治療黃褐斑,但仍然缺乏特別有效的治療手段。近年來,隨著黃褐斑發(fā)病率的逐年升高,且它作為女性常見損容性皮膚病越來越受到重視,對其治療的研究亦隨之大量涌現(xiàn)。本研究采用含有效成分為姜黃素的中藥---姜黃和郁金入方組成的祛斑湯來治療女性肝郁氣滯型黃褐斑,然后分別用皮膚色度儀、Wood燈的方法觀察治療組和對照組治療后的療效并做初步分析,以期能為黃褐斑的治療提供新思路。目的:探討含有效成分姜黃素的中藥祛斑湯治療黃褐斑的療效并做初步分析。方法:將67例辯證為肝郁氣滯型的黃褐斑患者隨機分為治療組(35例)和空白對照組(32例)。予以治療組12周含有效成分姜黃素的中藥祛斑湯(柴胡10g郁金20g姜黃10g當歸15g芍藥15g茯苓15g白術15g益母草15g丹參15g甘草10g)治療。1.分別于治療前、療中、療后使用皮膚色度儀監(jiān)測及記錄兩組患者面部黃褐斑的色度值(皮膚亮度L*、皮膚紅綠色度a*、皮膚黃藍色度b*)的變化并做統(tǒng)計分析。2.觀察兩組治療前后自然光下和Wood燈下皮膚色斑的變化,做標準圖像采集,根據(jù)治療后色斑殘留的情況進行PGA評分及對比。3.采集黃褐斑皮損做免疫組化染色,觀察鏡下黑色素細胞在治療前后的變化。結果:1.經過3個月的治療,治療組的皮膚亮度(L*)在治療后明顯升高、皮膚紅綠色度(a*)在治療后明顯下降,且治療組與對照組相比,色度L*值和a*值的變化差異有統(tǒng)計學意義(P0.05);皮膚黃藍色度(b*)在治療后變化不明顯,治療組與對照組相比,b*值的變化差異無統(tǒng)計學意義。2.經過3個月的治療,自然光下和Wood燈下觀察色斑治療前后的變化,PGA評分顯示治療組治療后色斑的變化明顯優(yōu)于對照組,兩組差異有顯著統(tǒng)計學意義(P0.05)。3.經過3個月的治療,治療組黃褐斑皮損治療前后經Bcl-2染色后觀察鏡下黑色素細胞,治療后陽性比例較治療前明顯減小,治療后黑色素細胞數(shù)量發(fā)生了變化,較治療前有所減少。結論:含有效成分姜黃素的改良中藥祛斑湯能淡化肝郁氣滯型黃褐斑患者的面部色斑。
[Abstract]:Chloasma is a difficult skin disease with pigmentation acquired in the face. It is commonly seen in women, especially in women of childbearing age. The main symptoms were deep or light brown spots at the same exposure site of the face. This disease has almost no conscious symptoms and does not affect physical health, but can seriously affect the appearance and mental health of patients, can cause great emotional and mental pain, and even seriously affect their quality of life. According to the consensus of experts in the treatment of chloasma in 2015, the aim of the treatment is to cause the color spot to fade or return to normal, and to reduce or disappear the area. Although a variety of treatments for chloasma have been proven, there is still a lack of particularly effective treatment. In recent years, with the increase of chloasma incidence year by year, and it is more and more attention as a common female capacitive dermatosis, the treatment of chloasma has also emerged in large numbers. In this study, the treatment of chloasma in female patients with stagnation of liver-qi was carried out by using the decoction composed of turmeric and turmeric and turmeric decoction with curcumin as an active component. Then the therapeutic effect of the treatment group and the control group were observed by the method of skin colorimeter and Wood lamp respectively and the preliminary analysis was made in order to provide a new idea for the treatment of chloasma. Objective: to study the curative effect of Qubantang containing curcumin on chloasma. Methods: 67 patients with chloasma were randomly divided into treatment group (n = 35) and blank control group (n = 32). The treatment group was treated with Quban decoction with effective ingredient curcumin (Radix Bupleurum 10g, turmeric 20g, turmeric 10g, angelica sinensis 15g, paeoniflorin 15g, Rhizoma Atractylodes macrocephala 15g, Radix Salviae Miltiorrhizae 15g, Radix Salviae Miltiorrhizae 15g, Licorice 15g). Before, during and after treatment, the changes of colority of chloasma on the face of two groups were monitored and recorded by means of skin colorimeter (skin brightness, skin red and green color A, skin yellow and blue color), and statistical analysis was made .2.The results were as follows: (1) before, during and after treatment, the changes of the color of chloasma on the face of the two groups were monitored and recorded. The changes of skin spots under natural light and Wood lamp were observed before and after treatment, and the standard images were collected. The PGA score and contrast were made according to the residual situation of the spots after treatment. The changes of melanocytes before and after treatment were observed by immunohistochemical staining. The result is 1: 1. After 3 months of treatment, the skin brightness of the treatment group increased significantly after treatment, and the skin red and green degree decreased after treatment, and the treatment group was compared with the control group. There was significant difference between the values of colority L * and A * (P 0.05), but there was no significant change after treatment, but there was no significant difference between the treatment group and the control group in the change of the value of B * and B * (P 0.05, P < 0.05), but there was no significant difference between the treatment group and the control group (P < 0.05). After 3 months of treatment, the changes of color spot before and after treatment were observed under natural light and Wood lamp. PGA score showed that the change of color spot in the treatment group was obviously better than that in the control group, and the difference between the two groups was statistically significant. After 3 months of treatment, melanocytes were observed by Bcl-2 staining before and after treatment in the treatment group. After treatment, the positive rate of melanocytes decreased significantly, and the number of melanocytes changed after treatment, which was less than that before treatment. Conclusion: the modified Quban decoction containing curcumin can desalinate the facial spots in patients with chloasma with stagnation of liver and qi.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R275.9

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