| Purpose: According to the curative effect observation of chloasma treatedby compound Chinese drugs (Liuwei dihuang Wan, LWDHW and Xiaoyao Wan, XYW)which is frequently used to treat chloasma in literatures and experienceprescription (Bushen huayu capsule, BSHYC) made by famous veteran doctorof traditionai Chinese medicine (TCM) in our university, the therapeuticsystem and theory based on syndrome differentiation of treating chloasmausing TCM is recognized and the predominance of using invigorating thekidney and removing the blood stasis method (IKRBSM) to treat chloasmais further identified, further to guide clinical therapy and spread. Andto investigate the influence of blood serum containing IKRBSM on melaninsynthesis function of melanocytes and tyrosinase activity by usinghistocytological methods and administration route of medicated bloodserum, so that to further study the action mechanism of BSHYC treatedchloasma.Methods: 75 cases with chloasma strictly chose by selective standard andrandomly divided into treated group, control group 1 and control group2. The treated group was treated with IKRBSM, the control group 1 wastreated with LWDHW and group 2 was treated with XYW. The changes of coloredspots area, colored spots chromaticity, and score index before and aftertreatment were used to estimate the therapeutic effect of IKRBSM treatedchloasma. And blood serum of patients were chose from three groups (5 caseseach group) after treated two months which was used normal blood serum as blank control group. Melanocytes were cultured in vitro, added 10%concentration of each mediated blood serum at logarithmic growth phase.And one week later, NaOH assay and oxidation of DL-dopa method were usedto detect conditions of melanocytes synthesis melanin and tyrosinaseactivity.Results:1 Colored spots area and score index were both decreased in each group,which explain that BSHYC, LWDHW, XYW all have the curative effect onchloasma. There is statistical significance (P＜0.05) in the differencesbefore and after treatment between BSHYC group and other two groups whichexplain that BSHYC can treat chloasma better than LWDWH and XYW.2 To compare clinical curative effect, 2 cases were almost curing, 14 caseswere excellence, 7 cases improved, and 2 cases were ineffective in BSHYCgroup with 25 cases. The effective power was 64%. In LWDHW group with 24cases, 1 case was almost curing, 7 cases were excellence, 11 cases improved,and 5 cases were ineffective. The effective power was 33.3%. In XYW groupwith 26 cases, 1 case was almost curing, 5 cases were excellence, 14 casesimproved, and 6 cases were ineffective. The effective power was 23%. Therehad no adverse effect in all three groups. Compared with LWDHW and XYWgroups, there is predominant curative effect in BSHYC (P＜0.01). There wasno statistical significance between LWDHW and XYW groups.3 In experiment of medicated blood serum with Chinese drugs influencedcommon melanocytes and melanin contents, there were inhibitory action onmelanin synthesis in all three groups compared with healthy blank controlgroup. And the inhibitory action was more obvious in BSHYC and LWDHW groups(P＜0.01). There was statistical significance between BSHYC and LWDHWgroups, BSHYC and XYW groups (P＜0.01). There was no difference betweenLWDHW and XYW groups (P＞0.05).Conclusion: BSHYC has well curative effect on chloasma therapy,especially in decreasing colored spots, improving colored spotschromaticity. In the histocytological level, BSHYC can inhibit tyrosinaseactivity and decrease melanin synthesis, thereby has the effects ofdecreasing colored spots, curing disease. |
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