| Objective:Melasma is a chronic,acquired facial hyperpigmentation skin disease,which occurs in young and middle-aged women.It is easy to relapse,difficult to cure,and has a damaging appearance,which brings a serious psychological burden to patients.The pathogenesis of chloasma is complex,and the specific mechanism is still inconclusive.At present,there is no standardized treatment plan.The main guiding principles include reducing melanin production,anti-inflammation,inhibiting vascular proliferation,repairing skin barrier,and anti-photoaging,including drug therapy,chemical skin replacement,and physical therapy.Clinical often according to the specific circumstances of patients,combined with clinical stage classification,choose a variety of treatment combined treatment,but the curative effect,side effects,recurrence rate of balance is difficult to grasp.Professor Zhang Fengchuan has used self-made Meibai Yurong Decoction to treat chloasma for more than 20 years.The curative effect is remarkable and the side effects are less,but the onset time varies greatly among individuals.The long-term application of intense pulsed light in the treatment of chloasma in the Department of Dermatology of our hospital has a quick effect,but it is easy to relapse.Methods:60 patients with chloasma in Shenzhen Hospital of Beijing University of Traditional Chinese Medicine(Longgang)were included in the clinical control study.The experimental group was treated with Meibai Yurong Decoction combined with intense pulsed laser,and the control group was treated with intense pulsed laser alone.The clinical efficacy was compared and statistically analyzed.The effective rate of MASI treatment,VISIA score and improvement rate of TCM symptom score were counted.Results:1.Among the enrolled patients,the minimus was 32 years old,the eldest was 55,and the average age was 42.85 ± 4.92.Among them,the age group 36 to 45 is the largest,which is basically consistent with other epidemiological studies.2.At the end of treatment,according to the MASI score decline index,the cure rate was counted,22 people in the experimental group improved and 8 people were ineffective;in the control group,14 were improved and 16 were ineffective.The total effective rate of the experimental group was 73.3%and 46.7%in the control group.The difference was statistically significant.3.The overall mean of color spots and brown pigment under VISIA in the two groups gradually increased,and the difference was statistically significant,indicating that with the progress of treatment,the color spot index and brown pigment index were gradually improved.The control group was better than the experimental group in improving the spot index,and the experimental group was better than the control group in improving the brown pigment index.4.At the end of the treatment,the cure rate was counted according to the TCM symptom score decline index,15 people in the experimental group improved and 15 people were ineffective;the control group improved 4 people,invalid 26 people.The total effective rate was 50%in the experimental group and 13.3%in the control group.The difference was statistically significant.5.There were 4 cases of adverse reactions in the experimental group,including 1 case of erythema,2 cases of pigment deepening,and 1 case of excessive sensitivity to intense pulsed light;there were 10 cases of adverse reactions in the control group,including 3 cases of erythema,5 cases of pigment deepening,and 2 cases of excessive sensitivity to intense pulsed light.The adverse reaction rate was 13.3%in the experimental group and 33.3%in the control group.The incidence of pigment deepening was 6.7%in the experimental group and 16.7%in the control group.The experimental group was better than the control group,and the difference was statistically significant.Conclusion:The improvement rate of MASI and TCM symptom score in the experimental group were better than those in the control group,and the incidence of adverse reactions was significantly lower than that in the control group.The treatment of intense pulsed light combined with Meibai Yurong Decoction has good clinical efficacy,less adverse reactions and more stable treatment effect.It is a combined treatment plan that can be clinically promoted. |
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