Clinical Study On The Relationship Between TCM Syndrome Differentiation Of Chloasma And Physiological Characteristics Of Skin Lesions

Objective:Firstly,to investigate the distribution of TCM constitution in patients with melasma;Secondly,to analyze the relationship between the facial lesions of patients with melasma and the constitutional elements of TCM,so as to provide reference clinical data for the physical identification and treatment of melasma.Methods:This research randomized 246 patients with melasma at Dongfang Hospital of Beijing University of Chinese Medicine from January 2016 to December 2017 in a random manner.The questionnaires were used to collect the basic information of patients and the facial photos were taken to record the skin lesions of patients.Western diagnostic criteria of melasma:Reference to the melasma diagnosis and treatment standards(2010 version)formulatedby PigmentologyGroup of National Institute of Integrative Medicine Dermatology Professional Committee.Classification of TCM constitutional:Reference to thestandardof'Constitution of TCM classification and judgment"formulatedby Chinese medicine society constitution branch which in charged of the State Administration of Traditional Chinese Medicine.Combined with clinical diagnosis,melasma patients will be divided into 9 types of TCM constitution,include Yang constitution,yin deficiency constitution,qi deficiency constitution,phlegm constitution,damp-heat constitution,blood stasis constitution,intrinsic constitution,qi depression constitution,peaceful physique.Other evaluation indicators such as MASI score(Melasma Area and Severity Index),position of melasma,disease factors of melasma etc.Results:There are no significant differences in the different physical types forthe distributed of Skin lesions,skin types,season of onset,aggravating season,and family history.Between different TCM constitution types of melasma patients,the total MASI score segmentation is significantly different.Yang deficiency accounts for the largest proportionin 0-10 points,Qi Yu constitution accounts for the largest proportion in 10-20 points,Blood stasis constitutionaccounts for the largest proportion in 20-30 and 30-40 points.The overall distribution of patients with MASI score trends from descending order:Blood stasis constitution,hot and humid physique,qi depression constitution,intrinsic constitution,yin deficiency constitution,yang constitution,phlegm constitution,qi constitution,peace constitution.There are no significant difference in MASI scores of forehead and chin among different types of physique,while there are significant differences in left zygomatic and right zygomatic scores.The MASI scores of different types of physical constitution have some correlation with MASI scores of different parts.MASI scores of patients with yang deficiency constitution,yin deficiency constitution,phlegm-dampness constitution and calm constitution are the most correlated with MASI scores of right zygomatic.The MASI score of blood stasis constitution,Qi stagnation constitution,damp-heat constitution and Qi deficiency constitution have the highest correlation with MASI score of left zygomatic department.There is no evidence for total MASI score associated with MASI scores in maxillary and chin among patients with melasma.Conclusion:There is a certain statistical correlation between the TCM constitution of melasma patients and skin lesions site as well as the severity score.A large sample studies and more advanced technology are neededto test and verify the effect of different types of constitution on the physiological characteristics of melasma.