吕霞 陶燕飞

[摘 要]目的 探究逍遙丸和氢醌乳膏联合艾灸对黄褐斑皮损和激素水平的影响。方法 选取上海市罗店医院2022年6月-10月收治的74例女性黄褐斑患者为研究对象，采用随机数字表法分为参照组和试验组，每组37例。参照组采用维A酸乳膏治疗，试验组采用逍遥丸、氢醌乳膏联合艾灸治疗，比较两组皮损积分、中医证候评分、激素水平、临床疗效及不良反应发生情况。结果 试验组治疗后皮损积分及中医证候评分均低于参照组，差异有统计学意义（P<0.05）；试验组治疗后FSH、E2及LH水平均低于参照组，差异有统计学意义（P<0.05）；试验组治疗总有效率为97.30%，高于参照组的81.08%，差异有统计学意义（P<0.05）；试验组不良反应发生率为5.40%，低于参照组的24.32%，差异有统计学意义（P<0.05）。结论 黄褐斑患者经逍遥丸、氢醌乳膏与艾灸联合治疗能有效调节性激素水平，减轻皮损，可改善其临床症状，且具有一定的治疗安全性，值得临床应用。

[关键词] 逍遥丸；氢醌乳膏；艾灸；黄褐斑

[中图分类号] R758.4+2 [文献标识码] A [文章编号] 1004-4949（2024）05-0021-04

Effects of Xiaoyao Pill and Hydroquinone Cream Combined with Moxibustion on Skin Lesions and Hormone Levels of Chloasma

LYU Xia1， TAO Yan-fei2

（Department of Dermatology1， Department of Traditional Chinese Medicine2， Luodian Hospital， Shanghai 201908， China）

[Abstract]Objective To investigate the effects of Xiaoyao pill and Hydroquinone cream combined with moxibustion on the skin lesions and hormone levels of chloasma. Methods A total of 74 female chloasma patients admitted to Shanghai Luodian Hospital from June to October 2022 were selected as the research objects. They were divided into reference group and experimental group by random number table method， with 37 patients in each group. The reference group was treated with tretinoin cream， and the experimental group was treated with Xiaoyao pill， hydroquinone cream combined with moxibustion. The skin lesion score， TCM syndrome score， hormone level， clinical efficacy and adverse reactions were compared between the two groups. Results After treatment， the scores of skin lesions and TCM syndromes in the experimental group were lower than those in the reference group， the differences were statistically significant （P<0.05）. After treatment， the levels of FSH， E2 and LH in the experimental group were lower than those in the reference group， the differences were statistically significant （P<0.05）. The total effective rate of treatment in the experimental group was 97.30%， which was higher than 81.08% in the reference group， and the difference was statistically significant （P<0.05）. The incidence of adverse reactions in the experimental group was 5.40%， which was lower than 24.32% in the reference group， and the difference was statistically significant （P<0.05）. Conclusion The combined treatment of Xiaoyao pill， hydroquinone cream and moxibustion can effectively regulate the level of sex hormones for patients with chloasma， reduce their skin lesions， improve clinical symptoms， and has certain therapeutic safety， which is worthy of clinical application.

[Key words] Xiaoyao pill； Hydroquinone cream； Moxibustion； Chloasma

黄褐斑（chloasma）是临床皮肤科常见的疾病类型，以面部出现对称性淡褐色或深褐色斑片为主要临床特征，病灶通常集中在脸颊及颧部，形状、颜色及大小均不规则[1]。黄褐斑发病机制十分复杂，与遗传基因、性激素分泌、紫外线照射、药物作用及化妆品等因素均有一定关联，多见于妊娠期及绝经期女性，严重影响患者面部美观及身心健康[2]。维A酸乳膏是临床常用于治疗皮肤老化及痤疮的药物，但其预防效果更佳，对于已经生成的黄褐斑不能从根本上消除病灶，停药后极易复发[3，4]。中医认为[5，6]，黄褐斑是由气血瘀滞及肝郁脾虚引发的内分泌失调。逍遥丸具有理气养血、疏肝解郁的功效，适用于治疗黄褐斑；为提升治疗效果可联合艾灸及氢醌乳膏发挥内调外治的作用，氢醌乳膏与逍遥丸联合应用能发挥中西药协同作用，可相互促进以发挥更好的效果，而艾灸能促进局部血液循环，有助于增强药效。……