目的 探讨化浊解毒熏蒸法对气滞血瘀型黄褐斑的治疗效果及其对血清雌二醇(E2)水平的影响.方法 选取2008年6月-2012年6月我院康复科收治的黄褐斑患者104例,中医辨证均属气滞血瘀型.按随机数字表法将患者随机分为对照组和治疗组,各52例.治疗组:采用自拟化浊解毒方,浓煎取汁500 ml,放到中药汽疗仪的蒸锅中加热,产生雾气后,嘱患者穿短袖衣裤进入汽疗舱,温度设定在38 ℃,每次熏蒸30 min,1次/d,10 d为1个疗程,连续2个疗程,每个疗程间隔5 d.对照组:将蒸馏水加入到汽疗仪的蒸锅中加热,熏蒸方法、疗程同治疗组.同时两组患者口服排毒养颜胶囊,0.8 g/次,2次/d,30 d为1个疗程.治疗后,对两组的临床疗效及治疗前后空腹静脉血E2水平进行比较.等级资料比较采用秩和检验,计量资料比较采用t检验.结果 治疗后,对照组基本治愈5例,显效9例,好转13例,无效25例;治疗组基本治愈27例,显效13例,好转8例,无效4例,两组疗效比较差异有统计学意义(u=993.5,P=0.017).治疗前对照组、治疗组患者血清E2水平分别为(91.3±2.1)ng/L和(92.6±2.2)ng/L,组间比较差异无统计学意义(P＞0.05);而治疗后治疗组患者血清E2水平(62.1±1.7)ng/L低于对照组的(71.2±2.0)ng/L,组间比较差异有统计学意义(P＜0.05).结论 化浊解毒熏蒸法治疗能明显降低气滞血瘀型黄褐斑患者血清E2水平,有较好的临床疗效,适合临床推广.%Objective To explore the therapeutic effect of Huazhuo Jiedu fumigation for qi stagnation and blood stasis type chloasma and its influence on the levels of serum estradiol ( E2 ) . Methods A total of 104 patients with qi stagnation and blood stasis type chloasma TCM in the rehabilitation of our hospital from June 2008 to June 2012 were analyzed. According to the random number table, these patients were randomly and evenly divided into control group and treatment group. The treatment group: treated by 500 ml concentrated Huazhuo Jiedu decoction heated in Chinese medicine steam treatment apparatus of the steamer, patients were asked to go into the steam treatment tank wearing short - sleeved clothes when steam came out. The temperature was set at 38 XI , each fumigation 30 min, one time a day, 10 days for 1 courses, 2 consecutive cycles with an interval of 5 days. Control group: the distilled water was added to the heated vapor therapy instrument in the steamer. Fumigation methods and treatment courses were the same as the treatment group. At the same time, both groups of patients ate Paiduyangyan capsule 0. 8 g/time, bis in die, 30 d for 1 courses. The efficacy of the two groups after treatment were evaluated. Fasting blood serum E2 level of the two groups before and after treatment were compared. Grade data were compared with the Wilcoxon rank sum test, measurement data using t test. Results In control group after treatment, 5 cases were cured, 9 cases obtained obvious effect, 13 cases were improved and 25 cases had no response, as for treatment group, the dates were 27, 13, 8 and 4 respectively, there was statistically significant difference in the therapeutic effect between the two groups ( u = 993. 5, P = 0. 017 ) . Before treatment, serum E2 levels of the patients in the treatment group and control group were (91.3 ±2. 1) ng/L and ( 92. 6 ±2. 2 ) ng/L, there was no statistically significant difference between groups ( P > 0. 05 ); While after the treatment, the serum E2 level ( 62. 1 ± 1. 7 ) ng/L in the treatment group was lower than that of the control group (71.2±2. 0) ng/L, there was statistically significant difference between groups ( P < 0. 05 ) . Conclusion Huazhuo detoxification fumigation treatment of qi stagnation and blood stasis type of chloasma can significantly decrease the E2 level in serum of patients. It has good clinical curative effect, and it is suitable for clinical application.
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