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Objective To investigate the therapeutic effect of licorice zinc on melasma.Methods Thirty-six BALB/c mice were equally divided into blank group,model group,licorzinc low-dose group,licorzine medium-dose group,licorzinc high-dose group and tranexamic acid group.Melasma was induced by 100 mJ/cm2 UVB irradiation combined with 15 mg/kg progesterone injection.Mice were treated with tranexamic acid(0.065 g/kg)and low(0.65 g/kg),medium(1.3 g/kg),or high(2.6 g/kg)doses of zinc licorice for 14 days.Skin was taken for HE and Masson-Fontana staining and measurement of SOD,MDA,GSP-Px,TNF-α,IL-1β,IL-6,plasma protein Nrf-2,nuclear protein Nrf-2 and HO-1 expression levels.Results Compared with model group,high-dose licorice zinc group showed decreased melanocyte formation,collagen cell necrosis,and inflammatory infiltration(P＜0.01);decreased MDA,IL-6,IL-1β,TNF-α and plasma protein Nrf-2 expression(P＜0.01);and increased GSP-Px,SOD and nuclear protein Nrf-2 and HO-1 expression(P＜0.01).Conclusions Zinc licorice activates the Nrf-2/HO-1 pathway to initiate high expression of HO-1,SOD and GSP-Px and fight oxidative stress,thereby reducing melanogenesis.
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Objective:To explore the efficacy of external treatment of integrated traditional Chinese and Western medicine on melanized type complicated with vascularized type of chloasma.Methods:A total of 82 patients (aged 26-50 years, with an average age of 44.5 years) with melanized type complicated with vascularized type of chloasma were selected, and randomly divided into groups: 28 cases in the traditional Chinese medicine control group were treated with traditional Chinese medicine pourmask combined with surrounded facial acupuncture; 26 cases in Western medicine control group underwent wet compress with 0.5% tranexamic acid solution. In the integrated Chinese traditional and Western medicine treatment group, 28 cases were treated with 2 regimens. After 8 weeks, MASI score was carried out, and vascular hyperplasia in skin lesions was observed by polari-light skin scope.Results:After treatment, the MASI scores in the three groups were all decreased, and the decreasing rate of MASI scores from high to low was as follows: Integrated Chinese traditional and Western medicine treatment group (8.60±4.53) > TCM control group (6.26±3.20) > Western medicine control group (4.39±2.11). After treatment, the vascular hyperplasia scores in the three groups were all decreased, and the value of vascular hyperplasia in the integrated Chinese traditional and Western medicine treatment group (2.57±0.63) and Western medicine control group (1.55±0.51) was greater than that in TCM control group (0.96±0.51), but there was no significant difference between the integrated Chinese traditional and Western medicine treatment group and Western medicine control group.Conclusions:External treatment of integrated traditional Chinese and Western medicine is effective in the treatment of melanized type complicated with vascularized type of chloasma, and wet compress with tranexamic acid solution can inhibit vascular hyperplasia in patients with chloasma.
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Objective:To observe the clinical effect of tranexamic acid radiofrequency introduction combined with Q-switched laser comprehensive treatment of moderate to severe melasma.Methods:From December 2019 to September 2021, ninety-six female patients with melasma [age 24-59 years old, average age (37.8±6.0) years old] were admitted to the Plastic and Aesthetic Department of the First Affiliated Hospital of Henan University of Chinese Medicine. They were divided into the Q-switched laser group and the combined group by random number table method, with 48 cases respectively. The Q-switched laser group received Q-switched laser therapy, while the combined group received tranexamic acid radiofrequency introduction combined with Q-switched laser comprehensive therapy. The melasma area and severity index (MASI) scores were compared between the two groups before and after treatment. The clinical efficacy, adverse reactions and recurrence rates of the two groups were compared.Results:The MASI scores of the Q-switched laser group and the combined treatment group were (28.28±1.24) points and (28.52±4.25) points respectively before treatment, and (13.38±7.96) points and (9.11±5.48) points respectively after treatment. The MASI scores of the two groups were decreased after treatment, which of the combined group was lower than that of the Q-switched laser group ( t=3.06, P<0.05). The total clinical effective rate of the combination group (93.75%) was higher than that of the Q-switched laser group (79.17%) (χ 2=4.36, P<0.05). The incidence rate of hyperpigmentation (2.08%) and recurrence rate (2.08%) of the combination group were lower than those of the Q-switched laser group (14.58%, 16.67%) (χ 2=6.01, P<0.05). Conclusions:Tranexamic acid radiofrequency introduction combined with Q-switched laser comprehensive treatment can improve skin lesions and clinical efficacy in patients with moderate to severe melasma, and reduce pigmentation and recurrence.
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Objective:To observe the efficacy and safety of ultra photon intense pulsed light combined with hydroquinone cream for the treatment of chloasma.Methods:From January 2020 to October 2022, a total of 30 patients with chloasma treated in the Department of Dermatology, Huazhong University of Science and Technology Union Shenzhen Hospital, ranged from 28 to 54 years old with an average age of 39 years, were randomly divided into three groups with 10 patients in each group: combined treatment group was treated with ultra photon intense pulsed light combined with hydroquinone cream; ultra photon intense pulsed light group was treated with ultra photon intense pulsed light alone; hydroquinone group was treated with hydroquinone cream alone. The efficacy and safety of the three groups were compared after four months of treatment.Results:After the treatment, 10 cases were effective in the combined treatment group, 5 cases were effective in the ultra photon intense pulsed light group and 2 cases were effective in the hydroquinone group. The total effective rate of the combined treatment group was significantly better than that of the ultra photon intense pulsed light group and the hydroquinone group, with statistical significance ( P<0.05). The average melasma area severity index score of the three groups after treatment was significantly decreased compared with that before treatment respectively ( P<0.05), and the average melasma area severity index score of the combined treatment group after treatment was significantly lower than that of hydroquinone group, with statistical significance ( P<0.05). No serious adverse reactions were observed in all the patients. Conclusions:Ultra photon intense pulsed light and hydroquinone cream can improve chloasma alone, but ultra photon intense pulsed light combined with hydroquinone cream has better therapeutic effect.
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Objective:To investigate the clinical efficacy of Huoxue Quban Decoction combined with Xiyu chloasma patch in the treatment of chloasma.Methods:Randomized controlled trial. A total of 126 chloasma patients were selected and divided into two groups according to the random number table method, 63 in each group. The control group were treated with Xiyu chloasma patch, and the observation group received Huoxue Quban Decoction combined with Xiyu chloasma patch. Both groups were treated continuously for 12 weeks. TCM syndrome scores were performed before and after treatment, and the severity of skin lesions was evaluated by the Melasma Area and Severity Index (MASI). Quality of life was evaluated by the Melasma Quality of Life (MELASQOL) scale. Serum SOD levels were measured by enzyme rate method, MDA levels were measured by micro method, and GSH-Px levels were measured by colorimetric method. Adverse reactions during treatment were recorded and clinical efficacy was evaluatedResults:The total effective rate of the observation group was 90.48% (57/63), while the control group was 71.43% (45/63). The difference between the two groups was statistically significant ( χ2=7.41, P=0.006). After treatment, the scores of traditional Chinese medicine syndrome scores ( Z=8.13), MASI ( Z=8.92), and MELASQOL ( t=11.52) in the observation group were significantly lower than those in the control group ( P<0.01). After treatment, the serum SOD [(203.07±25.24) g/L vs. (176.24±33.98) g/L, t=5.03] and GSH-Px [(8.28±1.27) U/L vs. (7.33±1.28) U/L, t=4.18] levels in the observation group were significantly higher than those in the control group ( P<0.01); MDA[(3.36±1.17) μmol/L vs. (5.20 ± 1.23) μmol/L, t=8.62] was significantly lower than that of the control group ( P<0.01). No significant adverse reactions occurred during the treatment period in both groups. Conclusion:The Huoxue Quban Decoction combined with Xiyu chloasma patch can improve the color, area and quality of life of chloasma lesions and reduce oxidative stress with high safety.
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Objective:To evaluate the efficacy of long-pulsed 1 064-nm Nd:YAG laser combined with a topical emulsion containing Camellia reticulata and Radix Notoginseng in the treatment of melasma. Methods:A total of 80 patients with melasma were enrolled from Department of Dermatology, People′s Hospital of Ningxia Hui Autonomous Region from June 2019 to June 2020, and randomly and equally divided into control group and observation group by using a random number table: 40 patients in the control group were treated with long-pulsed 1 064-nm Nd:YAG laser once every 2 weeks for 6 sessions as a course of treatment; another 40 in the observation group were treated with the same laser therapy as the control group and a topical emulsion containing Camellia reticulata and Radix Notoginseng twice a day for 3 months as a course of treatment. Melasma area and severity index (MASI), clinical efficacy, patient satisfaction rate and safety were compared between the 2 groups before and/or after treatment. Results:After 4- and 8-week treatment, there was no significant difference in the MASI score between the observation group (14.57 ± 3.22 points, 10.00 ± 2.94 points, respectively) and control group (14.74 ± 3.11 points, 11.31 ± 3.00 points, respectively; both P>0.05). After 12-week treatment, the MASI score was significantly lower in the observation group (4.80 ± 2.78 points) than in the control group (7.07 ± 3.22 points, t = -3.38, P<0.01). After 3-month treatment, the response rate was significantly higher in the observation group (36 cases, 90%) than in the control group (31 cases, 77.5%; χ2 = 4.58, P < 0.001) ; however, there was no significant difference in the patient satisfaction rate between the observation group (87.5%) and control group (72.5%, χ2 = 7.26, P = 0.06). In addition, no significant difference in the occurrence of adverse reactions was observed between the observation group (5 cases, 12.5%) and control group (7 cases, 17.5%; P > 0.05) . Conclusion:Compared with the long-pulsed 1 064-nm Nd:YAG laser alone, the topical emulsion containing Camellia reticulata and Radix Notoginseng in combination with the long-pulsed 1 064-nm Nd:YAG laser is more effective for the treatment of melasma, with higher patient satisfaction and less adverse reactions.
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The etiology of melasma is complicated. Although there are many treatment methods for melasma at present, no definite or satisfactory efficacy has been achieved. In recent years, good therapeutic outcomes have been achieved in the treatment of melasma with intense pulsed light. This review summarizes the progress in the treatment of melasma with intense pulsed light alone or in combination with various lasers, external drugs and systemic drugs in recent years.
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With the improvement of living standard and enhancement of health consciousness, Salviae Miltiorrhizae Radix et Rhizoma, as a common medicinal material that can be widely used in health food, is focused an increasing number of scholars′ attention at home and abroad. Based on Salviae Miltiorrhizae Radix et Rhizoma health food published by the food website of National Medical Products Administration (NMPA), this paper combs and analyzes their dosage forms, functional components, health-care functions and prescriptions of traditional Chinese medicine (TCM). Meanwhile, the Apriori algorithm module in SPSS Modeler 15.0 is used to explore the formulation rules of Salviae Miltiorrhizae Radix et Rhizoma health food. The results showed that capsules was the most common (about 55.34%), and the infusions and beverages were rare. In the aspect of health-care function, it is mainly used to auxiliary hypolipidemic, auxiliary protective function to chemical liver injury, enhance immunity and dispel chloasma. Among 92 cases of the health food with auxiliary hypolipidemic, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Gynostemmatis Pentaphylli Herba-Puerariae Lobatae Radix. Among 55 cases of the health food with auxiliary protective function to chemical liver injury, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Puerariae Lobatae Radix-Schisandrae Chinensis Fructus. Among 54 cases of the health food with immune-enhancing, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Astragali Radix-Lycii Fructus. Among 46 cases of the health food with dispelling chloasma, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Angelicae Sinensis Radix-grape seeds. The selection of prescription compatibility of Salviae Miltiorrhizae Radix et Rhizoma health food with different health-care functions is basically consistent with the TCM treatment with syndrome differentiation theory and modern medical theory. This article interprets the application of Salviae Miltiorrhizae Radix et Rhizoma health food from the perspective of dosage forms, functional components, health-care functions and compatibility of prescriptions, which can provide a basis and reference for precise and efficient research and development of this kind of health food.
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The pathogenesis of chloasma is complex and diverse. Traditional Chinese medicine （TCM） believes that it is mostly related to liver, spleen and kidney, with hematogenous impassability as the standard and pigmentation on the face or body surface as the main symptom. Western medicine believes that it is closely related to family inheritance, ethnic differences and ultraviolet radiation. At present, there are various clinical therapies, mainly including prevention of ultraviolet radiation, local whitening agent and chemical skin. In addition, TCM plays an important role in the treatment of chloasma, often involving internal use, topical use, acupuncture and moxibustion. Modern studies have shown that TCM therapies mainly regulate the metabolism of antioxidant, endocrine and melanin in vivo. Although the mechanism of action could not explained to some extent, there are still some restriction in the discussions on the mechanism of external use of TCM in controlling chloasma. As the skin nerve-endocrine-immune (NEI) network is proposed and further studied, the role of NEI network in realizing overall functional regulation with cytokines, hormones and neurotransmitters as information molecules has been widely verified and recognized. This paper symmetrically reviewed the pathogenesis of chloasma and the progress of the regulatory effect of TCM, and proposed the possible local efficacy of TCM for external use in treating chloasma by regulating surface NEI network. This is worth further study and exploration in the expectation of providing new ideas for the treatment of chloasma and the studies on the mechanisms of action of TCM for external use.
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OBJECTIVE@#To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver stagnation.@*METHODS@#A total of 92 patients of chloasma in premenopausal women with liver stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu (BL 18), Pishu (BL 20), Sanyinjiao (SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C (200 mg per time, 3 times a day) and vitamin E (100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index (MASI), the serum levels of follicular stimulating hormone (FSH), leuteinizing hormone (LH) and estradiol (E) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment.@*RESULTS@#Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6% (39/44), which was higher than 55.8% (24/43) in the control group (0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E in the control group (>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group (0.05).@*CONCLUSION@#Acupoint catgut embedding can improve the clinical symptoms of chloasma in premenopausal women with liver stagnation, the mechanism may be related to regulate the serum level of sex hormone to reduce high sensitivity of melanocytes to estrogen.
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Female , Humans , Acupuncture Points , Acupuncture Therapy , Catgut , Liver , Melanosis , Therapeutics , QiABSTRACT
Objective To explore the effect of intradermal injection of glutathione and tranexamic acid in the treatment of chloasma.Methods From July 2016 to May 2018,96 patients with chloasma admitted to the dermatology department of the Central Hospital of Shengli Oil Field were selected and randomly divided into control group and observation group,with 48 cases in each group.The macular color and area,curative effect(basic cure,obvious effect,improvement,ineffective),adverse reactions (acupuncture reaction,recurrence after treatment,gastrointestinal tract reaction,oral ulcer and menstrual quantity reduction) were observed.Results After treatment,both two groups showed significant improvement in chloasma color score and chloasma area (t =9.258,10.774,all P ＜ 0.05;t =11.673,12.66,all P ＜ 0.05).After treatment,the color score and area of chloasma in the observation group were (1.13 ± 0.91) points,(1.62 ± 1.26) cm2,respectively,which were significantly lower than those in the control group[(0.78 ± 0.62) points,(0.80 ± 0.83) cm2,t =2.132,3.641,all P ＜ 0.05].The total effective rate of the observation group was 91.67％,which was significantly higher than 62.50％ of the control group(x2 =11.558,P ＜ 0.05).Both two groups experienced needle sickness during treatment.After treatment,the gastrointestinal tract reaction,oral ulcer and the influence of menstruation occurred in the observation group.However,differences in adverse reaction between the two groups were not significant (all P ＞ 0.05).Conclusion The combination of tranexamic acid and glutathione has significant effect on reducing the color of patients' chloasma and reducing the area of patients' chloasma.In terms of treatment effect,the combined injection group is significantly superior to the conventional treatment group,and the combined injection group has a certain safety.
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Chemical peeling is one of the three most common skin resurfacing techniques.Alphahydroxy acid,salicylic acid,trichloroacetic acid and Jessner's solution are common chemical peeling agents,and their action depths range from the stratum corneum to the reticular layer of the dermis.Chemical peeling has been widely applied to aesthetic dermatology,and this review mainly summarizes common chemical peeling agents and application of chemical peeling in discosmetic dermatoses,such as acne and melasma,and facial rejuvenation.
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BACKGROUND@#Melasma is an acquired hyperpigmentary disorder occurring in the sun-exposed areas of the face and neck. There is little information on its prevalence, epidemiology and clinical characteristics in the Philippines.@*OBJECTIVE@#To determine the prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients@*METHODS@#This was a multicenter, cross-sectional study conducted from July to December 2013. The investigators determined the prevalence of melasma in 12,068 dermatology patients from 6 government hospitals and private centers in Metro Manila, Philippines. The melasma patients, aged 18 years and above were examined and given self-administered questionnaires to determine the epidemiological and clinical characteristics of their melasma.@*RESULTS@#Of the 12,068 dermatology patients who were seen at the selected hospitals and private centers, 153 (1.26%) were clinically diagnosed with melasma. Majority of the melasma patients were Filipinos (73.20%), aged 41-50 years old (37.91%), with an average age of 42.40 + 9.68 years, and Fitzpatrick skin types III and IV (29.41% and 57.52%, respectively). Melasma was more prevalent in females (81.70%), wherein majority had a prior history of pregnancy (76.8% of the females). Oral contraceptive use was also reported in 37.6% of the female patients and 63.83% of those who have used OCP, have used it for only 1 year or less. Majority had no thyroid disease (75.16%) and daily sun exposure was limited to 1 hr or less for most patients (43.14%). Their melasma was mostly malar in distribution (60.13%), epidermal (61.44%), and mild (51.63%) to moderate (27.45%) in severity. The average mMASI score was 4.63 + 3.32.@*CONCLUSION@#Prevalence of melasma was low among the Philippine dermatology patients sampled. Majority of the melasma patients were Filipinos, aged 41-50 years old, with Fitzpatrick skin type IV, limited sun exposure and no thyroid disease. They were mostly females, with a prior history of pregnancy. Their melasma was mostly malar, epidermal, and mild in severity. These descriptive data can serve as baseline information for further studies on melasma in the Philippines.
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PhilippinesABSTRACT
Objective@#To evaluate the clinical efficacy of Q-switched Nd:YAG laser in the treatment of melasma, and to explore factors influencing the efficacy.@*Methods@#Forty-four female patients with melasma were enrolled into this study, who received treatment with Q-switched Nd:YAG laser once every 2-3 weeks for a total of 10 sessions in Department of Dermatology, Hangzhou Third Hospital between August 2017 and October 2017. Skin lesions were classified into epidermal type and mixed type by reflectance confocal microscopy, and a VISIA skin imaging detector was used to evaluate if subclinical melasma existed in patients. According to the modified melasma area and severity index (mMASI) , the severity of skin lesions before and after the treatment, as well as the efficacy, was evaluated by dermatologists. Statistical analysis was carried out by using paired t test, chi-square test and multivariate unconditional Logistic regression.@*Results@#Of the 44 patients, 5 were cured, 15 received marked improvement, 12 received improvement, 12 showed no response, and the total response rate was 45.4%. The mMASI score significantly decreased after the treatment (3.2 ± 2.1) compared with that before the treatment (6.7 ± 2.9, t = 8.955, P < 0.001) . The mMASI score changed along with the treatment sessions. Specifically speaking, the mMASI score started to be significantly lower after the 3rd treatment than after the previous treatment (t = 3.780, P < 0.01) , and gradually decreased along with the increase in treatment sessions till the 8th treatment session, and no significant difference was observed between the 8th and 7th treatment sessions (t = 1.735, P > 0.01) . The response rate was significantly higher in the patients with stable melasma than in those with progressive melasma (χ2 = 16.454, P < 0.05) , in patients without dendritic melanocytes in skin lesions than in those with dendritic melanocytes in skin lesions (χ2 = 9.582, P < 0.05) , and in patients without subclinical melasma than in those with subclinical melasma (χ2 = 6.188, P < 0.05) , while there was no significant difference in the response rate between the patients with epidermal-type melasma and those with mixed-type melasma (χ2 = 2.463, P = 0.120) . Logistic regression analysis showed that clinical stages (OR [95% CI] = 0.180 [0.046 - 0.746], P = 0.018) , dendritic melanocytes (OR [95% CI] = 0.231 [0.059 - 0.769], P = 0.018) and subclinical melasma (OR [95% CI] = 0.158 [0.063 - 0.854], P = 0.011) were associated with the efficacy.@*Conclusion@#Q-switched Nd:YAG laser is effective and safe for the treatment of melasma, especially for patients with stable melasma, without dendritic melanocytes in skin lesions, and those without subclinical melasma.
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Objective To investigate morphological characteristics of female melasma lesions at different clinical stages by using three skin imaging techniques.Methods A total of 253 female outpatients with melasma were enrolled from the Third Affiliated Hospital of Zhejiang Chinese Medicine University between June 2017 and January 2018.According to the clinical staging criteria,melasma lesions at different clinical stages were observed with reflectance confocal microscopy (RCM),VISIA skin imaging detector and dermoscopy,and correlations of clinical staging with dendritic melanocytes,subclinical melasma and morphological changes of blood vessels were analyzed.Statistical analysis was carried out with SPSS19.0 software by using chi-square test and Mann-Whitney U test for the comparison of enumeration data.Results Of 253 patients with melasma,100 were with progressive melasma,and 153 with stablemelasma.RCM showed that dendritic melanocytes were observed in 78 (78％) patients with progressive melasma,as well as in 22 (14.4％)patients with stable melasma,and there was a significant difference between the 2 groups (x2 =102.40,P ＜ 0.01).VISIA skin imaging detector showed that subclinical melasma was observed in 78 (78％) patients with progressive melasma,as well as in 25 (16.3％) patients with stable melasma,and the prevalance of subclinical melasma was significantly higher in the patients with progressive melasma than in those with stable melasma (x2 =95.26,P ＜ 0.01).Dermoscopy showed that the frequency of morphological changes in blood vessels did not differ between the patients with progressive melasma (74％,74/100) and those with stable melasma (68.6％,105/153;x2 =0.84,P =0.39).Conclusion The dendritic melanocytes and subclinical manifestations under RCM and VISIA skin imaging detector can serve as reference indices for clinical staging of melasma.
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Objective Lab color mode can be used to digitize the color.This study explores the possibility of using Lab model to measure facial pigmentations.Methods Lab color model was used to measure the normal skin and three common clinical pigmentations (Ota nevus,freckles and melasma).We also analyzed the characteristics and assessed the data changes after the treatment.Results Average L,a and b values were 54.4,13.8 and 19.0 in normal skin,34.6,5.17 and 6.9 in Ota nevus,43.25,16.15 and 23.05 in freckles and 40.5,16.8 and 23.35 in melasma,respectively.The Lab values of freckles and melasma were close.The order of L value was:normal skin ＞ freckle ＞ melasma ＞Ota nevus;the order of value of a and b was:melasma ＞ freckle ＞ normal skin ＞ Ota nevus.After treatment,the Lab values gradually tended to be the values of normal skin.Conclusions The Lab color mode can be used as a digital description method for skin color and facial pigmentation,which provides an objective measure for clinical research.
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Objective To comparatively analyze the SD rat chloasma model established by using the two methods of progesterone injection and ultraviolet radiation.Methods The rat chloasma model was established by adopting the high and low doses of progesterone injection and ultraviolet irradiation.The plaque area was observed and the skin section was observed by light microscope.The SOD and MDA levels closely related with chloasma melanin deposition were detected.Results The significant pigment deposition on the back skin in the high dose progesterone group was seen by naked eye and the scattered pigment deposition was seen in the low dose progesterone group;significant pigment deposition could be found in the ultraviolet group.Compared with the control group,the MDA level of various tissues in the high dose progesterone group was increased,while the SOD level was decreased,serum and skin SOD level in the low dose progesterone group was decreased,the difference was statistically significant(P＜0.05).Serum and skin SOD level in the high dose ultraviolet group was decreased,while the MDA level was increased,the skin SOD level in the low dose ultraviolet group was decreased(P＜0.05),but the difference between the two groups was not statistically significant (P＞0.05).The melanin grains were heaped up as the small black body under light microscope,which in the progesterone group showed the clutter distribution,the difference between the high dose group and low dose group was significant;which in the ultraviolet group showed the linear dense arrangement and the intergroup had no significant difference.Conclusion Progesterone injection and ultraviolet irradiation all can successfully establish the SD rat chloasma model,and the constructing model effect and stability of ultraviolet irradiation are better.
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Objective To investigate the clinical efficacy of Dong's extra-point pricking bloodletting therapy for female chloasma of liver depression and qi stagnation type. Methods One hundred and twenty female patients with chloasma of liver depression and qi stagnation type were randomized to treatment and control groups, 60 cases each. The control group received Dong's extra-point pricking bloodletting therapy and the treatment group, conventional acupuncture. The symptom and sign score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 95.5％ in the treatment group and 81.7％ in the control group; there was a statistically significant difference between the two groups (P<0.05). The pre-/post-treatment symptom and sign score difference value was (0.98±0.23) in the treatment group and (0.81±0.18) in the control group; there was a statistically significant difference between the two groups (P<0.05). Conclusion Dong's extra-point pricking bloodletting therapy is an effective way to treat female chloasma of liver depression and qi stagnation type.
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OBJECTIVE: To systematically evaluate therapeutic efficacy and safety of Compound muni ziqi granules in the adjuvant treatment of chloasma, and to provide evidence-based reference for clinical treatment. METHODS; Retrieved from Chinese Journal Full-text Database (CJFD), China Scientific Journal Database (CSJD), Wanfang database, Medline and Embase, randomized controlled trials (RCTs) about therapeutic efficacy (total response rate, cure rate, the decrease level of E2, FSH and LH in serum) and safety of Compound muni ziqi granules alone or combined with routine drug (trial group) vs. routine drug (control group) in the treatment of chloasma were collected. Meta-analysis was conducted by using Rev Man 5. 3 statistical software after data extraction of clinical studies meeting inclusion criteria and quality evaluation with Cochrane systematic evaluator manual 5. 1. 0. RESULTS: Totally 12 RCTs were enrolled, involving 1 100 patients. Results of Meta-analysis showed that total response rate [OR=2. 84, 95％CI(2. 20, 3. 67), P<0. 001], cure rate [OR=2. 11, 95％CI(1. 59, 2. 79),P<0. 001],decrease level of Ez [OR=-98. 64, 95％ CI (-110. 84, -86. 44), P <0. 001], decrease level of FSH [OR=-1. 85, 95％CI(-2. 58,-1. 11),P<0. 001] and decrease level of LH [OR= - 5. 85, 95％ CI (-6. 83, -4. 87), P<0. 001] in trial group were significantly better than control group, with statistical significance. In trial group, a few patients suffered from the increase of menstruation, the decrease of menstruation, temporary pigmentation and transient burnout; but all symptoms did not affect the treatment. CONCLUSIONS: Compound muni ziqi granules show definite clinical efficacy and good response rate in the adjuvant treatment of chloasma with mild ADR.
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Objective To evaluate the clinical efficacy of compound glycyrrhizin injection in the treatment of melasma.Methods A total of 30 melasma patients with blood vessel scores of ++ or +++ and melanin scores of ++ or +++,which were evaluated by dermoscopy and reflectance confocal microscopy (RCM) respectively,were collected from the Department of Dermatology of Hangzhou Third Hospital between May 2015 and July 2016.All the patients were randomly divided into 2 groups by drawing lots:treatment group treated with intravenous drips of compound glycyrrhizin injection at a dose of 40 ml once every three days for 8 sessions,oral vitamin C tablets at a dose of 0.2 g thrice a day,and oral vitamin E tablets at a dose of 0.1 g once a day,and control group treated with oral vitamin C and vitamin E tablets at the same dose as the treatment group.Three months after starting the treatment,the therapeutic effect was evaluated using melasma area and severity index (MASI).Meanwhile,RCM,dermoscopy and VISIA skin detector were used to detect skin lesions,and the melanin score,blood vessel score and brown spot and erythema indices were calculated.Results For the treatment group,the melanin score and blood vessel score were both significantly decreased at 3 months after starting the treatment compared with those before the treatment (Z =2.773,3.135,P =0.006,0.002,respectively),so were the brown spot index (38.3 ± 3.1 vs.43.9 ± 5.8,Z =3.091,P =0.002)and erythema index (26.5 ± 5.6 vs.33.3 ± 7.7,t =2.752,P =0.010).For the control group,the melanin score significantly decreased at 3 months after starting the treatment compared with those before the treatment (P =0.023),while no significant differences were observed in the blood vessel score or VISIA indices (P ＞ 0.05).Three months after starting the treatment,9 cases showed marked improvement,and 6 showed improvement in the treatment group;3 cases showed marked improvement,11 improvement,and 1 showed no improvement in the control group.The therapeutic effect in the treatment group was significantly superior to that in the control group (Z =2.276,P =0.029).Conclusion Compound glycyrrhizin injection is effective for the treatment of melasma,and RCM,dermoscopy and VISIA skin detector can be used to assist efficacy evaluation in melasma.