摘要
【目的】观察健脾祛湿法联合中药熏蒸疗法治疗脾虚湿蕴型脂溢性脱发的临床疗效及其对激素水平的影响。【方法】选取2023年1月至2024年2月期间上海中医药大学附属曙光医院皮肤科收治的脾虚湿蕴型脂溢性脱发患者104例,按随机数字表法将其分为试验组和对照组,每组各52例。对照组给予服用非那雄胺片治疗,试验组在对照组的基础上给予健脾祛湿法联合中药熏蒸疗法治疗,疗程为3个月。观察2组患者治疗前后血清激素水平、脱发数量评分和临床症状(包括头发油腻、瘙痒、鳞屑、新发生长情况)评分以及皮肤镜下毛发相关指标的变化情况,并评估2组患者的临床疗效及不良反应发生情况。【结果】(1)疗效方面,治疗3个月后,试验组的总有效率为94.23%(49/52),对照组为73.08%(38/52),组间比较(χ^(2)检验),试验组的疗效明显优于对照组(P<0.01)。(2)血清激素水平方面,治疗后,2组患者的血清睾酮水平均较治疗前降低(P<0.05),血清雌二醇水平均较治疗前升高(P<0.05),且试验组对血清睾酮水平的降低作用及对血清雌二醇水平的升高作用均明显优于对照组(P<0.01)。(3)脱发数量评分方面,治疗后,2组患者的脱发数量评分均较治疗前降低(P<0.05),且试验组的降低作用明显优于对照组(P<0.01)。(4)临床症状评分方面,治疗后,2组患者的头发油腻、瘙痒、鳞屑、新发生长评分均较治疗前降低(P<0.05),且试验组的降低作用均明显优于对照组(P<0.01)。(5)皮肤镜下毛发相关指标方面,治疗后,2组患者的皮肤镜下每平方厘米毛发数、直立再生毛发数均较治疗前明显增加(P<0.05),毳毛数、单一毛囊单位数、褐色毛周征数均较治疗前明显减少(P<0.05),且试验组对皮肤镜下毛发相关指标的改善作用均明显优于对照组(P<0.01)。(6)安全性方面,治疗期间,2组患者未见明显不良反应发生,具有较高的安全性。【结论】健脾祛湿法联合中药熏蒸疗法治疗脾虚湿蕴型脂溢性脱发疗效显著,能有效改善血清激素水平,促进毛发新生,减轻头发油腻、头皮瘙痒等症状,且安全性良好。
Objective To investigate the clinical efficacy of Jianpi Qushi Method(a spleen-invigorating and dampness-removing approach)combined with Chinese herbal fumigation therapy in treating seborrheic alopecia of spleen deficiency with dampness-accumulation type and to observe its influence on hormone levels.Methods The observation was carried out in 104 patients with spleen deficiency with dampness-accumulation type of seborrheic alopecia,who admitted to the Department of Dermatology at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2023 to February 2024.The patients were equally randomized into a trial group and a control group,with 52 cases in each group.The control group received oral administration of Finasteride Tablets,while the trial group was additionally treated with Jianpi Qushi Method combined with Chinese herbal fumigation therapy for 3 months.Serum hormone levels,hair loss scores,clinical symptom scores(including greasy hair,pruritus,scaling,and growth of new hair),and trichoscopic parameters of the hair in the two groups were assessed before and after treatment.After treatment,the clinical efficacy and adverse reactions in the two groups were also evaluated.Results(1)After 3 months of treatment,the total effective rate in the trial group was 94.23%(49/52)and that in the control group was 73.08%(38/52).The trial group demonstrated significantly superior efficacy compared to the control group(tested by chi-square test,P<0.01).(2)After treatment,both groups exhibited a significant decrease in serum testosterone level(P<0.05)and a significant increase in serum estradiol level(P<0.05)compared to those before treatment.Notably,the trial group showed a more pronounced reduction in testosterone and a greater elevation in estradiol than the control group(P<0.01).(3)Both groups displayed a significant reduction in hair loss scores after treatment(P<0.05),and the trial group achieved a markedly greater decrease than the control group(P<0.01).(4)After treatment,the clinical symptom scores for greasy hair,pruritus,scaling,and growth of new hair significantly decreased in both groups compared to those before treatment(P<0.05).And the trial group exhibited significantly greater improvements in the scores of all symptoms than the control group(P<0.01)(.5)After treatment,both groups showed a significant increase in hair density(hairs/cm²)and count of upright regrowing hair(P<0.05),along with a significant decrease in vellus hair count,hair count in the single hair follicle,and count of perifollicular keratosis(P<0.05).The trial group demonstrated significantly superior improvements in all trichoscopic parameters compared to the control group(P<0.01).(6)No significant adverse reactions were observed in either group during the treatment period,indicating a favorable safety profile for both therapeutic approaches.Conclusion Jianpi Qushi Method combined with Chinese herbal fumigation therapy exerts significant efficacy in treating seborrheic alopecia of spleen deficiency with dampness-accumulation type.The combined therapy is effective on regulating hormone levels,promoting hair regeneration,and alleviating symptoms such as greasy hair and pruritus,and demonstrates favorable safety.
作者
熊艺
何翔
王东明
耿兰馨
XIONG Yi;HE Xiang;WANG Dongming;GENG Lanxin(Dept.of Dermatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《广州中医药大学学报》
2025年第7期1673-1680,共8页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(编号:82104863)。
关键词
脂溢性脱发
健脾祛湿法
中药熏蒸疗法
脾虚湿蕴型
临床疗效
seborrheic alopecia
Jianpi Qushi Method
Chinese herbal fumigation therapy
spleen deficiency with dampness-accumulation type
clinical efficacy
作者简介
熊艺(1999-),男,在读硕士研究生,E-mail:penmg43563@163.com;通信作者:何翔(1975-),男,医学硕士,副主任医师,E-mail:heroxiang@hotmail.com。
