【作者】 唐冬菊；

【导师】 黄莺；

【作者基本信息】 成都中医药大学 ， 中医外科学， 2010， 硕士

【摘要】 目的：通过对女性黄褐斑患者血清性激素水平的测定,并将其与中医证型进行相关性探讨,为中医药治疗黄褐斑及中医辨证寻找微观理论依据,使中医症候客观化,为中西医结合治疗该病提供客观证据,从而在临床上达到对黄褐斑进行早预防,提高显效率,减轻患者心理负担,提高生活质量的目的。方法：按照黄褐斑常见中医辨证分型共收入女性患者80例,根据黄褐斑的剔除标准及退出标准,剔除3例,退出2例,最终获得有效病例75例作为研究对象,分为2型：气滞血瘀型42例和肝肾阴虚型33例,并设立20例一般健康人为对照组,采用电化学发光免疫法检测血清雌二醇(E2)、促卵泡生成素(FSH)、促黄体生成素(LH)、孕酮(P)、睾酮(T)的含量,并比较各组间性激素有无差异。结果：在月经周期的6到8天(卵泡中期)测定各自的FSH、LH、P、T、E2值,各组间性激素相比,肝肾阴虚型的E2高于气滞血瘀型和一般健康对照组(P<0.05),说明肝肾阴虚型与E2的增高有关系,E2可作为肝肾阴虚型黄褐斑的辨证标志；LH和P在三者间无统计学意义(P>0.05)；两中医证型各自的T与一般健康对照组比较,均低于一般健康对照组,有统计学意义(P<0.05),提示T与本实验涉及的黄褐斑中医辨证分型相关。气滞血瘀型的FSH与一般健康对照组比较,有统计学意义(P<0.05),但肝肾阴虚型的FSH与一般健康对照组比较以及两中医证型间的FSH比较均无统计学意义(P>0.05)。结论：女性黄褐斑发病与下丘脑—垂体—性腺轴失衡有关,E2可作为肝肾阴虚型黄褐斑的辨证标志,黄褐斑的气滞血瘀型与肝肾阴虚型的T均低于一般健康对照组,但两证型间的T比较,无统计学意义,LH、P在三者间均无统计学意义,可指导临床。更多还原

【Abstract】 Objectives:At first place, we measured the sex hormone level in blood serum of female patients suffering from chloasma and analysed the relationship between the data and syndrome types in TCM. Through all above,we built the theoretical foundation for treating chloasma by TCM methods and determining the syndrome differentiation. And, symptoms in TCM could be made objectively sustainable. Meanwhile,this study provided evidences to treatment of this disease by combination of Chinese and Western medicine. Consequently,we could be able to prevent the onset of chloasma as early as possible, make the treatment more effective, alleviate the psychological burden of patients, and improve the life quality.Methods:We collected 80 patients initially, thus only 75 ones has been used in the study, because among them,3 was eliminated and 2 was excluded owing to the eliminated and excluded criterions.According to the syndrome differentiations of chlasma in TCM,the 75 patients were divided into two types:qi stagnation and blood stasis (forty two cases) and yin deficiency of kidney and liver (thirty three cases).At the same time, we get twenty normal cases as the control group.We measured estradiol E2, follicle-stimulating hormone(FSH),luteinizing hormone(LH),progesterone P, testosterone levels of T in blood serum of them by electrochemiluminescence immunoassay, and compared the Levels of sex hormone among the three groups。Results:we measured the level of E2、LH、FSH、T、P during the sixth to eighth day in the menstrual cycle and compared them among groups.As a result, the E2 level in the group of liver and kidney yin deficiency was highest(P<0.05), indicating that Liver and kidney yin deficiency is relative to E2, and E2 could be used as sign of this type.There was no statistical significance while comparing the LH and P levels among the three groups (P>0.05); the respective testosterone T level of the two groups of patients were both lower than that of the control group, there was statistical significance (P<0.05), indicating that there was some relationship between testosterone T and the onset of chloasma; the FSH level of group of the qi stagnation and blood stasis type was higher than that of control group, there was statistical significance (P<0.05). Thus, there was no statistical significance while comparing the FSH level between the group of liver and kidney yin deficiency type and the control group and between the two groups of patients (P>0.05).Conclusions:The onset of chloasma is correlative to the unbalance of hypothalamus-pituitary-gonadal axis.E2 can be used as the sign of the type of yin defficiency of kidney and liver in chloasma.The testosterone T level of two groups of patients are lower than the control group; but there is no statistical significance while comparing it between the two groups of patients. And the LH and P levels also failed to be compared among the three groups statistically.The conclusion is able to guide the clinical practice.更多还原