目的 评估大光斑低能量Q开关Nd:YAG激光治疗黄褐斑的疗效和安全性。方法 采用Q开关Nd∶YAG激光器以波长1064 nm,光斑6～7 mm,能量2.0～2.5 J/cm²,对黄褐斑患者进行治疗,以治疗处呈现微红为治疗终点,每月1次,治疗5次,共治疗黄褐斑36例。结果 36例患者中基本治愈8 例(22.23%),显效15例(41.67%),好转9例(25%),无效4例(11.11%),前两者之和为总有效率,达63.89%。患者耐受性好,无明显副作用。结论 大光斑低能量Q开关Nd:YAG激光为治疗黄褐斑提供了安全有效的方法。

Objective To evaluate the efficacy and security of Q-switched laser with Large Spot and Low Fluence for the treatment of melasma. Methods Thirty-six patients with melasma were enrolled in study. 1064 nm Q-switched Nd:YAG laser was used with light spot of 6-7 mm and 2.0-2.5 J/cm² in fluence.Treatments are ended when the melasma area turns slight red. Subjects were received a total of 5 treatments at one month intervals. Results Thirty-six patients completed the trial. 22.23% of patients achieved 90% to 100% clearance and 41.67% achieved 60% to 90% clearance. The total efficient rate reached 63.89% .Side effects was minimal and all the patients tolerated the treatment well. Conclusion Q-switched Nd:YAG laser with Large Spot and Low Fluence provides a safe and effective treatment method for melasma.

目的 观察隔药壮灸神阙穴治疗女性黄褐斑的临床疗效及对血清性激素水平的影响。方法 将72例患者随机分为2组,治疗组38例和对照组34例,治疗组予隔药壮灸神阙穴治疗,对照组予口服维生素C、维生素E治疗,10次为1个疗程,第2、4、6疗程末观察疗效,治疗前后测定月经第2～3天血清雌二醇(E2)、孕酮(P)、泌乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平。结果 第6疗程末治疗组总有效率为83.33％,对照组总有效率30.30%,治疗组疗效优于对照组(P＜0.05),治疗组治疗前后E2、LH下降水平有统计学意义(P＜0.05)。对照组治疗前后E2、P、PRL、FSH、LH、T水平变化不明显(P＞0.05)。治疗后2组E2、LH比较,差异有统计学意义(P＜0.05)。结论 隔药壮灸神阙穴治疗女性黄褐斑临床疗效较好,可能通过调节性激素而起到治疗作用。

Objective To observe the clinical efficacy on female chloasma treated with acupuncture of Zhuang minority medicine at Shengque xue and its influence on sex hormone levels. Methods 72 cases were divided randomly into a treatment group(38 cases) and a control group(34 cases). In treatment group, acupuncture of Zhuang minority medicine at Shengque xue was applied. In control group, oral administration of vitamin C and vitamin E were given. The cases of treatment group were treated ten times as one session. At the end of 2,4,6 treatment session efficacy were analyzed respectively. The levels of serum estradiol(E2), progesterone(P), prolactin(PRL), follicule stimulating hormone(FSH), luteinizing hormone(LH) and testosterone(T) were detected on day 2-3 of menstruation. Results At the end of 6 treatment session the total effective rate was 83.33％ in treatment group and was 30.30% in control group, the efficacy in treatment group were superior to that in control group, with significant difference(P＜0.05). In treatment group, the levels of LH and E2 after treatment were lower as compared with those before treatment(P＜0.05). In control group, there were no obvious changes in E2,P, PRL, FSH, LH and T before and after treatment(P＞0.05). The levels of LH and E2 after treatment were significantly different in comparison of two groups(P＜0.05). Conclusion Acupuncture of Zhuang minority medicine at Shengque xue achieves a definite efficacy on female chloasma in clinic and its pharmacological mechanism may be relevant with its regulation on sex hormone levels for the patients.