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山东中医药大学,济南 250355
Received:26 March 2021,
Published Online:25 May 2021,
Published:20 July 2021
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陈乐乐,陈曙光,周祥禄等.白癜风发病机制及中医药防治研究进展[J].中国实验方剂学杂志,2021,27(14):242-250.
CHEN Le-le,CHEN Shu-guang,ZHOU Xiang-lu,et al.Pathogenesis of Vitiligo and Its Prevention and Treatment with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(14):242-250.
陈乐乐,陈曙光,周祥禄等.白癜风发病机制及中医药防治研究进展[J].中国实验方剂学杂志,2021,27(14):242-250. DOI: 10.13422/j.cnki.syfjx.20211492.
CHEN Le-le,CHEN Shu-guang,ZHOU Xiang-lu,et al.Pathogenesis of Vitiligo and Its Prevention and Treatment with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(14):242-250. DOI: 10.13422/j.cnki.syfjx.20211492.
白癜风是一种常见的色素脱失性皮肤病,表现为局限性或泛发性,皮损处常为乳白色或浅粉色,表面光滑无皮疹,现代医学认为其与免疫功能、氧化应激、黑色素细胞自毀、遗传、神经化学因子等因素密切相关,但具体发病机制仍不明确,易诊难治,复发率高,严重影响了患者的生活质量和心理健康。目前西医治疗以服用糖皮质激素、免疫调节剂、维生素D
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衍生物及抗氧化剂等为主,短期疗效显著,但长期服用会引发一系列不良反应。中医药治疗白癜风历史悠久,积累了丰富的经验,在临床应用中安全性高,不良反应少,且中医药具有多成分、多靶点、多通路的作用特点,使其在防治白癜风方面具有独特的优势,受到众多医家学者的广泛关注。近年来,中医药在预防和治疗白癜风方面的研究不断深入,越来越多的单味中药、中药单体成分及复方被证实可以通过调节改善多种机制而发挥治疗作用。该文系统整理了近5年文献库中有关中医药改善白癜风发病机制的研究文献,将从中医药调节免疫功能紊乱、改善氧化应激损伤、保护黑色素细胞功能、调节线粒体结构与功能、调控肠道菌群环境及微小RNA(miRNA)异常表达等方面进行详细综述,以期进一步总结阐明白癜风的病理机制,并为中医药防治白癜风的深入研究和临床应用提供理论参考与科学依据。
Vitiligo is a common pigmentary disorder characterized by localized or generalized depigmentation of the skin, resulting in milky white or light pink patches with smooth surface but no rashes.Modern medicine believes that it is closely related to immune function, oxidative stress, autoimmune destruction of melanocytes, heredity, and neurochemical factors, but the specific pathogenesis is still unclear.Due to the easy diagnosis but hard management and the high recurrence rate, vitiligo has seriously affected the quality of life and mental health of patients.At present, it is mainly treated with glucocorticoids, immunomodulators, vitamin D
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derivatives, and antioxidants in western medicine, and the resulting short-term outcomes are satisfactory.However, a series of side effects may be caused by the long-term use.Traditional Chinese medicine (TCM) has a long history of dealing with vitiligo.Guided by the rich experience accumulated in daily practice, it exerts the preventive and therapeutic effects against vitiligo via multiple components, multiple targets, and multiple pathways, without inducing obvious adverse reactions, which has made it widely concerned by many doctors and scholars.As the research concerning the prevention and treatment of vitiligo with TCM intensifies, more and more single Chinese medicinals, Chinese medicinal monomers, and compound prescriptions have been proved to play a therapeutic role via multiple mechanisms.After reviewing the articles on the alleviation of vitiligo with TCM published in the past five years and retrieved from the literature databases, this paper summarized the efficacy of TCM in regulating immune dysfunction, improving oxidative stress injury, protecting melanocyte function, adjusting mitochondrial structure and function, and controlling the alteration of intestinal micro-flora and abnormal microRNA (miRNA) expression, so as to clarify the pathogenesis of vitiligo and provide theoretical and scientific basis for the in-depth study and clinical application of TCM in the prevention and treatment of vitiligo.
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