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河南中医药大学,郑州 450046
武晏屹,硕士,从事中药药理研究,E-mail:wuyanyi11@163.com
苗明三,博士,教授,博士生导师,从事中药药理研究,E-mail:miaomingsan@163.com
网络出版日期:2020-06-01,
纸质出版日期:2020-09-05
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武晏屹,白明,田硕等.黄褐斑发病机制与中医药调控[J].中国实验方剂学杂志,2020,26(17):219-224.
WU Yan-yi,BAI Ming,TIAN Shuo,et al.Pathogenesis and Traditional Chinese Medicine Regulation of Chloasma[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(17):219-224.
武晏屹,白明,田硕等.黄褐斑发病机制与中医药调控[J].中国实验方剂学杂志,2020,26(17):219-224. DOI: 10.13422/j.cnki.syfjx.20201601.
WU Yan-yi,BAI Ming,TIAN Shuo,et al.Pathogenesis and Traditional Chinese Medicine Regulation of Chloasma[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(17):219-224. DOI: 10.13422/j.cnki.syfjx.20201601.
黄褐斑的发病机制复杂多样,中医认为多与肝、脾、肾三大脏器相关,以血脉不通为标,面部或体表色素沉着为主症;西医则认为与家族遗传、种族差异、紫外线照射等密切相关。目前临床上疗法多样,主要有预防紫外线辐射、局部增白剂、化学换肤等。此外,中医药在黄褐斑的治疗中也发挥着举足轻重的作用,常采用中药内服、局部外用、针灸等。现代研究表明,中医药疗法主要以调控体内抗氧化、内分泌及黑色素代谢为主,虽能一定程度解释作用机制,但对中医药外用调控黄褐斑作用机制的探讨仍存在一定局限。随着皮肤“神经-内分泌-免疫”(NEI)网络的提出及深入研究,NEI网络以细胞因子、激素、神经递质作为信息分子实现整体功能调控的作用得到广泛的验证与认可,本文在对黄褐斑的发病机制及目前中医药的调控进展进行系统综述的基础上,提出中药外用治疗黄褐斑可能通过调节体表NEI网络发挥局部疗效,值得进一步深入研究及探讨,以期对黄褐斑的治疗及中药外用作用机制的研究提供新思路。
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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