透骨草-侧柏叶煎剂治疗雄激素性秃发的疗效及对患者焦虑与抑郁水平的影响

夏继宁; 项晶

doi:10.16766/j.cnki.issn.1674-4152.002827

透骨草-侧柏叶煎剂治疗雄激素性秃发的疗效及对患者焦虑与抑郁水平的影响

doi: 10.16766/j.cnki.issn.1674-4152.002827

夏继宁^,,
项晶

嘉兴市中医医院皮肤科，浙江嘉兴 314001

基金项目:

浙江省中医药科技计划项目 2020ZB250

详细信息

通讯作者:
夏继宁, E-mail: dermatoxia@163.com

中图分类号: R246.7R758.71
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- 文章访问数: 540
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- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2022-05-19
- 网络出版日期: 2023-04-07

Clinical effect of Tougucao Cebaiye Decoction on androgenic alopecia and on the level of anxiety and depression

XIA Ji-ning^,,
XIANG Jing

Department of Dermatology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang 314001, China

摘要

摘要: 目的观察透骨草-侧柏叶煎剂联合西医药物治疗雄激素性秃发(AGA)的疗效，及其对患者焦虑和抑郁状况的缓解作用。方法选取2019年6月—2021年6月嘉兴市中医医院收治的AGA患者124例，应用随机数字表法将患者分为治疗组与对照组，每组62例。2组均给予非那雄胺片口服及米诺地尔酊外用治疗，在此基础上，治疗组给予透骨草-侧柏叶煎剂治疗，疗程为6个月。比较治疗前后2个固定观察区(额角、头顶)毛发镜下的客观指标(总毛干数、毛干直径变异数量)、中医证候积分(脱发、瘙痒、油腻、鳞屑)及临床疗效，分析AGA患者焦虑、抑郁情绪，比较治疗后透骨草-侧柏叶煎剂对AGA患者情绪的影响。结果治疗后，治疗组患者头顶毛干直径变异数低于对照组[(17.31±3.16)根vs.(23.67±3.78)根，t=10.164, P < 0.001]，毛干总数高于对照组[(55.18±4.32)根vs.(53.09±4.95)根，t=2.505, P=0.014]，额角毛干总数高于对照组[(48.83±3.24)根vs.(46.66±3.37)根，t=3.681, P < 0.001]。治疗后，治疗组患者脱发、瘙痒、油腻、鳞屑评分均低于对照组(均P < 0.001)。治疗组总有效率为88.71%，高于对照组的74.19%(χ²=4.324, P=0.038)。治疗后，治疗组患者GAD-7评分、PHQ-9评分低于对照组(均P < 0.05)，治疗组患者生理、心理、独立性和环境等领域WHOQOL-BREF评分均高于对照组(均P < 0.001)。结论透骨草-侧柏叶煎剂联合西医药物可有效抑制湿热型AGA患者脱发症状，改善中医证候积分，提高疗效，缓解焦虑及抑郁心理状况，提高生存质量水平。
- 透骨草-侧柏叶煎剂 /
- 雄激素性秃发 /
- 焦虑 /
- 抑郁
Abstract: Objective This study aimed to observe the therapeutic effect of Tougucao Cebaiye Decoction combined with western medicine on androgenic alopecia (AGA) and its relief effect on anxiety and depression level of patients. Methods A total of 124 patients with AGA admitted to Jiaxing Hospital of Traditional Chinese Medicine from June 2019 to June 2021 were selected and divided into the treatment group and control group by using the random number table method, with 62 cases in each group. Both groups were given finasteride tablets and minoxidil tincture orally. On this basis, the treatment group was given Tougucao Cebaiye Decoction for 6 months. The objective indexes (total number of hair stems, variation of hair stem diameter), TCM syndrome score (alopecia, pruritus, greasy, scaly) and clinical efficacy were compared before and after treatment in two fixed observation areas (frontal horn and head). The anxiety and depression of AGA patients were analysed, and the effects of Tougucao Cebaiye Decoction on the mood of patients with AGA after treatment were compared. Results After treatment, the variation in vertical hair stem diameter was lower in the treatment group than in the control group (17.31±3.16 vs. 23.67±3.78, t=10.164, P < 0.001). The total number of hair stem count was higher than that in the control group (55.18±4.32 vs. 53.09±4.95, t=2.505, P=0.014), and the total number of hair stems in frontal horn was higher than that in the control group (48.83±3.24 vs. 46.66±3.37, t=3.681, P < 0.001). After treatment, the scores of alopecia, pruritus, greasy and scaly were lower in the treatment group than in the control group (all P < 0.001). The total effective rate of the treatment group was 88.71%, which was higher than that of the control group (74.19%, χ²=4.324, P=0.038). After treatment, the GAD-7 and PHQ-9 scores were lower in the treatment group than those in the control group (all P < 0.05), and the WHOQOL-BREF scores of physiology, psychology, independence and environmental domains in the treatment group were higher than those in the control group (all P < 0.001). Conclusion Tougucao Cebaiye Decoction combined with western medicine can effectively inhibit hair loss symptoms in patients with damp heat type AGA, improve TCM syndromes, improve therapeutic effect, alleviate anxiety and depression and improve quality of life.
- Tougucao Cebaiye Decoction /
- Androgenic alopecia /
- Anxiety /
- Depression

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表 1 2组雄激素性秃发患者头顶毛发镜征象指标比较(x ±s，根)

Table 1. Comparison of trichoscopic indicators in two groups of patients with androgen alopecia(x ±s, root)

组别	例数	毛干直径变异数		毛干总数
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	62	24.73±4.25	23.67±3.78	52.49±5.30	53.09±4.95
治疗组	62	23.88±4.19	17.31±3.16^a	52.06±5.62	55.18±4.32^a
t值		1.121	10.164	0.438	2.505
P值		0.264	＜0.001	0.662	0.014
注：与同组治疗前比较，^a P < 0.05。

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表 2 2组雄激素性秃发患者额角毛发镜征象指标比较(x ±s，根)

Table 2. Comparison of frontal horn trichoscopic signs between two groups of androgen alopecia(x ±s, root)

组别	例数	毛干直径变异数		毛干总数
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	62	40.29±5.48	38.57±4.39^a	45.36±3.53	46.66±3.37^a
治疗组	62	39.12±5.75	37.84±4.02^a	45.58±3.44	48.83±3.24^a
t值		1.160	0.966	0.352	3.681
P值		0.286	0.336	0.726	＜0.001

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表 3 2组雄激素性秃发患者中医证候积分比较(x ±s，分)

Table 3. Comparison of TCM syndrome scores between two groups(x ±s, score)

组别	例数	脱发		瘙痒		油腻		鳞屑
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	62	3.65±0.63	1.97±0.49^a	3.53±0.51	1.49±0.35^a	3.67±0.44	2.08±0.53^a	3.44±0.52	1.76±0.42^a
治疗组	62	3.74±0.61	1.18±0.22^a	3.58±0.47	0.93±0.30^a	3.54±0.45	1.37±0.46^a	3.50±0.48	1.08±0.35^a
t值		0.808	11.581	0.568	9.565	1.626	7.966	0.668	9.794
P值		0.421	＜0.001	0.571	＜0.001	0.106	＜0.001	0.506	＜0.001
注：与同组治疗前比较，^a P < 0.05。

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表 4 2组雄激素性秃发患者临床疗效比较[例(%)]

Table 4. Comparison of clinical efficacy of two groups of androgenic alopecia areata[cases (%)]

组别	例数	痊愈	显效	有效	无效	总有效
对照组	62	8(12.90)	12(19.35)	26(41.94)	16(25.81)	46(74.19)
治疗组	62	10(16.13)	16(25.81)	29(46.77)	7(11.29)	55(88.71)
注：2组总有效率比较，χ²=4.324，P=0.038。

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表 5 2组雄激素性秃发患者焦虑抑郁情绪评分比较(x ±s，分)

Table 5. Comparison of anxiety and depression scores in two groups of androgenic alopecia areata(x ±s, score)

组别	例数	GAD-7评分		PHQ-9评分
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	62	6.95±1.49	4.66±1.24^a	6.73±1.45	4.58±1.17^a
治疗组	62	6.82±1.36	4.02±1.18^a	6.51±1.41	4.11±1.06^a
t值		0.507	2.944	0.857	2.344
P值		0.613	0.004	0.393	0.021
注：与同组治疗前比较，^a P < 0.05。

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表 6 2组雄激素性秃发患者生存质量比较(x ±s，分)

Table 6. Comparison of quality of life between two groups of androgenic alopecia(x ±s, score)

组别	例数	生理领域		心理领域		独立性领域		环境领域
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	62	15.82±1.64	19.64±1.85^a	13.62±1.47	16.55±1.66^a	6.72±0.63	8.81±0.86^a	18.57±1.82	23.17±1.90^a
治疗组	62	15.93±1.59	21.35±1.81^a	13.54±1.51	17.74±1.69^a	6.64±0.68	9.73±0.95^a	18.36±1.86	24.96±1.97^a
t值		0.396	5.099	0.328	3.955	0.679	5.812	0.645	5.111
P值		0.705	＜0.001	0.745	＜0.001	0.498	＜0.001	0.520	＜0.001
注：与同组治疗前比较，^a P < 0.05。

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