目的:观察埋线配合艾灸、放血疗法治疗雄激素性脱发的临床治疗效果,并探讨其疗效机制。方法:根据治疗的先后顺序,按照随机数字表将84例雄激素性脱发患者随机分为埋线组和西药组。埋线组取双侧肾关穴、明黄穴及足三里穴埋线,每月1次,并配合艾灸少腹部及脱发局部放血治疗;西药组口服非那雄胺,1mg/d。两组治疗时间均为3个月,随访3个月。于治疗前、治疗1个月、3个月及随访3个月分别检测患者血清睾酮(T)、雌二醇(E2)的水平,并计算其比值,统计分析两组治疗1个月及3个月、随访3个月的T、E2、T/E2及疗效。结果:两组患者治疗1个月后的疗效差异无统计学意义(P〉0.05),埋线组治疗3个月及随访3个月的疗效均优于西药组(均P〈0.05);治疗3个月时,埋线组血清E2水平低于西药组(P〈0.05);随访3个月时,埋线组T、E2及T/E2均低于西药组(均P〈0.05)。结论:埋线配合艾灸及放血疗法治疗雄激素性脱发疗效确切,其作用机制可能与下调患者血清T水平、降低T/E2值有关。
Objective To observe the clinical efficacy of catgut embedment combined with moxibustion and bloodletting in the treatment of androgenic alopecia and to probe into its therapeutic mechanism. Methods Eighty-four patients with androgenic alopecia were divided into catgut embedment group (group A) and western medicine group (group B) on the basis of random number table and according to the order of treatment. For the pateints in group A, Shenguan (肾关) on both sides, Minghuang (明黄) and Zusanli (足三里 ST 36) were selected to receive catgut embedment therapy, once every month, combined with moxibustion on the lower abdomen and local bloodletting treatment. For the patients in group B, finasteride 1mg/d was orally administrated. The treatment period for two groups was 3 months, and the follow-up visit lasted for 3 months. Serum testosterone (T) and estradiol (E2) contents were detected respectively before treatment, after i month and 3 months of treatment and after 3 months of follow-up visit, and the specific values were calculated to make statistical analysis of T, E2, T/E2 and curative effects of the two groups after i month and 3 months of treatment and after 3 months of follow-up visit. Results There was no statistical significance in curative effect between the two groups after i month of treatment (P〉0.05), and the curative effect in group A were better than that in group B after 3 months of treatment or after 3 months of follow-up visit (both P〈0.05); E2 level in group A was lower than that in group A after 3 months of treatment (P〈0.05); T, E2 and T/E2 in group A were all lower than that in group B after 3 month of follow-up visit (all P〈0.05). Conclusion The curative effect of treating androgenic alopecia with catgut embedment, moxibustion and bloodletting is definite, and its mechanism of action may be related to the reduction of T levels and T/E2 values.