目 录CONTENT中文摘要ABSTRACT IN CHINESE 1英文摘要ABSTRACT IN ENGLISH 3正文TEXT 5 前言INTRODUCTION5资料与方法MATERIALS AND METHODS7研究结果RESULTS11分析和讨论ANALOGY AND DISCUSSION 13小结CONCLUSION23参考文献REFERENCES24致谢ACKNOWLEDGEMENT27附录APPENDIXES28 针灸对成年女性黄褐斑患者血液流变学的影响专 业：针灸推拿学研究生：张巧凤导 师：林宏教授黄碧玉副教授 中 文 摘 要ABSTRACT IN CHINESE目的：观察针灸治疗成年女性黄褐斑的临床疗效及对机体血液流变学的影响，分析黄褐斑皮损消退与血液流变学部分指标改变的关系，旨在探讨针灸治疗女性黄褐斑的作用机理，为临床防治黄褐斑寻求理论依据与最佳防治方案。方法：按照中国中西医结合皮肤科学会色素病学组委员会拟定的黄褐斑临床诊断标准，选择40例成年女性黄褐斑患者，采用简单随机法分为治疗组（A组）和对照组（B组），各20例。 A组给予针灸治疗，B组给予口服维生素EC复合剂，共治疗60天。比较两组血液流变学指标变化及皮损消退情况，并观察皮损消退、皮损积分、病程、年龄之间的相关性。结果：（1）A组和B组治疗前血液流变学指标全血粘度（b）高切、中切、低切、红细胞压积（Hct）、红细胞电泳时间（EET）和皮损积分无显著性差异（P0.05）；治疗后两组血液流变学指标全血高、中、低切粘度、EET明显降低（P0.01）， Hct无显著差异（P0.05）；皮损积分明显降低（P0.01）。 （2）A组不论在血液流变学指标（全血高、中、低切粘度，EET，Hct）下降还是在皮损积分改变方面，均优于B组。全血粘度（高、中、低切）、EET、皮损积分有非常显著差异（P0.01）；Hct无显著差异（P0.05）。 （3）A、B两组积分下降指数相比有非常显著差异（P0.01）。 （4）成年女性黄褐斑患者皮损积分与血液流变学水平（全血高、中、低切粘度，EET）之间呈中度正相关关系（P0.01），与Hct之间相关系数无统计学意义（P0.05）。（5）皮损积分与病程呈低度正相关（P0.05），与积分下降指数呈低度负相关（P0.05）、病程与积分下降指数呈低度负相关（P0.05），年龄与积分下降指数、病程与年龄、皮损积分与年龄相关性均无统计学意义（P0.05）。结论：（1）针灸治疗成年女性黄褐斑效果优于西药维生素EC复合剂，（2）黄褐斑应该及早进行治疗，病程越短效果越好。（3）针灸改善血液流变学可能是其治疗黄褐斑的重要机理之一。主题词：黄褐斑/针灸疗法 血液粘度/针灸效应血液流变学/针灸效应红细胞压积女性成年人A study on the effect of Acupuncture and Moxibustion on hemorheology in adult female chloasma patients Major: Acupuncture & Moxibustion, MassagePostgraduate: Zhang QiaofengTutor: Prof. Lin HongAss. prof. Huang BiyuABSTRACTPurpose: To explore the theory basis and the best programme in the clinical prevention and cure of chloasma, we observed the clinical efficacy of treating adult female chloasma with acupuncture and moxibustion and the effect on those treated patients hemorheology by analysing the improvement of cutaneous pigmentation and the change of the whole blood viscocity(b) in the condition of high shear rate , middle shear rate, low shear rate, hematocrit(Hct) and erythrocyte electrophoresis time(EET) in hemorheology. The effective mechanism of acupuncture and moxibustion treating adult female chloasma was studied .Methods: According to the clinical diagnostic criterion of the national combined traditional Chinese and western medicine dermatological dyschromatosis committee,40 chosed adult female chloasma patients were randomly divided into 2 groups(n20) , treatment group (group A) and medicine control group(group B), Group A was treated by Acumoxi. Group B was given by the medicine Vitamin E and C complex. Sixty days later, between different groups the five hemorheological indexes and the cutaneous pigmentation conditions were estimated. The relation was observed among the clinical efficacy 、the skin damage mark 、the disease course and year. Results: (1) There were no evident difference between the two groups in skin damage mark and the whole blood viscocity(b) in the condition of high shear rate , middle shear rate, low shear rate, Hct, EET levels before treatment (P0.05), whereas except Hct both of them decreased after treatment（P0.01）. (2)The levels of the whole blood viscocity(b) and EET and skin damage mark in acupuncture and moxibustion group decreased more markedly than those in the medicine control group（P0.01）. Hct has no evident difference. (3) There was very obvious difference between the acupuncture and moxibustion group and the medicine control group（P0.01）. (4)The whole blood viscocity(b) and EET concentration were positively correlated in middle degree with the skin damage mark（P0.01）, while Hct has no obvious difference. (5)The skin damage mark were positively correlated in low degree with the disease course （P0.05）, negatively correlated in low degree with the mark decreasing index（P0.05）,and the disease course negatively correlated in low degree with the mark decreasing index（P0.05）.The others have no obvious difference（P0.05）.Conclusion: （1）Acupuncture and moxibustion have better clinical efficacy on the adult female chloasma than the medicine Vitamin E and C complex . （2）Chloasma should be treated in the early period,and the shorter the disease course, the better the clinical efficacy . （3）Acupuncture and Moxibustion can improve the hemorheology , which may be an important mechanism to treat chloasma .MeSH Term: chloasma/am therblood viscocity/am effhemorheology /am eff hematocrit female adult针灸对成年女性黄褐斑患者血液流变学的影响专 业：针灸推拿学研究生：张巧凤导 师：林宏教授黄碧玉副教授前 言INTRODUCTION黄褐斑(chloas