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目的:探讨桃红四物汤加减联合氨甲环酸治疗黄褐斑的疗效及对患者性激素水平和氧化应激指标的影响。方法:选择义乌市中医医院2017年1月至2019年12月收治的黄褐斑患者96例为观察对象，采用随机数字表法分为观察组(48例)与对照组(48例)。对照组给予氨甲环酸治疗，观察组在对照组基础上联合桃红四物汤加减治疗。两组疗程均为12周。比较两组临床疗效，治疗前后黄褐斑面积和严重指数(MASI)评分、性激素及氧化应激水平变化，不良反应发生情况。结果:观察组治疗总有效率[91.67%(44/48)]高于对照组[68.75%(33/48)](χn 2＝7.940，n P<0.05)；观察组治疗后MASI评分[(8.64±1.27)分]低于对照组[(17.93±2.53)分](n t＝22.736，n P<0.05)；观察组治疗后血清雌二醇[(19.83±4.21)ng/L]、黄体生成素(LH)[(3.79±0.68)mU/L]和卵泡刺激素(FSH)[(5.23±1.76)mU/L]均低于对照组[(43.79±4.69)ng/L、(5.81±1.07)mU/L、(10.64±2.60)mU/L](n t＝26.339、11.039、11.938，均n P<0.05)；观察组治疗后血清丙二醛[(3.67±0.40)μmol/L]低于对照组[(4.52±0.32)μmol/L]，而超氧化物歧化酶[(78.84±5.67)IU/L]高于对照组[(60.65±5.29)IU/L](n t＝11.496、16.252，均n P<0.05)。n 结论:桃红四物汤加减联合氨甲环酸治疗黄褐斑疗效良好，可改善患者性激素和氧化应激水平，且无明显不良反应。“,”Objective:To explore the therapeutic effect of Taohong Siwu decoction combined with tranexamic acid in the treatment of chloasma, and its influence on the level of sex hormone and oxidative stress parameters.Methods:From January 2017 to December 2019, 96 cases with chloasma in Yiwu Hospital of Traditional Chinese Medicine were selected and divided into observation group (48 cases) and control group (48 cases) according to the random digital table method.The control group was given tranexamic acid.The observation group was given Taohong Siwu decoction on the basis of the control group.The course of treatment in both two groups was 12 weeks.The therapeutic effect, melasma area and severity index (MASI) score, sex hormone and oxidative stress level before and after treatment, and the adverse reactions were compared between the two groups.Results:The total effective rate of the observation group (91.67%) was higher than that of the control group (68.75%) (χn 2=7.940, n P<0.05). The MASI score of the observation group[(8.64±1.27)points] was lower than that of the control group[(17.93±2.53)points] (n t=22.736, n P<0.05). The serum levels of En 2 [(19.83±4.21)ng/L], LH [(3.79±0.68)mU/L] and FSH [(5.23±1.76)mU/L] in the observation group were lower than those in the control group [(43.79±4.69)ng/L, (5.81±1.07)mU/L and (10.64±2.60)mU/L] (n t=26.339, 11.039, 11.938, all n P<0.05). The MDA of the observation group [(3.67±0.40)μmol/L] was lower than that of the control group [(4.52±0.32)μmol/L], while the SOD of the observation group[(78.84±5.67)IU/L] was higher than that of the control group[(60.65±5.29)IU/L], the differences were statistically significant(n t=11.496, 16.252, all n P<0.05).n Conclusion:Taohong Siwu decoction combined with tranexamic acid has good effect on chloasma patients.It can improve the level of sexual hormone and oxidative stress, and has no obvious adverse reactions.