Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Samitivej Esthetics Institute, Samitivej Sukhumvit Hospital, Bangkok, Thailand.
Front Public Health. 2021 Nov 4;9:761017. doi: 10.3389/fpubh.2021.761017. eCollection 2021.
Acupuncture shows benefits for patients with melasma, although no optimal number of sessions have been determined. The prospective observational study was conducted in melasma patients who were treated with acupuncture procedures two times a week and were evaluated after the 5th and the 10th sessions of acupuncture, with a 1-week follow-up after the last session. Participants Groups A and B received five and 10 acupuncture sessions, respectively. Melasma was assessed by using the melanin index (MI), melasma area and severity index (MASI), patient-reported improvement scores, and acupuncture-related adverse events. Out of 113 participants, 67 received five sessions of acupuncture treatment while 39 received 10 sessions. At 1 week after five sessions of acupuncture in Group A, the mean MI decreased by 28.7 (95% CI -38.5 to -18.8, < 0.001), whereas the median MASI decreased by 3.4 (95% CI -6.9 to -1.2, < 0.001) points. At 1 week after ten sessions of acupuncture in Group B, the mean MI decreased by 31.3 (95% CI -45 to -17.6, < 0.001), whereas the median MASI decreased by 5.4 (95%CI -9.9 to -3, < 0.001) points. The first five sessions of acupuncture had a higher incremental effect than the last five sessions, although there was no statistically significant difference. Twenty-nine participants reported minor side effects. Group B had a risk ratio (RR) of having adverse events 1.8 times (95% CI 1.0-3.4, = 0.05) compared with Group A. Short acupuncture regimens of 5-10 sessions in melasma seem to be effective and practical with minor side effects.
针灸对黄褐斑患者有益，尽管尚未确定最佳疗程数。这项前瞻性观察性研究纳入了接受每周两次针灸治疗的黄褐斑患者，分别在第 5 次和第 10 次治疗后以及最后一次治疗后 1 周进行评估。患者分为 A 组和 B 组，分别接受 5 次和 10 次针灸治疗。采用黑素指数（MI）、黄褐斑面积和严重程度指数（MASI）、患者报告的改善评分和针灸相关不良事件评估黄褐斑。113 名参与者中，67 人接受 5 次针灸治疗，39 人接受 10 次针灸治疗。在 A 组接受 5 次针灸治疗 1 周后，平均 MI 降低 28.7（95%CI -38.5 至 -18.8，<0.001），中位数 MASI 降低 3.4（95%CI -6.9 至 -1.2，<0.001）点。在 B 组接受 10 次针灸治疗 1 周后，平均 MI 降低 31.3（95%CI -45 至 -17.6，<0.001），中位数 MASI 降低 5.4（95%CI -9.9 至 -3，<0.001）点。虽然没有统计学差异，但前 5 次针灸治疗的增量效果高于后 5 次。29 名参与者报告有轻微副作用。与 A 组相比，B 组发生不良事件的风险比（RR）为 1.8 倍（95%CI 1.0-3.4，=0.05）。黄褐斑的 5-10 次短疗程针灸似乎有效且实用，副作用较小。
