黄褐斑是一种发生于颜面部的呈对称而局限的淡褐色或深褐色常见的色素沉着病.笔者自1997年以来,应用中西医结合治疗黄褐斑57例,用内服、外用,并用中药离子喷雾,有效率达100%,随访3个月～14个月,证实治疗效果稳定.一、临床资料本组病例57例,均为女性,年龄最大47岁,最小22岁,平均年龄33.2岁,未婚18例,已婚39例,其中2例伴有面部扁平疣,4例伴有座疮(活动期),5例伴有不同程度的雀斑.二、治疗方法一般黄褐斑用中医论证常与脾气不足、肝气郁滞、风邪痰饮有关,可以分为脾虚、阴虚、肝郁3种类型.笔者按其不同的症状给予不同的处方.1.内服方法(1)脾虚型组方:沙参15g、黄芪15g、获苓12g、冬瓜仁3g、生薏仁30g、川穹6g、柴胡10g、甘草6g、升麻6g.每日一剂,复渣再煎,分2次服.(2)阴虚型组方:菟丝子15g、女贞子15g、生熟地各15g、当归10g、白芍10g、泽泻10g、旱莲草10g、何首乌10g、枸杞子10g.每日一剂,复渣再煎,分2次服.(3)肝郁型组方:山萸肉10g、淮山药10g、陈皮10g、丹皮10g、生熟地各15g、白芍10g、茯苓10g、荆芥10g、防风10g.每日一剂,复渣再煎,分2次服.(4)西药内服:口服维生素C片剂300mg,1日3次2维生素E丸0.1g,1日3次;止血环酸片剂250mg,1日3次.2 外用方法(1)用柴胡、当归、川芎、沙参、防风水煎,多次过滤,取 Chloasma is a common and localized light brown or dark brown common pigmented disorder that occurs in the facial area. Since 1997, 57 cases of melasma have been treated with combination of Chinese and Western medicine. Chinese medicine ion spray, the effective rate of 100%, followed up for 3 months to 14 months, the treatment proved stable.A clinical data 57 cases of this group of patients, all women, the oldest 47 years old, the youngest 22 years old, with an average age of 33.2 Old, unmarried 18 cases, 39 married, of which 2 cases were accompanied by facial flat wart, 4 cases with acne (active), 5 cases with varying degrees of freckles. Second, the general treatment of melasma with Chinese medicine Evidence often associated with lack of temper, liver qi stagnation, Feng Xie Tan drink, can be divided into spleen deficiency, yin deficiency, liver depression three types of the author according to their different symptoms are given different prescriptions.1 oral method (1) Group prescription: Radix 15g, astragalus 15g, obtained Ling 12g, melon kernel 3g, raw barley 30g, Chuan dome 6g, Bupleurum 10g, licorice 6g, cohosh 6g. (2) Yin-type group prescription: dodder 15g, Ligustrum lucidum 15g, 15g, 15g Angelica, Angelica 10g, white peony root 10g, Alisma 10g, Eclipta 10g, the first 10g, medlar 10g. One day, complex residue and then fried, divided into 2 times service. (3) liver depression type group: cornus 10g, yam 10g, dried tangerine peel 10g, Dan leather 10g, , White peony root 10g, Poria 10g, Nepeta 10g, wind 10g. A daily dose of complex residue and then decoction, divided into 2 times service. (4) Western medicine oral: oral vitamin C tablets 300mg, 1 3 times 2 vitamin E Pill 0.1g, on the 1st 3 times; hemostatic ring acid tablets 250mg, 3 times on the 1st .2 external methods (1) with Bupleurum, Angelica, Chuanxiong, Radix, windbreak decoction, multiple filtration, take