中药外洗法治疗雄激素性脱发的研究进展

Research Progress on External Washing Therapy with Chinese Medicine for Androge⁃ netic Alopecia

摘要:

中药外洗法在治疗雄激素性脱发（AGA） 中展现出良好的应用前景。本文基于中医“外治之理即内治之理”的核心思想，梳理了AGA的病因病机与中药外洗的治法源流。通过文献研究从单味中药外洗，辨证复方外洗（针对湿热内蕴、血虚风燥、肝肾不足、血热风燥等证型），中药外洗与西药外用、针刺、内服用药、生活干预等多手段联合治疗3个层面综述其临床研究进展。结果显示三者均可改善脱发、毛发稀疏、头皮油脂分泌过多、头皮瘙痒等症状，联合治疗方案较单一疗法在提升有效率、降低不良反应、兼顾整体方面更具优势。其作用机制涉及抗炎抗菌、调节皮脂分泌、调节头皮微循环、调控毛囊微环境等。本文同时分析了当前诊疗标准不统一、辨证复方分布不均等问题，提出未来应加强高质量临床研究、推动制剂改良与标准化建设，以发挥中西医结合诊疗优势。

Abstract:

Abstract： External washing therapy with Chinese medicine has shown promising prospects in the treatment of androgenetic alopecia （AGA）. Grounded in the core traditional Chinese medicine （TCM） principle that "the principles of external treatment are the same as those of internal treatment，" this paper reviews the etiology and pathogenesis of AGA as well as the historical development of Chinese medicine external washing therapies. Through a literature review， clinical research progress is summarized from three perspectives：（1） single Chinese herbal medicine；（2） syndromebased compound prescriptions （targeting syndromes such as damp-heat internal accumulation， blood deficiency with wind-dryness，deficiency of liver and kidney，and blood heat with wind-dryness）；and （3） combined multi-modality therapies， including integration with external use of western medications， acupuncture， oral administration， and lifestyle interventions. The results indicate that all three approaches can alleviate symptoms such as hair loss， sparse hair， excessive scalp sebum secretion， and scalp itching. Combined treatment regimens demonstrate superior advantages over monotherapy in terms of improving efficacy rates， reducing adverse reactions， and addressing the patient holistically. The mechanisms of action involve anti-inflammatory and antibacterial effects，regulation of sebum secretion，improvement of scalp microcirculation，and modulation of the hair follicle microenvironment. This paper also analyzes current issues，including the lack of standardized diagnostic and therapeutic criteria and uneven distribution of syndrome-differentiated compound prescriptions. It proposes that future efforts should strengthen high-quality clinical research， promote formulation improvement and standardization， and fully leverage the advantages of integrated traditional Chinese and western medicine in diagnosis and treatment.