Abstract:Alopecia areata is a non-cicatricial inflammatory alopecia. Studies have shown that psychological stress is closely related to the occurrence and development of alopecia areata. There are similarities and commonalities between the theory of emotional pathogenicity in traditional Chinese medicine and psychological stress in modern medicine. The internal injury of seven emotions and the disorder of qi and blood are important factors of alopecia areata. Based on the theory of emotional pathogenicity in traditional Chinese medicine, this paper discusses the effect of psychological stress on the mechanism of alopecia areata from three aspects: neuro-endocrino-immune network disorder, oxidative stress and inflammatory response, scalp microcirculation disorder, and emphasizes the importance of individualized psychological intervention in the treatment of alopecia areata, with a view to providing new ideas for clinical diagnosis and treatment of alopecia areata.
田彩蝶 刘青武 杨顶权 李双 段欣欣. 基于情志致病理论探讨心理应激对斑秃的作用机制的研究进展[J]. 中国医药导报, 2023, 20(24): 40-43.
TIAN Caidie LIU Qingwu YANG Dingquan LI Shuang DUAN Xinxin. Research progress on the mechanism of psychological stress on alopecia areata based on the theory of emotional pathogenicity. 中国医药导报, 2023, 20(24): 40-43.
[1] Sterkens A,Lambert J,Bervoets A. Alopecia areata:a review on diagnosis,immunological etiopathogenesis and treatment options [J]. Clin Exp Med,2021,21(2):215-230.
[2] Lee HH,Gwillim E,Patel KR,et al. Epidemiology of alopecia areata,ophiasis,totalis,and universalis: A systematic review and meta-analysis [J]. J Am Acad Dermatol,2020,82(3):675-682.
[3] Wang H,Pan L,Wu Y. Epidemiological Trends in Alopecia Areata at the Global,Regional,and National Levels[J]. Front Immunol,2022,13:874677.
[4] 中华医学会皮肤性病学分会毛发学组.中国斑秃诊疗指南(2019)[J].临床皮肤科杂志,2020,49(2):69-72.
[5] Zhou C,Li X,Wang C,et al. Alopecia Areata:an Update on Etiopathogenesis,Diagnosis,and Management[J]. Clin Rev Allergy Immunol,2021,61(3):403-423.
[6] Liu LY,King BA,Craiglow BG. Health-related quality of life (HRQoL)among patients with alopecia areata (AA):a systematic review [J]. J Am Acad Dermatol,2016,75(4):806- 812.
[7] 王欣扬,吴承艳.中医脱发病证源流考略[J].中华中医药杂志,2021,36(5):2485-2489.
[8] 和靖,李炜弘,李晗,等.从情志应激探析斑秃的治法治则[J].世界科学技术-中医药现代化,2020,22(12):4314- 4318.
[9] 王明明,蔡圣朝,黄雪珍.蔡圣朝治疗斑秃经验[J].中医学报,2018,33(5):790-792.
[10] 任非非,郭蓉娟.心身医学视角下脑小血管病与情志的相关性初探[J].中华中医药杂志,2022,37(1):95-99.
[11] 顾思梦,余蕾,王福顺,等.中医情志的现代心理学探究[J].世界科学技术-中医药现代化,2016,18(4):709-713.
[12] Pondeljak N,Lugovi■-Mihi■ L. Stress-induced Interaction of Skin Immune Cells,Hormones,and Neurotransmitters [J]. Clin Ther,2020,42(5):757-770.
[13] Bertolini M,McElwee K,Gilhar A,et al. Hair follicle immune privilege and its collapse in alopecia areata [J]. Exp Dermatol,2020,29(8):703-725.
[14] 赵敏,张纪岩.慢性心理应激与免疫[J].中国免疫学杂志,2017,33(7):961-966.
[15] Gilhar A,Paus R,Kalish RS. Lymphocytes,neuropeptides,and genes involved in alopecia areata [J]. J Clin Invest,2007,117(8):2019-2027.
[16] Theoharides TC. Neuroendocrinology of mast cells:Challenges and controversies [J]. Exp Dermatol,2017,26(9):751-759.
[17] Yamanaka-Takaichi M,Mizukami Y,Sugawara K,et al. Stress and Nasal Allergy:Corticotropin-Releasing Hormone Stimulates Mast Cell Degranulation and Proliferation in Human Nasal Mucosa [J]. Int J Mol Sci,2021,22(5):2773.
[18] O’Sullivan JDB,Peters EMJ,Amer Y,et al. The impact of perceived stress on the hair follicle:Towards solving a psychoneuroendocrine and neuroimmunological puzzle [J]. Front Neuroendocrinol,2022,66:101008.
[19] Zhang X,Yu M,Yu W,et al. Development of alopecia areata is associated with higher central and peripheral hypothalamic-pituitary-adrenal tone in the skin graft 81 induced C3H /HeJ mouse model [J]. J Invest Dermatol,2009, 129 (6):1527-1538.
[20] ■ztürk P,Ar?覦can■,Kuruta■ EB,et al. Oxidative Stress Bio- markers and Adenosine Deaminase over the Alopecic Area of the Patients with Alopecia Areata [J]. Balkan Med J,2016, 33(2):188-192.
[21] Acharya P,Mathur MC. Oxidative stress in alopecia areata:a systematic review and meta-analysis [J]. Int J Dermatol,2020,59(4):434-440.
[22] 刘楠,马占波,傅文青,等. 慢性束缚应激对小鼠毛囊细胞生长周期的影响[J].中国临床心理学杂志,2012(6):769-772.
[23] Wei L,Li Y,Tang W,et al. Chronic Unpredictable Mild Str- ess in Rats Induces Colonic Inflammation [J]. Front Physiol,2019,10:1228.
[24] Tomaszewska K,Koz?覥owska M,Kaszuba A,et al. Increased Serum Levels of IFN-γ,IL-1β,and IL-6 in Patients with Alopecia Areata and Nonsegmental Vitiligo [J]. Oxid Med Cell Longev,2020,2020:5693572.
[25] Zhou N,Fan W,Li M. Angiogenin is expressed in human dermal papilla cells and stimulates hair growth [J]. Arch Dermatol Res,2009,301(2):139-149.
[26] Simonetti O,Lucarini G,Bernardini ML,et al. Expression of vascular endothelial growth factor,apoptosis inhibitors (survivin and p16)and CCL27 in alopecia areata before and after diphencyprone treatment:an immunohistochemical study [J]. Br J Dermatol,2004,150(5):940-948.
[27] 瞿锐,刘久波,唐吉云.斑秃患者血液流变性及甲襞微循环变化的研究[J].中国微循环,2004,8(2):109-110.
[28] 吴相锋,来静,吴相春,等.慢性束缚心理应激对大鼠血管内皮结构和功能的影响[J].疑难病杂志,2011,10(2):123-125.
[29] 吴祥岷,郑心.郑心柴胡舒肝散治疗中青年斑秃[J].实用中医内科杂志,2018,32(5):4-6.
[30] 赵杭,赵东瑞,陶茂灿.陶茂灿教授从肝论治成年女性斑秃经验[J].浙江中医药大学学报,2021,45(10):1113- 1116.
[31] Hussain ST,Mostaghimi A,Barr PJ,et al. Utilization of Mental Health Resources and Complementary and Alternative Therapies for Alopecia Areata:A U.S. Survey [J]. Int J Trichology,2017,9(4):160-164.
[32] 刘奇方,彭达意,林汉彪,等.斑秃脱发性疾病患者睡眠质量状况调查及心理干预效果观察[J].沈阳医学院学报,2018,20(2):116-118,121.
[33] Han JJ,Li SJ,Joyce CJ,et al. Association of resilience and perceived stress in patients with alopecia areata:A cross- sectional study [J]. J Am Acad Dermatol,2022,87(1):151- 153.