Article
LIU Changhua, ZHANG Meina, AN Caixia, LI Shiru, YAO Dong
Objective: To investigate the role and mechanism of tranexamic acid combined with insomnia group cognitive-behavioral therapy to improve relevant indicators in patients with melasma combined with insomnia. Method: A total of 114 patients with melasma combined with insomnia who attended the Fifth Hospital of Xiamen from January 2022 to June 2024 were selected for the study, and were divided into Group A, Group B, and Group C using the random number table method, with shedding cases in each group, and finally 31 cases were included in Group A, 30 cases in Group B, and 32 cases in Group C. Group A was treated with insomnia group cognitive-behavioral (GCBT) therapy, group B with oral tranexamic acid tablets, and group C with tranexamic acid combined with insomnia group cognitive-behavioral therapy. The scores of melasma and insomnia-related scales were compared before and after treatment, and the clinical efficacy of the three groups was evaluated, and the levels of sex hormones, serum oxidative stress indicators and inflammatory factors were compared among the three groups. Result: After 3 months of treatment, the melasma area and severity index (MASI) and Pittsburgh sleep quality index (PSQI) decreased in all three groups compared with the pre-treatment period, and the scores of group C were lower than those of group A and group B, and the difference was statistically significant (P<0.05). After treatment, sex hormone levels [estradiol (E2), progesterone (P), follicle-stimulating hormone (FSH)] and inflammatory factors decreased in the three groups compared with those before treatment, and the decrease in Group C was more significant, with statistically significant differences (P<0.05). After treatment, the serum oxidative stress indexes of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the three groups were higher than those before treatment, and the levels of malondialdehyde (MDA) and lipid peroxidation (LOP) were lower than those before treatment, and the oxidative stress capacity of group C was improved more obviously, and the difference was statistically significant (P<0.05).The total effective rate of treatment in group C was higher than that in group A and group B, and the difference was statistically significant (P<0.05). Conclusion: Tranexamic acid combined with insomnia group cognitive-behavioral therapy is effective in treating patients with melasma combined with insomnia, and can significantly improve the area and severity of melasma as well as the sleep quality of insomnia patients.