What are the correct treatment principles for vitiligo

Normally we rarely see patients with vitiligo, simply because vitiligo does not appear in particularly obvious parts of the skin, usually on the limbs, back, chest, and some more serious ones will appear on the scalp and face. Vitiligo is an acquired skin disease in which the epidermis loses its pigment. Oval and round spots can be clearly seen on the skin with clear boundaries, and can be separated from normal skin. For treatment, a combination of internal and external methods can be used. It is more effective to use both Chinese and Western medicine, because vitiligo is mostly caused by insufficient Qi and blood, and weak Qi and blood. It is a personal physical problem, and it is necessary to improve the patient's body resistance, increase immunity, and replenish Qi and blood to achieve the treatment effect.

The summary of TCM treatment of vitiligo is as follows:

1. Internal and external treatment

Traditional Chinese medicine usually uses the method of syndrome differentiation and treatment to treat vitiligo. Generally speaking, due to the different physical conditions of each patient, the causes of vitiligo are different, and therefore the treatment methods are also different.

1. Method of replenishing qi and blood

The patient suffers from deficiency of Qi and blood, and is attacked by wind evil, causing disharmony between the Ying and Wei systems. Most of them are in the stable stage of vitiligo, with the main symptoms of light white spots, accompanied by fatigue, pale complexion, pale tongue, and deep, thin and astringent pulse.

The treatment should be to replenish qi and blood, and dispel wind and harmonize blood.

Shang et al. [1] used a homemade Xiaobai Recipe II (15 g Codonopsis pilosula, 20 g Rhizoma Coptidis, 10 g Atractylodes macrocephala, 20 g Poria cocos, 20 g Salvia miltiorrhiza, 10 g Carthamus tinctorius, 10 g Angelica sinensis, 10 g Saposhnikovia divaricata, 20 g Tribulus terrestris, 20 g Polygonum multiflorum, 6 g Amomum villosum, 10 g Lablab dahliae, 10 g Dioscorea opposita) decocted in water for oral administration, 1 dose per day, twice a day. Children should use a reduced dosage. If white spots occur on the face, add 10 grams of bupleurum or 10 grams of angelica dahurica, add 10 grams of angelica dahurica or 10 grams of Chuanxiong on the head, add 20 grams of Pueraria lobata on the neck and back; add 10 grams of Dipsacus asper to the waist; add 10 grams of Curcuma longa to the upper limbs; add 10 grams of Achyranthes bidentata to the lower limbs; add 10 grams of Clematidis for widespread occurrence; add 10 grams each of Prunus mume and Schisandra chinensis for progressive stage, etc. At the same time, apply nitrogen mustard alcohol or Psoralea corylifolia tincture externally, 2 to 3 times a day. A total of 84 patients with vitiligo were treated, 17 of whom were cured, with an overall effective rate of 78.57%.

2. Method of nourishing liver and kidney

The patient suffers from liver and kidney yin deficiency, disharmony of qi and blood, and malnutrition of the skin. The course of the disease is long, and the white spots may be localized or widespread. The hair turns gray, the skin becomes dry, and there is dizziness and tinnitus. Weak waist and knees, pale red tongue with little coating, and weak pulse.