Principles of Differentiation and Prescription for Vitiligo in Traditional Chinese Medicine Based on a Literature Investigation

Abstract

Background/Aims: Vitiligo is a common disorder of depigmented skin. Traditional Chinese medicine (TCM) has been proved to be effective for the treatment of vitiligo, but the standard differential syndromes and effective formulas and herbs are still controversial. The aim of this study is to analyze the principles of differentiation and prescription in treating vitiligo in TCM based on a large-scale literature investigation. Methods: Articles about vitiligo treatment using TCM were searched in three databases, including China National Knowledge Infrastructure (1979-2014), China Science Periodical Database (1990-2014) and PubMed (1984-2014). The frequency of differential syndromes, formulas and herbs was analyzed using a metrological method and logistic multiple regression analysis. Results: Five syndromes account for the major differential categories in vitiligo: liver and kidney deficiency, Qi stagnation and blood stasis, liver depression and Qi stagnation, disharmony between Qi and blood, and blood conflicting with wind. The common formula prescriptions most frequently used were Tong-Qiao-Huo-Xue decoction, Xiao-Yao powder and Si-Wu decoction. The most frequently prescribed herbs were Angelica sinensis, Ligusticum wallichii, Tribulus terrestris, Polygonum multiflorum, Fructus psoraleae, Radix Paeoniae Rubra, Rehmannia glutinosa, Glossy Privet Fruit, Eclipta alba, Salvia miltiorrhiza, Liquorice, and Angelica dahurica, which shows that the treatment principles of vitiligo are tonifying the liver and kidney, activating blood and expelling wind. Conclusion: The most frequent syndromes of vitiligo are liver and kidney deficiency, Qi stagnation and blood stasis. Most TCM doctors prefer prescribing herbs with efficacy in tonifying the liver and kidney, activating blood and expelling wind in treating vitiligo.