白驳酊联合308 nm准分子激光治疗肝肾不足型白癜风的临床研究

Clinical Study of Baibo Tincture Combined with 308 nm Excimer Laser in the Treatment of Vitiligo with Liver and Kidney Deficiency

关键词:  白癜风  白驳酊  308 nm准分子激光  肝肾不足

Key words:  vitiligo  baibo tincture  308 nm excimer laser  deficiency of liver and kidney

摘要:

目的 观察白驳酊联合308 nm准分子激光治疗肝肾不足型白癜风的临床疗效。方法 选取浙江省台州医院2017年3月—2019年3月期间接收的128例肝肾不足型白癜风患者，按随机数字表法分为观察组和对照组，各64例。对照组采用308 nm准分子激光进行治疗，观察组在此基础上外用白驳酊，2组疗程均为12周。观察2组疗效并对比分析中医症候、DLQI评分、色素积分、皮损面积、首次复色时间并检测碱性成纤维细胞生长因子（basic fibroblast growth factor，bFGF）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、干扰素-γ（interferon-γ，IFN-γ）及CXC趋化因子配体10（CXC chemokine ligand 10，CXCL10）水平，记录治疗期间不良反应发生情况，同时进行为期1年的随访，比较复发率。结果 治疗后观察组总有效率85.94%、优效率65.63%均高于对照组的78.13%和45.31%（P<0.05）。观察组中医症候、DLQI评分低于对照组（P<0.05）；色素积分、皮损面积低于对照组（P<0.05），且首次复色时间短于对照组（P<0.05）；bFGF水平高于对照组（P<0.05），TNF-α、CXCL10及IFN-γ水平低于对照组（P<0.05）。观察组总复发率为4.69%，低于对照组的18.75%（P<0.05）。结论 应用白驳酊联合308 nm准分子激光治疗，可有效改善肝肾不足型白癜风患者临床症状，调节bFGF、TNF-α、CXCL10、IFN-γ水平，提高患者生活质量，远期疗效佳，值得临床应用。

Abstract:

OBJECTIVE To observed the clinical efficacy of baibo tincture combined with 308 nm excimer laser in the treatment of vitiligo with liver and kidney deficiency. METHODS A total of 128 patients with vitiligo(traditional Chinese medicine syndrome of deficiency of liver and kidney) received in Taizhou Hospital of Zhejiang Province from March 2017 to March 2019 were divided into observation group and control group according to random number table method, with 64 cases in each group. The control group was treated with 308 nm excimer laser, and the observation group was treated with baibo tincture on the basis of this, and the treatment courses of both two groups were 12 weeks. The curative effect of the two groups was observed, and the traditional Chinese medicine symptoms, DLQI score, pigmentation score, skin lesion area, and first color rendering time were compared and analyzed. Meanwhile, the levels of basic fibroblast growth factor(bFGF), tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), CXC chemokine ligand 10(CXCL10) were detected. The occurrence of adverse effects during treatment was recorded while a one-year follow-up was conducted to compare recurrence rates. RESULTS After treatment, the total effective rate and excellent efficiency of the observation group were 85.94% and 65.63% higher than the control group 78.13% and 45.31%(P<0.05). Compared with the control group, traditional Chinese medicine symptoms and DLQI scores in the observation group were lower(P<0.05). The pigmentation integral and skin lesion area in the observation group were lower(P<0.05), and the time of first color restoration was shorter(P<0.05). The levels of bFGF in the observation group were higher(P<0.05), and the levels of TNF-α, CXCL10 and IFN-γ were lower(P<0.05). The overall recurrence rate was 4.69% in the observation group, which was lower than the rate of 18.75% in the control group(P<0.05). CONCLUSION Baibo tincture combined with 308 nm excimer laser treatment can effectively improve the clinical symptoms of vitiligo with liver and kidney deficiency patients, regulate the levels of bFGF, TNF-α, CXCL10, IFN-γ, improve the quality of life of patients, with good long-term efficacy, which is worthy of clinical application.