本文選題：共聚焦激光掃描顯微鏡 + 面部白癜風(fēng)�。� 參考：《浙江中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的①應(yīng)用共聚焦激光掃描顯微鏡(CLSM)觀察0.1%他克莫司軟膏治療面部白癜風(fēng)的藥物療效。②應(yīng)用CLSM觀察維阿露溶液治療面部白癜風(fēng)的藥物療效。 方法①收集我院皮膚科門(mén)診35例面部白癜風(fēng)患者,給予0.1%他克莫司軟膏,每日2次,連續(xù)用藥12個(gè)月,每1-2月隨訪1次,(隨機(jī)選取20例患者,前4個(gè)月,每1-2周隨訪1次)；進(jìn)行CLSM掃描和數(shù)碼相機(jī)拍照,并及時(shí)記錄掃描結(jié)果。②收集我院皮膚科門(mén)診20例面部白癜風(fēng)患者,給予外用維阿露溶液,每天2次,并在用藥后30分鐘局部日光浴10分鐘。連續(xù)用藥4個(gè)月,每1-2周隨訪1次,進(jìn)行CLSM掃描和數(shù)碼相機(jī)拍照,并及時(shí)記錄掃描結(jié)果。 結(jié)果①他克莫司中,痊愈11例,顯效7例,好轉(zhuǎn)6例,無(wú)效11例,有效率為68.57%顯效率為51.43%。35例患者中,肉眼評(píng)估皮損出現(xiàn)大面積復(fù)色的患者中,CLSM下白斑區(qū)基底層都可見(jiàn)大量樹(shù)突狀、折光明亮的黑素細(xì)胞或大量色素顆粒、色素環(huán)。肉眼評(píng)估皮損無(wú)任何復(fù)色的患者中,部分患者CLSM下白斑區(qū)基底層未見(jiàn)樹(shù)突狀、折光明亮的黑素細(xì)胞；然部分患者CLSM下可見(jiàn)數(shù)量不定的樹(shù)突狀黑素細(xì)胞。在選取的20例患者中,CLSM評(píng)估的平均起效時(shí)間為(4.29±2.84)周,明顯優(yōu)于肉眼評(píng)估的平均起效時(shí)間為(7.40±3.24)周,兩者有統(tǒng)計(jì)學(xué)差異(t=2.50,P0.05)。根據(jù)CLSM所觀察的結(jié)果,總結(jié)了黑素細(xì)胞三種分布模式,邊緣型：白斑邊緣區(qū)域基底層可見(jiàn)少許樹(shù)突狀黑素細(xì)胞；毛囊周?chē)停喊装邊^(qū)基底層毛囊周?chē)梢?jiàn)數(shù)量不定的樹(shù)突狀黑素細(xì)胞；彌漫型：白斑區(qū)基底層多個(gè)毛囊及其毛囊間可見(jiàn)大量樹(shù)突狀黑素細(xì)胞或色素顆粒、色素環(huán)出現(xiàn)。②維阿露中,CLSM的平均起效效時(shí)間為(4.53±2.47)周,也明顯優(yōu)于肉眼評(píng)估的平均起效時(shí)間為(9.83±2.76)周,兩者有統(tǒng)計(jì)學(xué)差異(t=5.26,P0.05)。 結(jié)論CLSM可以作為白癜風(fēng)外用藥物療效觀察的有效手段,有助于增強(qiáng)患者用藥信心,更適合科學(xué)研究。CLSM下白癜風(fēng)復(fù)色時(shí)期存在邊緣型、毛囊周?chē)汀浡腿N黑素細(xì)胞的分布模式。
[Abstract]:Objective 1 to observe the therapeutic effect of 0.1% tacrolimus ointment on facial vitiligo by confocal laser scanning microscope (CLSM). Methods (1) 35 patients with vitiligo were treated with 0.1% tacrolimus ointment twice a day for 12 months and followed up once every 1-2 months. (20 patients were randomly selected for the first 4 months and followed up once every 1-2 weeks). CLSM scanning and digital camera were performed, and the scanning results were recorded in time. 2. Twenty patients with vitiligo were collected from our dermatology outpatient department. The patients were given vitiligo solution twice a day, and after 30 minutes local sunbathing for 10 minutes. The patients were followed up once every 1-2 weeks for 4 months. CLSM scan and digital camera were taken and the scan results were recorded in time. Results (1) in tacrolimus, 11 cases were cured, 7 cases were markedly effective, 6 cases were improved, 11 cases were ineffective, the effective rate was 68.57% and the effective rate was 51.43.35 cases. A large number of dendritic cells or a large number of pigment granules and pigment rings were found in the basal layer of the leukoplakia area under CLSM in patients whose lesions were evaluated by naked eye. No dendritic cells were found in the basal layer of leukoplakia in some of the patients who were not stained by the naked eye, while in some patients, the number of dendritic melanocytes in the subbasal layer of the leukoplakia was not seen. The mean onset time of CLSM evaluation was (4.29 鹵2.84) weeks, which was significantly better than that of naked eye assessment (7.40 鹵3.24) weeks. There was statistical difference between the two groups (t 2.50 P 0.05). According to the results observed by CLSM, three distribution patterns of melanocytes were summarized: a few dendritic melanocytes were found in the basal layer of the marginal region of leukoplakia; Perifollicular type: a large number of dendritic melanocytes are seen around the basal follicle of the white spot area, and a large number of dendritic melanocytes or pigment particles are found between the multiple hair follicles of the basal layer of the white spot area and their hair follicles. The average effective time of CLSM was (4.53 鹵2.47) weeks, which was significantly better than that of naked eye evaluation (9.83 鹵2.76) weeks. There was statistical difference between the two groups (t 5.26P). Conclusion CLSM can be used as an effective method to observe the curative effect of external medicine for vitiligo, which is helpful to enhance patients' confidence in medication, and is more suitable for the scientific study of marginal type and perifollicular type of vitiligo in the period of color recovery of vitiligo under CLSM. Distribution patterns of diffuse melanocytes.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R758.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 于海紅,張?jiān)滦?復(fù)方卡力孜然酊治療白癜風(fēng)療效觀察[J];國(guó)外醫(yī)學(xué)(中醫(yī)中藥分冊(cè));2005年04期

2 李劍;張勇;傅雯雯;林曉;蘇麗娜;項(xiàng)蕾紅;鄭志忠;;外用他克莫司軟膏治療白癜風(fēng)臨床觀察[J];臨床皮膚科雜志;2007年12期

3 李河山;李坤;;復(fù)方卡力孜然酊治療白癜風(fēng)療效觀察[J];臨床皮膚科雜志;2008年02期

4 吳文育,楊勤萍,陳美娟,陳仁貴,顧軍,王學(xué)民,朱光斗,鄭志忠;復(fù)方卡力孜然酊治療白癜風(fēng)[J];中華皮膚科雜志;2005年04期

，

本文編號(hào)：2060180