【摘要】：目的:1、評(píng)估NB-UVB聯(lián)合硫辛酸治療散發(fā)型白瘢風(fēng)的臨床療效及安全性。2、評(píng)估NB-UVB、C02點(diǎn)陣激光聯(lián)合外用皮質(zhì)類固醇激素乳膏治療肢端型白癜風(fēng)的臨床療效及安全性。方法:1、招募散發(fā)型白癜風(fēng)患者,采用隨機(jī)、雙盲研究方法,將患者分為A、B兩組。A組:NB-UVB(3次/周)+硫辛酸片(300mg/日);B組:NB-UVB(3次/周)+安慰劑(1片/日);療程6個(gè)月,試驗(yàn)結(jié)束后評(píng)價(jià)治療療效。2、招募肢端型白癜風(fēng)患者,采用隨機(jī)、自身對(duì)照研究方法,將研究對(duì)象的對(duì)稱性皮損隨機(jī)分成A、B兩組。A組:NB-UVB聯(lián)合點(diǎn)陣激光及外用鹵米松/三氯生乳膏;B組:NB-UVB聯(lián)合外用鹵米松/三氯生乳膏。點(diǎn)陣激光每2周一次,NB-UVB每周3次,鹵米松/三氯生乳膏每天兩次,療程12周,試驗(yàn)結(jié)束后評(píng)價(jià)治療療效。結(jié)果:1、NB-UVB聯(lián)合硫辛酸治療散發(fā)型白瘢風(fēng)試驗(yàn)中。治療3月A組與B組顯效率分別為42.9%(3/7),12.5%(1/8);有效率分別為85.7%(6/7),75%(6/8)。顯效率(P=0.282,P0.05)及有效率(P=1.0,P0.05)均無(wú)明顯統(tǒng)計(jì)學(xué)差異。治療6月A組與B組顯效率分別為57.1%(4/7),50%(4/8);有效率分別為100%(7/7),75%(6/8)。顯效率(P=1.0,P0.05)及有效率(P=0.467,P0.05)均無(wú)明顯統(tǒng)計(jì)學(xué)差異。不同部位復(fù)色率不同,軀干部位復(fù)色率較高:A組52.8±38.4%,B組40.4±29.7%;肢端復(fù)色率較低:A組10.5± 13.7%,B組0.33±0.81%。治療過(guò)程中均未見(jiàn)明顯嚴(yán)重不良反應(yīng)。2、NB-UVB、點(diǎn)陣激光聯(lián)合外用皮質(zhì)類固醇激素乳膏治療肢端型白癜風(fēng)試驗(yàn)中,A組與B組顯效率分別為31.25%(5/16),12.5%(2/16);有效率分別為50%(8/16),31.25%(5/16)。顯效率(P=0.394,P0.05)及有效率(P=0.473,P0.05)均無(wú)明顯統(tǒng)計(jì)學(xué)差異。A組開(kāi)始復(fù)色出現(xiàn)在治療2.67± 1周,B組為3.2±1.79周,滿意度評(píng)分A組5.29±2.70,B組4.0±2.18。治療過(guò)程中均未出現(xiàn)嚴(yán)重不良反應(yīng)。結(jié)論:1、NB-UVB單一治療散發(fā)型白癜風(fēng)安全有效,治療6月顯效率及有效率分別為50%及75%。相同療程下聯(lián)合硫辛酸治療組顯效率及有效率均高于單一對(duì)照組,但兩者療效、顯效率及有效率比較均無(wú)明顯統(tǒng)計(jì)學(xué)差異,考慮可能為病例數(shù)過(guò)少,需擴(kuò)大樣本量進(jìn)一步研究,該研究亦發(fā)現(xiàn)不同部位NB-UVB治療療效不同,軀干復(fù)色率較高,肢端最低。2、NB-UVB、C02點(diǎn)陣激光及外用皮質(zhì)類固醇激素乳膏治療肢端型白癜風(fēng)安全有效,點(diǎn)陣激光治療組顯效率及有效率優(yōu)于對(duì)照組,開(kāi)始復(fù)色時(shí)間短于對(duì)照組,患者滿意度高于對(duì)照組,但兩者療效、顯效率及有效率均無(wú)明顯統(tǒng)計(jì)學(xué)差異,考慮可能為病例數(shù)過(guò)少,需進(jìn)一步擴(kuò)大樣本量研究。對(duì)常規(guī)治療無(wú)效的肢端型患者可嘗試該治療方案。
[Abstract]:Objective: 1. To evaluate the clinical efficacy and safety of NB-UVB combined with lipoic acid in the treatment of sporadic leukoplakia. Two groups. A group: NB-UVB (3 times a week) + lipoic acid tablets (300 mg a day); B group: NB-UVB (3 times a week) + placebo (1 tablet a day); 6 months of treatment, after the end of the trial to evaluate the efficacy of treatment. 2, recruited patients with acral vitiligo, using a randomized, self-controlled study method, the symmetrical lesions of the subjects were randomly divided into A, B groups. A group: NB-UVB combined with lattice laser. Group B: NB-UVB combined with halometasone/triclosan cream. Dot-matrix laser once every two weeks, NB-UVB three times a week, halometasone/triclosan cream twice a day for 12 weeks. The therapeutic effect was evaluated after the trial. Results: 1. NB-UVB combined with lipoic acid in the treatment of sporadic leucorrhea. The efficiencies were 42.9% (3/7), 12.5% (1/8), 85.7% (6/7) and 75% (6/8), respectively. There was no significant difference between the efficiencies (P = 0.282, P 0.05) and (P = 1.0, P 0.05). The efficiencies of group A and group B were 57.1% (4/7), 50% (4/8), 100% (7), 75% (6/8) and 75% (P = 1.0, P = 0.467, P = 0.05). There was no significant difference between the two groups in the color change rate of different parts. The color change rate of trunk was higher in group A (52.8 65507 In the vitiligo test, the effective rates of group A and group B were 31.25% (5/16) and 12.5% (2/16), 50% (8/16) and 31.25% (5/16), respectively. There was no significant difference between the effective rates (P = 0.394, P 0.05) and the effective rates (P = 0.473, P 0.05). Conclusion: 1. NB-UVB alone is safe and effective in the treatment of sporadic vitiligo, and the effective rate is 50% and 75% in 6 months, respectively. The study also found that NB-UVB in different parts of the body had different therapeutic effects, with a higher rate of trunk discoloration and the lowest limb discoloration. NB-UVB, C02 lattice laser and topical corticosteroid cream were safe and effective in the treatment of acral vitiligo. The effective rate is better than that of the control group, the beginning of discoloration is shorter than that of the control group, and the patients'satisfaction is higher than that of the control group.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R758.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 龔洋洋;陳];;光療在白癜風(fēng)治療中的臨床應(yīng)用[J];國(guó)際皮膚性病學(xué)雜志;2016年05期

2 武海恩;劉永斌;單云輝;楊雅方;王瑩;馬天琪;秦朋;崔亮;姚放;李鐵男;;單頻準(zhǔn)分子光治療進(jìn)展期局限型白癜風(fēng)療效評(píng)價(jià)[J];中華皮膚科雜志;2015年04期

3 王曉紅;趙正娟;趙欣美;;點(diǎn)陣激光聯(lián)合紫外線光療治療白癜風(fēng)的臨床效果[J];中華醫(yī)學(xué)美學(xué)美容雜志;2014年05期

4 何紫薇;王蕾;劉林燕;賴梅生;;白癜風(fēng)白斑面積測(cè)量方法現(xiàn)狀與展望[J];中國(guó)皮膚性病學(xué)雜志;2012年09期

5 ;白癜風(fēng)臨床分型及療效標(biāo)準(zhǔn)(2003年修訂稿)[J];中華皮膚科雜志;2004年07期

，

本文編號(hào)：2250293