308nm準分子光聯(lián)合UVA1治療白癜風的臨床研究
發(fā)布時間：2019-01-19 13:52
【摘要】：目的:近年來國內(nèi)外關于308nm準分子激光或UVA治療白癜風的文獻報道有很多,但關于308nm準分子光或UVA1治療白癜風的研究相對較少,且研究多集中在激光與外用藥聯(lián)合治療白癜風方面。尚未見到UVA1和308nm準分子光聯(lián)合治療白癜風的文獻報道。本研究將UVA1與308nm準分子光聯(lián)合作用于白癜風患者,與UVA1、308nm準分子光單獨治療白癜風的療效相比較,探討聯(lián)合療法是否優(yōu)于單一的UVA1或308nm準分子光光療。方法:隨機入選30例白癜風患者,每例患者選取頭面頸部、軀干、四肢指端對稱或者相鄰部位的白斑3處,共90處。將皮損隨機分入308nm準分子光組、UVA1組和聯(lián)合治療組,每組30處。308nm準分子光組使用308nm準分子光照射,UVA1組使用UVA1照射,聯(lián)合治療組同時予308nm準分子光和UVA1照射。每組每周照射2次,治療前和開始治療后每4周進行1次評估,一共照射12周。采用自身對照的研究方法,在治療結束3天后進行療效評價及不良反應的分析,治療期間不使用其他外用藥物或口服藥。結果:在經(jīng)過8周治療后,聯(lián)合治療組總有效率高于UVA1組,差異有統(tǒng)計學意義(P0.05);聯(lián)合治療組總有效率高于308nm準分子光組,差異無統(tǒng)計學意義(P0.05);308nm準分子光組總有效率高于UVA1組,療效差異無統(tǒng)計學意義(P0.05)。經(jīng)過12周治療后,聯(lián)合治療組總有效率高于UVA1組,差異有統(tǒng)計學意義(P0.05);聯(lián)合治療組總有效率高于308nm準分子光組,差異無統(tǒng)計學意義(P0.05);308nm準分子光組總有效率高于UVA1組,差異有統(tǒng)計學意義(P0.05)。經(jīng)過12周治療后,對于頭面頸部皮損,聯(lián)合治療組的總有效率高于UVA1組,差異有統(tǒng)計學意義(P0.05);聯(lián)合治療組的總有效率高于308nm準分子光組,差異無統(tǒng)計學意義(P0.05);308nm準分子光組的總有效率高于UVA1組,差異有統(tǒng)計學意義(P0.05)。對于軀干部皮損,聯(lián)合治療組總有效率雖然高于308nm準分子光組和UVA1組,但經(jīng)秩和檢驗P0.05,因此認為三組療效差異無統(tǒng)計學意義。對于四肢指端皮損,聯(lián)合治療組和308nm準分子光組的總有效率雖然高于UVA1組,但經(jīng)秩和檢驗P0.05,因此認為三組療效差異無統(tǒng)計學意義。聯(lián)合治療組與308nm準分子光組及UVA1組之間不良反應發(fā)生率差異無統(tǒng)計學意義(P0.05),其中UVA1組不良反應發(fā)生率最低17.86%。結論:在治療8周后,聯(lián)合療法療效不優(yōu)于單一308nm準分子光治療,但優(yōu)于單一UVA1治療;治療12周后,聯(lián)合療法療效不優(yōu)于單一308nm準分子光治療,但兩者療效均優(yōu)于單一UVA1。聯(lián)合療法治療頭面頸、軀干、四肢指端白癜風的有效率要略高于單一局部照射308nm準分子光或UVA1,尤其適用于頭面頸部白癜風患者的治療。
[Abstract]:Objective: in recent years, there have been many reports on the treatment of vitiligo by 308nm excimer laser or UVA, but there are few studies on 308nm excimer laser or UVA1 in the treatment of vitiligo. The study focused on the combination of laser and external medicine in the treatment of vitiligo. UVA1 and 308nm excimer light combined therapy for vitiligo has not been reported in the literature. In this study, the combination of UVA1 and 308nm excimer light in vitiligo patients was compared with UVA1308nm excimer light alone in the treatment of vitiligo, to explore whether the combined therapy is superior to UVA1 or 308nm excimer phototherapy alone. Methods: thirty patients with vitiligo were randomly selected. Each patient was divided into three parts, including head, face, neck, trunk, extremities and fingers. The lesions were randomly divided into 308nm excimer group, UVA1 group and combined treatment group, each group 30 times. 308nm excimer group was irradiated with 308nm excimer light, UVA1 group was treated with UVA1 irradiation, and combined treatment group was treated with 308nm excimer light and UVA1 irradiation at the same time. Each group was irradiated twice a week and evaluated once every 4 weeks before and after treatment for a total of 12 weeks. A self-controlled study was used to evaluate the efficacy and adverse reactions 3 days after the end of the treatment. No other topical or oral drugs were used during the treatment. Results: after 8 weeks of treatment, the total effective rate of the combined treatment group was higher than that of the UVA1 group, the difference was statistically significant (P0.05), the total effective rate of the combined treatment group was higher than that of the 308nm excimer light group, the difference was not statistically significant (P0.05). The total effective rate of 308nm excimer light group was higher than that of UVA1 group, and there was no significant difference in curative effect (P0.05). After 12 weeks of treatment, the total effective rate of the combined treatment group was higher than that of the UVA1 group, the difference was statistically significant (P0.05), the total effective rate of the combined treatment group was higher than that of the 308nm excimer light group, the difference was not statistically significant (P0.05). The total effective rate of 308nm excimer group was higher than that of UVA1 group (P0.05). After 12 weeks of treatment, the total effective rate of the combined treatment group was higher than that of the UVA1 group, and the difference was statistically significant (P0.05). The total effective rate of the combined treatment group was higher than that of the 308nm excimer light group, the difference was not statistically significant (P0.05); the total effective rate of the 308nm excimer light group was higher than that of the UVA1 group, and the difference was statistically significant (P0.05). The total effective rate of the combined treatment group was higher than that of the 308nm excimer light group and the UVA1 group, but the rank sum test showed that there was no statistical difference among the three groups. The total effective rate of the combined treatment group and 308nm excimer light group was higher than that of the UVA1 group, but the total effective rate was higher than that of the UVA1 group, but the rank sum test showed that there was no significant difference between the three groups. There was no significant difference in the incidence of adverse reactions between the combined treatment group and the 308nm excimer light group and the UVA1 group (P0.05). The incidence of adverse reactions in the UVA1 group was the lowest (17.86g). Conclusion: after 8 weeks of treatment, the therapeutic effect of combined therapy is not better than that of single 308nm excimer light, but superior to that of single UVA1, and after 12 weeks of treatment, the combined therapy is not better than that of single 308nm excimer light, but both of them are superior to single UVA1.. The effective rate of combined therapy for vitiligo of head, neck, trunk and extremities is slightly higher than that of single local irradiation of 308nm excimer or UVA1, especially suitable for head, neck and neck patients with vitiligo.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R758.41
本文編號：2411431
[Abstract]:Objective: in recent years, there have been many reports on the treatment of vitiligo by 308nm excimer laser or UVA, but there are few studies on 308nm excimer laser or UVA1 in the treatment of vitiligo. The study focused on the combination of laser and external medicine in the treatment of vitiligo. UVA1 and 308nm excimer light combined therapy for vitiligo has not been reported in the literature. In this study, the combination of UVA1 and 308nm excimer light in vitiligo patients was compared with UVA1308nm excimer light alone in the treatment of vitiligo, to explore whether the combined therapy is superior to UVA1 or 308nm excimer phototherapy alone. Methods: thirty patients with vitiligo were randomly selected. Each patient was divided into three parts, including head, face, neck, trunk, extremities and fingers. The lesions were randomly divided into 308nm excimer group, UVA1 group and combined treatment group, each group 30 times. 308nm excimer group was irradiated with 308nm excimer light, UVA1 group was treated with UVA1 irradiation, and combined treatment group was treated with 308nm excimer light and UVA1 irradiation at the same time. Each group was irradiated twice a week and evaluated once every 4 weeks before and after treatment for a total of 12 weeks. A self-controlled study was used to evaluate the efficacy and adverse reactions 3 days after the end of the treatment. No other topical or oral drugs were used during the treatment. Results: after 8 weeks of treatment, the total effective rate of the combined treatment group was higher than that of the UVA1 group, the difference was statistically significant (P0.05), the total effective rate of the combined treatment group was higher than that of the 308nm excimer light group, the difference was not statistically significant (P0.05). The total effective rate of 308nm excimer light group was higher than that of UVA1 group, and there was no significant difference in curative effect (P0.05). After 12 weeks of treatment, the total effective rate of the combined treatment group was higher than that of the UVA1 group, the difference was statistically significant (P0.05), the total effective rate of the combined treatment group was higher than that of the 308nm excimer light group, the difference was not statistically significant (P0.05). The total effective rate of 308nm excimer group was higher than that of UVA1 group (P0.05). After 12 weeks of treatment, the total effective rate of the combined treatment group was higher than that of the UVA1 group, and the difference was statistically significant (P0.05). The total effective rate of the combined treatment group was higher than that of the 308nm excimer light group, the difference was not statistically significant (P0.05); the total effective rate of the 308nm excimer light group was higher than that of the UVA1 group, and the difference was statistically significant (P0.05). The total effective rate of the combined treatment group was higher than that of the 308nm excimer light group and the UVA1 group, but the rank sum test showed that there was no statistical difference among the three groups. The total effective rate of the combined treatment group and 308nm excimer light group was higher than that of the UVA1 group, but the total effective rate was higher than that of the UVA1 group, but the rank sum test showed that there was no significant difference between the three groups. There was no significant difference in the incidence of adverse reactions between the combined treatment group and the 308nm excimer light group and the UVA1 group (P0.05). The incidence of adverse reactions in the UVA1 group was the lowest (17.86g). Conclusion: after 8 weeks of treatment, the therapeutic effect of combined therapy is not better than that of single 308nm excimer light, but superior to that of single UVA1, and after 12 weeks of treatment, the combined therapy is not better than that of single 308nm excimer light, but both of them are superior to single UVA1.. The effective rate of combined therapy for vitiligo of head, neck, trunk and extremities is slightly higher than that of single local irradiation of 308nm excimer or UVA1, especially suitable for head, neck and neck patients with vitiligo.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R758.41
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