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目的:探讨退白汤联合窄谱中波紫外线(NB-UVB)治疗寻常型白癜风的临床疗效及对外周血TNF-α、IL-10表达水平的影响和临床意义。方法:138例寻常型白癜风患者分为退白汤+NB-UVB组、退白汤组、NB-UVB组各46例,每组又分为进展期和稳定期各23例。退白汤+NB-UVB组内服退白汤,2次/d,并予NB-UVB局部照射,2次/w;退白汤组单纯内服退白汤;NB-UVB组单纯使用NB-UVB局部照射,方法均同退白汤+NB-UVB组,3组疗程均为12周。另选志愿者30例作为健康对照组。分别于治疗前和治疗后第4、8、12周记录皮损色素积分,同时评价临床疗效,检测健康对照组以及白癜风患者TNF-α、IL-10表达水平。结果:退白汤+NB-UVB组进展期和稳定期治疗后皮损色素积分分别为(2.6±0.9)、(1.8±0.8),退白汤组分别为(1.8±0.7)、(1.0±0.7),NB-UVB组分别为(1.6±0.8)、(0.9±0.6),退白汤+NB-UVB组进展期和稳定期与退白汤组、NB-UVB组进展期和稳定期分别比较,差异均有统计学意义;退白汤+NB-UVB组进展期和稳定期有效率分别为91.30%和65.22%,退白汤组分别为65.22%和34.78%,NB-UVB组分别为60.87%和30.43%,各组进展期和稳定期比较、退白汤+NB-UVB组进展期和稳定期与退白汤组、NB-UVB组进展期和稳定期分别比较,差异均有统计学意义;退白汤+NB-UVB组进展期和稳定期、退白汤组和NB-UVB组进展期TNF-α水平较治疗前明显降低,IL-10水平较治疗前明显升高,差异均有统计学意义;退白汤+NB-UVB组与退白汤组、NB-UVB组比较,进展期和稳定期中上述各项指标差异均有统计学意义。结论:退白汤联合NB-UVB治疗寻常型白癜风疗效显著,可能是通过降低患者血清中TNF-α的表达水平,升高IL-10表达水平来发挥治疗白癜风的作用。
Objective: To investigate the clinical effect of Decoction combined with NB-UVB in the treatment of vitiligo vulgaris and its effect on the expression of TNF-α and IL-10 in peripheral blood and its clinical significance. Methods: One hundred and thirty-eight patients with dysfunctional uterine vitiligo were divided into Decoction + NB-UVB group, Decoction group and NB-UVB group, with 46 patients in each group divided into progressive and stable phases. The NB-UVB group was treated with NB-UVB orally, and the NB-UVB group was treated with NB-UVB irradiation twice a day for 2 times / w. Both with excrement soup + NB-UVB group, three groups of treatment were 12 weeks. Another 30 volunteers as a healthy control group. The skin pigmentation scores were recorded before treatment and at 4, 8 and 12 weeks after treatment respectively. Meanwhile, the clinical curative effect was evaluated, and the levels of TNF-α and IL-10 in healthy control group and vitiligo patients were detected. Results: The integrals of skin lesions were (2.6 ± 0.9) and (1.8 ± 0.8) in the Decoction + NB-UVB group and (1.8 ± 0.7) and (1.0 ± 0.7) , NB-UVB group were (1.6 ± 0.8), (0.9 ± 0.6) respectively. The difference between the developmental phase and the stabilization phase in the Decoction + NB-UVB group and that in the NB-UVB group and the NB- With NB-UVB group, NB-UVB group and NB-UVB group were 91.30% and 65.22%, respectively, 65.22% and 34.78% in the decoction group and 60.87% and 30.43% in NB-UVB group respectively Compared with the decoction group and the NB-UVB group, the differences were statistically significant in the progression and stabilization periods of decoction + NB-UVB group, The progression of TNF-αin the decoction group and the NB-UVB group was significantly lower than that before treatment, and the level of IL-10 in the UVB group was significantly higher than that before treatment, the difference was statistically significant; Decoction + NB -UVB group and the retreat white soup group, NB-UVB group, the progress and the stability of the above indicators were statistically significant differences. Conclusion: Reversing Decoction combined NB-UVB treatment of vitiligo significant effect may be through the reduction of serum TNF-α expression levels, increased IL-10 expression level to play the role of vitiligo treatment.