益肺健脾祛白方联合NB-UVB治疗儿童白癜风的疗效观察及其对IL-17的影响

发布时间：2018-06-06 20:55

本文选题：益肺健脾祛白方 + 儿童白癜风　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察益肺健脾祛白方联合窄谱中波紫外线(NB-UVB)治疗儿童白癜风前后的皮损面积及血清IL-17的变化,从而验证联合治疗的临床疗效,并探讨儿童白癜风与IL-17水平的关系。方法:遵循随机对照原则,将66例儿童白癜风,按随机数字表法分为治疗组(益肺健脾祛白方联合NB-UVB)32例和对照组(NB-UVB)34例。治疗组予内服益肺健脾祛白方联合NB-UVB局部照射,对照组予NB-UVB,治疗方法同治疗组,两组同时外用散寒活血祛白酊。1个月为一个疗程,共3个疗程。观察记录两组治疗前后皮损面积评分,并进行临床疗效判定。同时采用ELISA法对两组患儿治疗前后外周血IL-17水平进行检测,并比较治疗前后IL-17水平的差异。结果:(1)本研究共有3例脱落病例,所纳入实际病例为63例(治疗组31例,对照组32例)。两组患儿性别、年龄、病程、分期、分型比较,差异均无统计学意义(P0.05),具有可比性。(2)VASI评分比较:治疗前治疗组与对照组病情程度、VASI评分比较,差异均无统计学意义(P0.05),具有可比性。治疗3个月后,两组自身前后比较VASI评分均降低(P0.01);组间比较治疗组VASI评分明显低于对照组,差异有统计学意义(P0.05)。(3)临床疗效比较:治疗3个月后,治疗组31例儿童白癜风中,治愈6例,显效11例,好转11例,无效3例,临床总有效率90.32%;对照组32例患儿中,治愈3例,显效4例,好转17例,无效8例,临床总有效率75.00%。经统计学分析,治疗组总有效率90.32%明显高于对照组75.00%,差异有统计学意义(P0.05)。(4)IL-17水平比较:治疗前治疗组与对照组IL-17水平比较,差异无统计学意义(P0.05),具有可比性。治疗3个月后两组自身前后比较IL-17水平均降低(P0.01);组间比较治疗组IL-17水平显著低于对照组,差异有统计学意义(P0.05)。(5)治疗组与对照组在治疗过程中,均未出现明显不良反应。结论:益肺健脾祛白方联合NB-UVB治疗儿童白癜风临床疗效明显优于单用NB-UVB,可显著改善皮损面积,其作用机制可能与降低血清中IL-17含量有关。
[Abstract]:Objective: to observe the changes of skin lesion area and serum IL-17 in children with vitiligo before and after treatment with Yifei Jianpi Qubai Fang and NB-UVB (narrow spectrum ultraviolet B) in order to verify the clinical effect of combined therapy and to explore the relationship between IL-17 level and vitiligo in children. Methods: according to the principle of random control, 66 children with vitiligo were divided into treatment group (32 cases) and control group (34 cases). The treatment group was given local irradiation of Yifei Jianpi Qubai Fang combined with NB-UVB while the control group was treated with NB-UVB. The treatment group was treated with the same treatment group and the two groups were treated externally with the tincture of dispersing cold and activating blood circulation and removing white. One month was a course of treatment for three courses. To observe and record the score of skin lesion area before and after treatment, and to judge the clinical effect. At the same time, Elisa was used to detect the level of IL-17 in peripheral blood of the two groups before and after treatment, and to compare the level of IL-17 before and after treatment. Results there were 3 cases of shedding in this study, and 63 cases were included (treatment group 31 cases, control group 32 cases). There was no significant difference in sex, age, course of disease, stage and type between the two groups, but there was no significant difference between the two groups (P 0.05). The comparison of VASI scores between the treatment group and the control group before treatment was significant. The differences were not statistically significant (P 0.05) and were comparable. After 3 months of treatment, the VASI scores of the two groups were significantly lower than those of the control group before and after treatment, and the scores of VASI in the treatment group were significantly lower than those in the control group (P 0.05, P 0.05): after 3 months of treatment, there were 31 children with vitiligo in the treatment group. There were 6 cases of cure, 11 cases of remarkable effect, 11 cases of improvement, 3 cases of ineffective, the total effective rate of clinical was 90.32%, in the control group, 3 cases were cured, 4 cases were markedly effective, 17 cases were improved, 8 cases were ineffective, the total clinical effective rate was 75.00%. By statistical analysis, the total effective rate of the treatment group was 90.32% higher than that of the control group (75.00%), and the difference was statistically significant. After 3 months of treatment, the levels of IL-17 in the two groups were significantly lower than those in the control group (P 0.05) and the levels of IL-17 in the treatment group were significantly lower than those in the control group. Conclusion: the clinical effect of Yifei Jianpi Qubai Fang combined with NB-UVB in the treatment of children vitiligo is better than that of NB-UVB alone, and can significantly improve the area of skin lesion. The mechanism may be related to the decrease of IL-17 content in serum.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.41

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