308nm准分子光联合UVA1治疗白癜风的临床研究
发布时间：2019-01-19 13:52
【摘要】：目的:近年来国内外关于308nm准分子激光或UVA治疗白癜风的文献报道有很多,但关于308nm准分子光或UVA1治疗白癜风的研究相对较少,且研究多集中在激光与外用药联合治疗白癜风方面。尚未见到UVA1和308nm准分子光联合治疗白癜风的文献报道。本研究将UVA1与308nm准分子光联合作用于白癜风患者,与UVA1、308nm准分子光单独治疗白癜风的疗效相比较,探讨联合疗法是否优于单一的UVA1或308nm准分子光光疗。方法:随机入选30例白癜风患者,每例患者选取头面颈部、躯干、四肢指端对称或者相邻部位的白斑3处,共90处。将皮损随机分入308nm准分子光组、UVA1组和联合治疗组,每组30处。308nm准分子光组使用308nm准分子光照射,UVA1组使用UVA1照射,联合治疗组同时予308nm准分子光和UVA1照射。每组每周照射2次,治疗前和开始治疗后每4周进行1次评估,一共照射12周。采用自身对照的研究方法,在治疗结束3天后进行疗效评价及不良反应的分析,治疗期间不使用其他外用药物或口服药。结果:在经过8周治疗后,联合治疗组总有效率高于UVA1组,差异有统计学意义(P0.05);联合治疗组总有效率高于308nm准分子光组,差异无统计学意义(P0.05);308nm准分子光组总有效率高于UVA1组,疗效差异无统计学意义(P0.05)。经过12周治疗后,联合治疗组总有效率高于UVA1组,差异有统计学意义(P0.05);联合治疗组总有效率高于308nm准分子光组,差异无统计学意义(P0.05);308nm准分子光组总有效率高于UVA1组,差异有统计学意义(P0.05)。经过12周治疗后,对于头面颈部皮损,联合治疗组的总有效率高于UVA1组,差异有统计学意义(P0.05);联合治疗组的总有效率高于308nm准分子光组,差异无统计学意义(P0.05);308nm准分子光组的总有效率高于UVA1组,差异有统计学意义(P0.05)。对于躯干部皮损,联合治疗组总有效率虽然高于308nm准分子光组和UVA1组,但经秩和检验P0.05,因此认为三组疗效差异无统计学意义。对于四肢指端皮损,联合治疗组和308nm准分子光组的总有效率虽然高于UVA1组,但经秩和检验P0.05,因此认为三组疗效差异无统计学意义。联合治疗组与308nm准分子光组及UVA1组之间不良反应发生率差异无统计学意义(P0.05),其中UVA1组不良反应发生率最低17.86%。结论:在治疗8周后,联合疗法疗效不优于单一308nm准分子光治疗,但优于单一UVA1治疗;治疗12周后,联合疗法疗效不优于单一308nm准分子光治疗,但两者疗效均优于单一UVA1。联合疗法治疗头面颈、躯干、四肢指端白癜风的有效率要略高于单一局部照射308nm准分子光或UVA1,尤其适用于头面颈部白癜风患者的治疗。
[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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.41
本文编号：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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.41
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