320 nm强脉冲光与窄谱中波紫外线治疗稳定期白癜风近期疗效的比较

Short-term Outcomes of Curative Effect in Vitiligo Therapy Compared Between Intense Pulse Light and Narrow-band Ultraviolet B

目的比较320 nm强脉冲光与窄谱中波紫外线治疗稳定期白癜风的近期疗效。方法稳定期白癜风患者103例,随机分为2组,治疗组50例给予320nm强脉冲光治疗,能量密度360 J/cm^2,之后递增30～80J/cm^2,光斑面积1.5 cm×4.0 cm,脉宽30～50 ms,每月治疗1次;对照组53例给予窄谱中波紫外线照射皮损,能量密度0.3～4.0J/cm^2,3 d照射1次。照射后两组患者均口服复合维生素B、叶酸,外用复方卡力孜然酊。3个月为1个疗程,根据色素恢复的程度评价临床疗效。结果痊愈率治疗组(第1疗程为18.0%,第2疗程为64%)显著高于对照组(第1疗程为5.7%,第2疗程为13.2%)(均P<0.001),显效率治疗组第1疗程(38.0%)显著高于对照组第1疗程(24.5%)(P<0.01);治疗组病程<1年者疗效显著优于病程>1年者(显效率第1疗程病程<1年者48.5%,病程>1年者为17.7%,P<0.001)。痊愈率第2疗程治疗组为69.7%,对照组为13.2%(P<0.05);对不同部位皮损统计学分析的结果显示,以头面部疗效最好,躯干、四肢次之,手足较差。结论 320 nm强脉冲光治疗稳定期白癜风疗效明显优于窄谱中波紫外线,起效快,不良反应少,是治疗稳定期白癜风患者比较理想的选择。

Objective To observe the recent curative effect of 320 nm intense pulsed light（IPL） on vitiligo in steady period. Methods A prospective,randomized,open parallel controlled clinical trial was conducted.The curative effect of 320 nm IPL and narrow band ultraviolet B（NB-UVB）on vitiligo in steady period was observed and compared.Totally 111 patients with vitiligo in steady period were divided into two groups,the test group with 320 nm IPL therapy,once per-month and the control group with NB-UVB therapy, once per 3 d.The variation of pigmentation before and after treatment was recorded,analyzed and evaluated at the third and sixth months. Results At last,103 patients completed the clinical trial.The cure rate of test group was 18%and 64%at the third and sixth months,respectively,vs 5.7%and 13.2%in control group with statistically significant difference（both P0.001）,the effective rate in test group was 38%at the third month vs 24.5%in control group（P0.01）.The curative effect in patients with period of disease less than 1 year was much better than that more than one year（the effective rate 48.5%vs 17.7%at third month,64.0%vs 13.2% at sixth mouth,both P0.001）.The curative effect is best in lesions on head and face,better in lesions on trunk and limbs,and of a sort in lesions on hands and feet. Conclusions The 320 nm IPL has obviously curative effect on vitiligo in steady period.The most depigmentation can be gradually alleviated and cured after course of treatment.Both efficacy and safety of 320 nm IPL are better than NB-UVB in treatment of vitiligo in steady period.