308nm准分子激光联合0.1%他克莫司乳膏治疗白癜风的临床体会

Clinical study on combined 308nm excimer laser and topical tacrolimus 0.1% ointment for the treatment of vitiligo

目的:比较应用0.1%他克莫司软膏联合308nm准分子激光与单用308nm准分子激光治疗白癜风的效果。方法:64例白癜风患者,每个部位选择1～2处皮损将自身皮损分为A、B两组,分别108处皮损,A组予308nm准分子激光治疗,2次/周,共30次;B组在激光治疗的基础上外用0.1%他克莫司乳膏,2次/天。治疗过程中记录疗效及不良反应。结果:两组分别108处皮损,所有患者完成了治疗。总有效率:A组65.74%(71/108),B组89.81%(97/108),(χ2=18.10,P<0.05);其中面颈部有效率:A组88.10%(38/42),B组92.86%(39/42)(χ2=0.26,P>0.05);躯干部有效率:A组53.84%(28/52),B组94.23%(49/52)(χ2=22.06,P<0.05);四肢有效率A组50.00%(5/10),B组80.00%(8/10);手足有效率:A组0(0/4),B组25.00%(1/4);平均治疗次数:A组21.8次、B组19.4次,平均出现色素次数:A组7次、B组5.5次。结论:308nm准分子激光联合他克莫司乳膏治疗白癜风起效快、疗效好,副作用少;面颈部单用308nm准分子激光亦可获良效。

Objective To compare the efficacy of combined topical tacrolinus 0.1% ointment and 308- nm excimer laser therapy vs 308-nm excimer laser monotherapy in treating vitiligo. Methods 64 cases of vitiligo patients ,for each patient,1~2 target lesions were chosen.the target lesions were randomly divided into A and B groups ,the lesions were 108 lesions respectively.Each lesion in group A was treated with only the 308 nm excimer laser monotherapy twice weekly,for a total of 30 sessions. Each lesion in group B was treated with the 308nm excimer laser twice weekly and topical tacrolimus 0.1% ointment was applied twice daily on target Iseions.Efficacies were evaluated 30times.adverse effects were recorded. Results The lesions were 108 lesions respectively.All patients were treated completely the total effective rate was 65.74% （71/108）in group A and 89.81%（97/108）in group B （χ^2=18.10,P〈0.05）;The effective rate of the face and neck was 88.10%（38/42）in group A and 92.86%（39/42）in group B （χ^2=0.26, P〉0.0）;The effective rate of thetrunk was 53.84%（28/52）in group A and 94.23%（49/52）（χ^2=22.06,P〈0.05） in group B;The effective rate of limbs was 50.00% （5/10）in group A and 80.00% （8/10）in group B,The effective rate of hands and feet was 0/0 in group A and 25.00%（1/4）in group B;the average number of treatment was 21.8 in group A and 19.4 in group B,the average number of repigment was 7 in group A and 5.5 in group B. Conclusion Combined topical tacrolinus 0.1% ointment and 308 nm excimer laser therapy in treating vitiligo caused more significant and quicker repigmentation. Good respone observed in patients having lesions involving in face and neck only fhe 308 nm excimer laser monotherapy.