综合疗法治疗重型斑秃的皮肤镜下疗效观察

Clinical Observation on Effect of Comprehensive Therapies in Treating Severe Alopecia Areata through Dermoscopy

目的运用名中医禤国维教授提出的综合疗法治疗重型斑秃,利用无创性的皮肤镜观察其疗效,并探讨综合疗法的作用靶点,为今后提出适宜技术提供依据。方法将75例重型斑秃患者随机分为治疗组(50例)、对照组(25例),治疗组采用中药加减、梅花针合TDP神灯照射、益发口服液、强的松治疗;对照组采用强的松、胱氨酸片、复方甘草酸苷片、谷维素片治疗。利用皮肤镜对运用综合疗法治疗的重型斑秃患者进行临床微观观察。结果本研究治疗组总有效率为86.0%,对照组的总有效率为64.0%,2组比较,P<0.05;皮肤镜观察第4、8、12周靶目标区终毛数密度分别与0周比较,差异均有统计学意义(P<0.05);第4周与第8周、第8周与第12周比较,差异有统计学意义(P<0.05);治疗组与对照组分别于4、8、12周对应比较,差异均具有统计学意义(P<0.05)。结论本研究从临床疗效、皮肤镜功效判定方面比较显示既重视整体观念又重视局部外治的综合疗法在治疗重型斑秃方面有着比较确切的疗效,值得临床推广。

OBJECTIVE To observe the effect of comprehensive therapies created by prestigious Chinese practitioner and professor Xuan Guowei through noninvasive dermoscopy and explore its targets to provide reference for better techniques in the future. METHODS Seventy-five cases with severe alopecia areata were randomly divided into treatment group （50 cases） and control group （25 cases）. The former was treated by modified Chinese decoction, plum-blossom needling combined with TDP, Yifa Liquid and Prednisone. And the control group were given Prednisone, Berberine Hydrochloride Tablets, Compound Gly- cyrrhizin Tablets and Oryzanol Tablets. Clinical microscopic observation was made on comprehensive therapies in treating se- vere alopecia areata through dermoscopy. RESULTS Total effective rates in treatment group and control group were 86.0% and 64.0% respectively. Statistical difference existed when we made comparisons on hair density in targeted area between the 4th, 8th, 12th w and the week before treatment （P〈0.05） ; there was statistical difference when comparisons were made be- tween the 4th, 8th w and the 12th w （P〈0.05） ; there was statistical difference when comparisons were made between treat- ment group and control group in the 4th, 8th w and the 12th w respectively（P〈0.05）. CONCLUSION According to the clin- ical observation and dermoscopic functional evaluation, comprehensive therapies, which highlights holistic treatment as well as local external treatment, are effective in treating severe alopecia areata and can be widely used.