NB-UVB联合退白汤治疗寻常型白癜风的疗效及对Th17相关因子的调节作用

The Efficacy of NB-UVB Combined with Tuibai Decoction in the Treatment of Vitiligo Vulgaris and the Regulating Effect on Th17 Correlated Factors

目的探讨退白汤联合窄谱中波紫外线(NB-UVB)治疗寻常型白癜风的疗效及对外周血IL-17,IL-22,IL-23的调节作用与临床意义。方法 138例寻常型白癜风患者分为治疗组、对照Ⅰ组、对照Ⅱ组各46例,每组又分为进展期和稳定期各23例。治疗组内服退白汤,2次/d,并予NB-UVB局部照射,2次/周;对照Ⅰ组单纯内服退白汤;对照Ⅱ组单纯使用NB-UVB局部照射,方法均同治疗组,3组疗程均为12周。另选志愿者30例作为健康对照组。分别于治疗前和治疗后检测健康对照组以及白癜风患者IL-17,IL-22,IL-23含量,同时评价临床疗效。结果治疗组进展期和稳定期有效率分别为91.30%和65.22%,对照Ⅰ组分别为65.22%和34.78%,对照Ⅱ组分别为60.87%和30.43%,治疗组与对照Ⅰ组、对照Ⅱ组进展期和稳定期分别比较,差异均有统计学意义(P<0.05);治疗组进展期和稳定期、对照Ⅰ组和对照Ⅱ组进展期IL-17,IL-22,IL-23分别与治疗前比较,差异均有统计学意义(P<0.05 or P<0.01);治疗组与对照Ⅰ组、对照Ⅱ组比较,进展期和稳定期中上述各项指标差异均有统计学意义(P<0.05)。结论退白汤联合NB-UVB治疗寻常型白癜风疗效显著,可能是通过降低患者血清中Th17细胞相关因子IL-17,IL-22,IL-23的含量来发挥治疗白癜风的作用。

Objective To investigate the efficacy of Tuibai decoction combined with narrow-band ultraviolet B （ NB- UVB） in the treatment of vitiligo vulgaris, and to investigate the regulating effect and clinical value on the expression levels of IL-17 ,IL-22,IL-23 in peripheral blood. Methods One hundred and thirty eight pa- tients with vitiligo vulgaris were divided into treatment group, control group I and control group II with 46 cases in every group, and then all groups were divided into progressvie period and stable period with 23 ca- ses in each. Treatment group were treated with Tuibai decoction in oral administration,2 times/d, with NB- UVB local irradiation, 2 times/w. Control group I were only treated with Tuiyin decoction, and control group 11 were only treated with NB-UVB local irradiation. The theraputic methods were the same with that in treatment group. All groups were treated for 12 weeks, and another 30 subjects were chosen as healthy control group. Before and after treatment,IL-17, IL-22, IL-23 expression levels of healthy control group and patients with vitiligo were determinated. Meanwhile, the efficacy were evaluated. Results After treatment, effective rates of progressvie period and stable period of treatment group were 91.30% and 65.22% re- spectively,65.22% and 34.78% in control group I ,60.87% and 30.43% in control group I1. Compa- ring progressive period with stable period of three groups, comparing the progressive period and stable peri- od of treatment group with that of two control groups, the differences were statistically significant （P 〈 0.05）. The differences of expressions of IL-17, IL-22, IL-23 in the progressive period of two control groups ,compared with that before treatment ,were statistically significant（ P 〈 0. 05 ）. The differences of a- bove-mentioned indicators of progressive period and stable period were statistically significant（ P 〈 0.05 ）. Conclusion Tuibai decoction combined with NB-UVB in the treatment of vitiligo vulgaris is effective, possibly by reducing expression levels of IL-17 ,IL-17, IL-23 which are related with Th17 cells.