退白汤联合NB-UVB对寻常型白癜风患者IL-6和TGF-β表达水平的影响

Effect of Tuibai Soup combined with NB-UVB on IL-6 and TGF-β in peripheral blood of vulgaris vitiligo

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临床疗效及对外周血TL-6、TGF-β表达水平的影响和临床意义。方法：132例寻常型白癜风患者分为治疗组、退白汤组、NB-UVB组各44例,治疗组内服退白汤,2次/d,并予NB-UVB局部照射,2次/w,退白汤组单纯内服退白汤,NB-UVB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-6、TGF-β含量,同时评价临床疗效。结果：治疗组有效率81.82%,与退白汤组61.36%、NB-UVB组54.55%比较,差异均有统计学意义;治疗前,治疗组、退白汤组、NB-UVB组不同分期、不同皮损面积、不同病程患者血清IL-6、TGF-β水平分别与健康对照组比较,差异均有统计学意义;治疗后,治疗组IL-6、TGF-β水平：进展期分别为（40.8±7.1）、（462.2±90.4）,稳定期分别为（48.7±6.5）、（412.7±73.8）,皮损面积〈1%分别为（44.8±6.5）、（447.7±79.2）,1%-5%分别为（46.1±6.9）、（426.2±80.6）,〉5%分别为（42.3±7.1）、（435.7±86.6）,病程〈1年分别为（43.7±8.9）、（436.1±77.8）,1-5年分别为（44.5±8.3）、（439.7±79.2）,〉5年分别为（44.1±7.9）、（435.8±86.9）与治疗前、退白汤组、NB-UVB组分别比较,差异均有统计学意义,与皮损面积呈显著相关性,与病程无相关性。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IL-6的表达水平,升高TGF-β表达水平来发挥治疗白癜风的作用。

Objective： To study the clinical curative effect and the impact of expression level of IL-6 and TGF-β in peripheral blood of vulgaris vitiligo who received the Tuiyin Soup combined with NB-UVB therapy. Methods： 132 patients of vulgaris vitiligo were devided into treatment group,Tuibai soup group,and NB-UVB group with 44 cases in each group. The treatment group were given Tuibai soup 2 times / d with NBUVB 2 times / w. Tuibai soup group were only given Tuibai soup,and the NB-UVB group were only given NB-UVB partial irradiation. The treatment methods were the same with treatment group,and the treatment course of three groups were all 12 weeks. In addition,30 cases of volunteers were chosen as healthy control group. We checked the expression levels of IL-6 and TGF-β of the patients before and after treatments and evaluate the clinical curative effect at the same time. Results： The efficiency ratio of treatment group was 81. 82%,compared with Tuibai soup group（ 61. 36%） and NB-UVB group（ 54. 55%）,the differences were significant（ P〈0. 05 or P〈0. 01）. Before the treatment,the expression levels of IL-6 and TGF-β in peripheral blood of vulgaris vitiligo of treatment group,Tuibai soup group and NB-UVB group with different stages,different lesion areas and different disease courses,compared with the healthy control group,the differences were significant（ P 〈0.01）. After the treatment,the expression levels of IL-6 and TGF-β of treatment group were：（ 40. 8 ± 7. 1）,（ 462. 2 ± 90. 4） in progressive stage;（ 48. 7 ± 6. 5）,（ 412. 7 ± 73. 8） in stable stage;（ 44. 8 ± 6. 5）,（ 447. 7 ± 79. 2） with skin lesions 1%,（ 46. 1 ± 6. 9）,（ 426. 2 ± 80.6） with lesions 1% - 5%,（ 42. 3 ± 7. 1）,（ 435. 7 ± 86. 6） with lesions 5%,（ 43. 7 ± 8. 9）,（ 436. 1 ± 77. 8） with disease course 1 year,（ 44. 5 ± 8. 3）,（ 439. 7 ± 79. 2） with disease course 1 - 5 years,（ 44. 1 ± 7. 9）,（ 435. 8 ± 86. 9） with disease course 5 years. There was a positive correlation between the expression level of IL-6 and TGF-β and the lesion area,while there was no correlation with the disease courses. Conclusion： The clinical curative effect of Tuibai soup combined with NB-UVB was obvious. Perhaps the treatment works effectively by reducing the expression level of IL-6 and increasing the expression level of TGF-β in peripheral blood of vulgaris vitiligo.