中西医结合疗法治疗重型斑秃的疗效观察

Clinical Effect of Integrated Traditional Chinese and Western Medicine Therapy in the Treatment of Severe Alopecia Areata

目的探讨中西医结合疗法对重型斑秃的临床疗效。方法选取襄阳市某医院2012年2月-2015年2月收治的105例重型斑秃患者作为研究对象,随机分为观察组(n=53)与对照组(n=52)。对照组患者采用常规西药治疗,观察组患者在对照组的基础上采用中医综合治疗,比较2组患者的治疗总有效率、治疗前后血清细胞因子干扰素(IFN-γ)及白细胞介素(IL-2,IL-4,IL-10)水平、新发开始生长时间、治疗前后终毛数密度、不良反应发生率及半年复发率。结果观察组患者的治疗总有效率为86.8%,对照组患者的治疗总有效率为67.3%,观察组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,2组患者IFN-γ,IL-2,IL-4,IL-10等血清细胞因子水平比较差异无统计学意义;治疗后,2组患者IFN-γ,IL-2水平降低,IL-4,IL-10水平升高,与治疗前相比,差异有统计学意义(P<0.05);且观察组患者治疗后IFN-γ,IL-2水平低于对照组,IL-4,IL-10水平高于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗4周、8周及12周时的终毛数密度均高于对照组,新发开始生长时间则短于对照组,差异有统计学意义(P<0.05)。观察组患者不良反应发生率分别为7.6%,对照组患者不良反应发生率为5.7%,二者相比,差异无统计学意义。观察组患者复发率为11.3%,低于对照组的26.9%,差异有统计学意义(P<0.05)。结论中西医结合疗法对重型斑秃的临床效果显著,能快速缓解脱发症状并促进毛发新生,安全可靠,值得临床推广应用。

Objective To observe the curative effect of integrated traditional Chinese and Western medicine therapy in the treatment of severe alopecia areata under dermoscopy. Methods The study was performed by selecting 105 patients with severe alopecia areata in one of Xiangyang hospitals from Feb. 2012 to Feb. 2015. Patients were randomized into observation group （n = 53） and control group （n = 52）. The control group was treated with routine Western medicine and the observation group was treated with traditional Chinese medicine on the basis of Western medicine. Total curative rate, serum cytokine before and after the treatment （IFN-γ, IL-2,IL-4,IL-10）, time of new hair growth, density of hair before and after the treatment, incidence of ad- verse reactions and recurrence rate during the half-year follow-up period were compared between the two groups. Results The total effective rate of the observation group （86.8%） was higher than that of the control group （67.3%） （P〈0.05）. There were no significant differences between serum cytokines, such as IFN-γ, IL-2,IL-4 and IL-10 before treatment for both groups. After treatment, level of IFN-γand IL-2 decreased, while level of IL-4 and IL-10 increased. Comparing with the results before treatment, the differences manifes- ted to be statistically significant （P〈0.05）. Meanwhile, the level of IFN-γ and IL-2 after treatment of obser- vation group was lower than that of control group, and vice versa in terms of IL-4 and IL-10 （P〈0.05）. Den- sity of hair after 4 weeks, 8 weeks and 12 weeks treatment of observation group was higher than that of con- trol group （P〈0.05）, and time of new hair growth was significantly shorter than that of the control group （P〈0.05）. The incidence of adverse reactions of the two groups were 7.6% and 5.7%, respectively （P〉0.05）. The recurrence rate of the observation group （11.3%） was lower than that of the control group（26.9%） （P〈0.05）. Conclusion The clinical effect of integrated traditional Chinese and Western medicine therapy in the treatment of severe alopecia areata is obvious, manifesting in alleviating the symptoms of hair loss and pro- moting new hair growth quickly. Therefore, the treatment is reliable to be popularized.