加味桃红四物汤联合他克莫司软膏治疗气滞血瘀型白癜风的疗效观察

Clinical Efficacy of Modified Taohong Siwu Decoction Combined Tacrolimus Ointment in Treatment of Vitiligo Patients with Qi Stagnation Blood Stasis Syndrome

目的观察加味桃红四物汤联合0.1%他克莫司软膏治疗气滞血瘀型白癜风患者临床疗效及反射式共聚焦显微镜(RCM)细胞图像特征。方法将90例气滞血瘀型白癜风患者随机分为对照组和治疗组,每组45例,对照组给予外用0.1%他克莫司软膏治疗,治疗组在外用0.1%他克莫司软膏治疗基础上结合口服加味桃红四物汤治疗,两组疗程均为3个月,疗程结束后观察两组患者临床疗效,每2周随访1次,进行RCM扫描并及时记录扫描结果。结果治疗组有效率为84.44%(38/45),对照组有效率为62.22%(28/45),差异有统计学意义(χ^2=5.68, P<0.05)。RCM下恢复期白癜风基底层毛囊周围、毛囊间可见数量不定的树突状、折光明亮的黑素细胞,其中治疗组出现黑素细胞的时间[(4.68±2.29)周]明显早于对照组[(5.71±2.92)周],但差异无统计学意义(t=1.14, P>0.05)。结论加味桃红四物汤联合0.1%他克莫司软膏治疗气滞血瘀型白癜风临床疗效较单用西药组更好,RCM可作为观察白癜风黑素细胞恢复情况的无创、客观检测手段之一。

Objective To observe clinical efficacy of Modified Taohong Siwu Decoction(MTHSWD) combined with 0.1% Tacrolimus Ointment(TO) in treatment of vitiligo patients with qi stagnation blood stasis syndrome(QSBSS) and features of reflectance confocal microscopy(RCM). Methods Totally 90 vitiligo patients with QSBSS were randomly assigned to a treatment group and a control group, 45 in each group. Patients in the control group were externally applied with 0.1% TO(twice a day), while those in the treatment group additionally took MTHSWD. The treatment course for all was 3 months. The clinical efficacy was observed in the two groups after one treatment course. A follow-up was conducted every two weeks. RCM was performed at 2-week interval until 12 weeks and results were recorded. Results The effective rates of the treatment group and the control group were 84.44%(38/45) and 62.22%(28/45) respectively(χ~2=5.68, P<0.05). Uncountable dendritic melanocytes with clear reflection could be seen around underlayer hair follicle or between hair follicles in the recovery stage of vertiligo patients under RCM. The appearance time of melanocytes was(4.68±2.29)weeks in the treatment group, significantly earlier than that of the control group [(5.71±2.92)weeks; t=1.14, P>0.05]. Conclusions MTHSWD combined with 0.1% TO was effective in treatment of vitiligo patients with QSBSS. Moreover, RCM was used to be an non-invasive and objective detection way for the recovery of vitiligo melanocytes.