异常黏液质型白癜风特点及维吾尔医综合治疗临床研究

Characteristics of Abnormal Mucinous Vitiligo and Its Comprehensive Treatment by Uyghur Medicine

目的探讨维吾尔医综合治疗异常黏液质型白癜风的临床疗效及其可能的作用机制。方法选取维吾尔医医院2017年1月至2019年9月收治的异常黏液质型白癜风患者553例及同期健康志愿者100例。观察患者异常体液分型分布、原气分布、一般资料,以促进异常黏液质成熟及清除、活血化瘀、促进生成力、改造力和黑色素细胞的形成为原则对患者行维吾尔医综合治疗,观察疗效,比较受试者血清调节性T细胞(Treg)、白细胞介素17(IL-17)、白细胞介素23(IL-23)、转化生长因子-β_1(TGF-β_1)水平。结果553例患者以干寒性、干热性原气较多见,女性多于男性;黏液质分布,女性以咸味型、男性以涩味型多见;0~18岁以甜味型、31~50岁以咸味型或涩味型、51~65岁以咸味型多见(且前2个年龄段患病率较高);已婚人群以咸味型、其他人群以甜味型多见;维吾尔族以甜味型、淡味型多见,非维吾尔族以涩味型多见;体力劳动者以淡味型多见,非体力劳动者以涩味型多见;总痊愈率40.14%,其中酸味型、淡味型痊愈率较高;总无效率6.51%,其中涩味型无效率最高,酸味型无效率最低;患者治疗前后的血清调节性T细胞(Treg)、白细胞介素17(IL-17)、白细胞介素23(IL-23)、转化生长因子-β_1(TGF-β_1)水平均明显高于健康者(P<0.05);与治疗前比较,治疗后酸味型患者血清Treg及淡味型患者血清Treg,TGF-β_1,IL-23水平均明显升高,咸味型患者血清IL-23水平明显下降,甜味型患者IL-17水平明显升高(P<0.05)。结论涩味型白癜风多见于31~50岁男性、非维吾尔族、非体力劳动者,合并症较多,无效率较高,与血清Treg和Th17细胞及其相关因子变化关系不大;酸味型白癜风多见于0~18岁女性、维吾尔族、非体力劳动者,合并症较少,痊愈率较高,其机制可能与上调患者血清Treg细胞及因子,下调血清IL-17和IL-23水平有关。

Objective To explore the clinical efficacy and possible mechanism of Uyghur medicine in the treatment of abnormal mucinous vitiligo.Methods A total of 553 patients with abnormal mucinous vitiligo admitted to the Xinjiang Traditional Uyghur Medicine Hospital from January 2017 to September 2019,as well as 100 healthy volunteers in the same period were selected.Patients were treated with the principles of promoting the maturation and removal of abnormal mucus,promoting blood circulation and removing blood stasis,promoting productivity,transforming power,and melanocyte formation.Comprehensive Uyghur medical treatment was performed to observe the distribution of abnormal body fluid types,original temperament distribution,and general information.The efficacy was observed to compare subjects’serum regulatory T cell(Treg),interleukin 17(IL-17),interleukin 23(IL-23),and transforming growth factor-β1(TGF-β1)levels.Results In the 553 patients,the temperament of with dry cold and dry heat was more common,and with more female patients than male;for the distribution of mucus,female patients were mainly salty type,and male astringent type;patients of 0-18 years were mainly sweet type,31-50 years salty or astringent type,and 51-65 years salty type(the prevalence was higher in the first two age groups);married patients were mainly salty type,and other people sweet type;Uyghurs were mainly sweet and light flavor type,and non-Uyghurs astringent type;manual workers were mainly light flavor type,and non-manual workers astringent flavor;the total recovery rate was 40.14%,of which the sour type and light flavor type had a higher recovery rate;the total inefficiency was6.51%,of which the astringent type had the highest inefficiency and the sour type has the lowest inefficiency;the levels of serum regulatory Treg,IL-17,IL-23,TGF-β1 were significantly higher than those of healthy people(P<0.05);compared with before treatment,the levels of serum Treg in sour type patients and serum Treg,TGF-β1,IL in light flavor type patients after treatment were significantly increased,the level of serum IL-23 in salty type patients was significantly decreased,and the level of IL-17 in sweet type patients was significantly increased(P<0.05).Conclusion Astringent type of vitiligo is more common in males aged 31-50,non-Uyghurs,and non-manual workers.There are more complications and higher inefficiency,which is not related to changes in serum Treg and Th17 cells and related factors;sour type vitiligo is more common in females aged 0-18,Uyghurs,and non-manual workers,with fewer complications and higher recovery rate.The mechanism may be related to the up-regulation of serum Treg cells and factors,and down-regulation of serum IL-17 and IL-23 levels.