2940 nm点阵饵激光联合驱白铜凝胶与308 nm准分子激光治疗稳定期白癜风

Clinical efficacy of 2940nm Erb:YAG laser combined with Qubaitong gel encapsulation and 308nm excimer laser in the treatment of stable vitiligo

目的探讨2940 nm点阵饵激光联合驱白铜凝胶与308 nm准分子激光治疗稳定期白癜风的疗效与安全性。方法选取2017年1月—2019年1月医院经治稳定期白癜风患者228例作为研究对象。依据抽签法均分为A组、B组、C组、D组。A组:给予驱白铜凝胶封包;B组:给予308 nm准分子激光;C组:给予2940 nm点阵激光治疗;D组:给予308 nm准分子激光+驱白铜凝胶封包+2940 nm点阵饵激光治疗;4组治疗方案均每周1次,共24次。治疗前及治疗结束8周后,依据皮损复色情况评估疗效,采用皮肤病生活质量指数量表(DLQI)评估患者生活质量。治疗结束8周后由患者对治疗满意度进行评价。记录治疗期间发生的各类治疗相关不良事件。结果D组总有效率及强效率高于A组、B组、C组(P<0.05)。A组与B组极强效率均低于D组(P<0.05)。B组、C组及D组治疗后DLQI评分均低于治疗前(P<0.05)。D组治疗后DLQI评分均低于A组、B组及C组(P<0.05)。B组与C组治疗后DLQI评分均低于A组(P<0.05)。D组患者满意度评分高于A组、B组及C组(P<0.05)。B组与C组患者满意度评分高于A组(P<0.05)。D组治疗相关不良事件总发生率高于A组、B组及C组(P<0.05)。结论2940 nm点阵饵激光联合驱白铜凝胶封包与308 nm准分子激光可有效促进皮损复色、改善患者生活质量且有更高的患者满意度,但会增加治疗相关不良事件的发生率。

Objective To inrestigate the clinical efficacy and safety of 2940nm Erb:YAG laser combined with qubaitong gel encapsulation and 308nm excimer laser in the treatment of vitiligo in the stable.Methods 228 patients with stable vitiligo were collected from January 2017 to January 2019 in our hospital.They were divided into group A,group B,group C and group D according to the lottery method.Group A was given qubaitong gel encapsulation,Group B given 308 excimer laser,Group C given 2940nm fractional laser and group D given 308 excimer laser+qubaitong gel encapsulation+2940nm fractional laser.The four groups were treated once a week for 24 times.Before treatment and 8 weeks after treatment,the efficacy was evaluated according to the repigmentation of skin lesions,and patients’quality of life was evaluated using the Dermatological Quality of Life Index Scale(DLQI).Patients'satisfaction with treatment was evaluated 8 weeks after treatment.Various treatment-related adverse events during treatment were recorded.Results The total effective rate and the strong effective rate in group D were higher than those in group A,group B and group C(P<0.05).The extreme strong effective rates of group A and group B were lower than that of group D(P<0.05).The DLQI scores in group B,group C and group D after treatment were lower than those before treatment(P<0.05).The DLQI score in group D was lower than those in group A,B and C(P<0.05).The DLQI scores of group B and group C were lower than those of group A(P<0.05).Patients'satisfaction score in group D was higher than those in group A,group B and group C(P<0.05).Patients in group B and C had higher satisfaction scores than that in group A(both P<0.05).The overall incidence of treatment-related adverse events in group D was higher than those in group A,group B and group C(P<0.05).Conclusion 2940nm Erb:YAG Laser combined with qubaitong gel encapsulation and 308nm excimer laser can effectively promote the repigmentation of skin lesions,improve patients'quality of life and have higher patient satisfaction,but increase the incidence of treatment-related adverse events.