毫火针联合卤米松及白灵方治疗顽固性白癜风的效果观察

Fire-needle therapy combined with halometasone and Bailing prescription the treatment of resistant vitiligo

目的顽固性白癜风是困扰患者的临床疾病,本研究旨在评价毫火针联合白灵方及卤米松治疗顽固性白癜风的临床效果。方法选取徐汇医院皮肤科既往接受1年以上白癜风治疗,病情抵抗,疗效不佳的顽固性白癜风患者,开展随机、自身、对照临床研究。对照组外用卤米松联合口服白灵方每日1剂,研究组在对照组的基础上加用毫火针治疗,每2周1次,疗程12周。根据全国中西医结合皮肤性病学会色素性皮肤病学组制定的白癜风疗效标准判定疗效。对比2组治疗疗效(显效率、有效率)及不良反应发生率的差异。结果42例患者共64处靶皮损纳入分析。研究组显效率为40.6%(26/64靶皮损),基础治疗组显效率为21.9%(14/64靶皮损)。研究组总有效率为71.8%(46/64靶皮损),基础治疗组总有效率为48.4%(31/64靶皮损),联合毫火针治疗组疗效明显优于对照组(P<0.05)。研究组与对照组分别有3例及2例患者发生不良反应,不良反应发生率比较差异无统计学意义(P>0.05)。结论对于顽固性白癜风,在外用卤米松及口服白灵方的基础上,联合毫火针有显著的增加效应,且没有增加不良反应。显示了毫火针在顽固性白癜风联合治疗中的优势。

Objective To evaluate the add-on effect of fire-needle therapy combined with Bailing prescription and halomethasone in the treatment of resistant vitiligo.Methods Patients with refractory vitiligo who had received vitiligo treatment for more than one year in the Department of Dermatology of Xuhui Hospital were selected to carry out a randomized,self controlled clinical study.The control group was treated with halometasone combined with Bailing prescription once a day,while the study group was treated with fire-needle therapy on the basis of the control group,once every two weeks,with a course of 12 weeks.According to the efficacy standard of vitiligo formulated by pigmented dermatology group of national society of integrated traditional Chinese and western medicine dermatology and Venereology,the efficacy was determined.The curative effect(significant efficiency,effective rate)and the incidence of adverse reactions were compared between the two groups.Results A total of 64 target lesions in 42 patients were included in the analysis.The significant efficiency of the combination group was 40.6%,and that of the basic treatment group was 21.9%.The effective rate of the combination group was 71.8%,and the basic treatment group was 48.4%.The combination group showed significantly superior efficacy than that of the basic treatment group(P<0.05).There were 3 cases and 2 cases of adverse reactions in the combination group and the basic treatment group respectively,and there was no significant difference in the incidence of adverse reactions(P>0.05).Conclusion The fire-needle therapy combined with Bailing prescription and halomethasone can significantly increase the treatment effect of refractory vitiligo,and does not increase the adverse reactions.It shows the advantage of milli fire acupuncture in the treatment of refractory vitiligo.