窄谱中波紫外线联合CO_(2)点阵激光治疗局限型白癜风对患者不良反应及生活质量的影响

Effect of Narrow Band Ultraviolet B Combined with CO_(2) Lattice Laser in the Treatment of Localized Vitiligo on Adverse Reactions and Quality of Life of Patients

目的:探讨窄谱中波紫外线联合CO_(2)点阵激光治疗局限型白癜风对患者不良反应及生活质量的影响。方法:选取2019年1月-2020年1月本院收治的局限型白癜风患者110例。采用随机数字表法将患者分为对照组和研究组,每组55例。对照组应用窄谱中波紫外线治疗,研究组应用窄谱中波紫外线联合CO_(2)点阵激光治疗。比较两组不良反应发生情况,比较两组治疗前后GQOLI-74各维度评分及GM-CSF、CD4^(+)CD25^(+)Treg、CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IL-17、IFN-γ、TNF-α水平。结果:研究组瘙痒、水疱、疼痛、红肿、结痂的总发生率低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组社会功能、躯体功能、物质生活状态、心理功能评分均高于对照组,差异均有统计学意义(P<0.05)。治疗后,研究组CD4^(+)、CD4^(+)/CD8^(+)、CD4^(+)CD25^(+)Treg水平均高于对照组,GM-CSF、CD8^(+)水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,研究组IL-17、IFN-γ、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。结论:在局限型白癜风治疗过程中,窄谱中波紫外线联合CO_(2)点阵激光治疗效果理想,能提高生活质量,降低不良反应发生率,临床上应进一步推广应用。

Objective:To explore the effect of narrow band ultraviolet B combined with CO_(2)lattice laser in the treatment of localized vitiligo on the adverse reactions and quality of life of patients.Method:A total of 110 patients with localized vitiligo admitted to our hospital from January 2019 to January 2020 were selected.The patients were divided into control group and study group by random number table method,55 cases in each group.The control group was treated with narrow band ultraviolet B,and the study group was treated with narrow band ultraviolet B combined with CO_(2)lattice laser.The incidence of adverse reactions between two groups was compared,the scores of GQOLI-74 and the levels of GM-CSF,CD4^(+)CD25^(+)Treg,CD8^(+),CD4^(+),CD4^(+)/CD8^(+),IL-17,IFN-γand TNF-αwere compared between two groups before and after treatment.Result:The total incidence of pruritus,blisters,pain,redness and scab in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,the scores of social function,physical function,physical life status and mental function in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of CD4^(+),CD4^(+)/CD8^(+)and CD4^(+)CD25^(+)Treg in the study group were higher than those in the control group,while the levels of GM-CSF and CD8^(+)were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of IL-17,IFN-γand TNF-αin the study group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:In the treatment of localized vitiligo,narrow band ultraviolet B combined with CO_(2)lattice laser has ideal therapeutic effect,which can improve the quality of life and reduce the incidence of adverse reactions,and it should be further promoted and applied in clinical practice.