激光联合自拟祛白汤治疗外阴白斑的临床疗效

Joint Effect of Laser and Qubai Decoction on Vulvar Leukoplakia

目的观察超脉冲CO_(2)激光联合自拟祛白汤治疗外阴白斑的临床疗效。方法选取2017年8月至2019年10月,外阴白斑患者120例,根据随机数字表法分为激光组、中药组和传统组,每组患者各40例。激光组采用超脉冲CO2激光治疗联合内服自拟祛白汤,激光治疗能量密度45~55 mJ/个脉冲,每月1次;祛白汤每日一剂,早晚分服,连续治疗3个月;中药组采用维生素E软膏和2%丙酸睾丸酮鱼肝油软膏涂抹,外加内服自拟祛白汤治疗3个月;传统组仅采用维生素E软膏和2%丙酸睾丸酮鱼肝油软膏涂抹治疗3个月。三组治疗后1个月,判定各组患者的临床效果及患者满意度;治疗后3个月,观察各组复发情况。结果(1)治疗后1个月,激光组总有效率87.5%,中药组总有效率47.5%,传统组总有效率25.0%,激光组临床总有效率显著高于中药组和传统组,差异均具有统计学意义(P<0.05)。(2)治疗后1个月,激光组患者满意度为97.5%,中药组满意度为70.0%,传统组满意度为27.5%,激光组满意度明显高于中药组和传统组,差异均具有统计学意义(P<0.05)。(3)治疗后3个月,激光组复发1例(9.09%)、中药组复发2例(50%)、传统组复发1例(100%),激光组复发率显著低于中药组和传统组,差异均具有统计学意义(P<0.05)。结论超脉冲CO2激光联合自拟祛白汤治疗外阴白斑临床疗效显著,复发率低,患者满意度高,值得推广应用。

Objective To observe the joint clinical effect of ultra-pulsed CO_(2) laser and Qubai Decoction on vulvar leucoplakia.Methods Totally 120 patients with vulvar leukoplakia from Aug.2017 to Oct.2019 were randomly divided into three groups:the laser group,traditional Chinese medicine group and traditional group.The patients in the laser group were given ultra-pulsed CO_(2) laser irradiation plus self-made Qubai Decoction.The patients in the traditional Chinese medicine group were treated with vitamin E ointment and 2%testosterone propionate cod liver oil ointment in addition to self-made Qubai Decoction.The patients in the traditional group were dealt only with vitamin E ointment and 2%testosterone propionate cod liver oil ointment.The treatment of each group lasted for 3 months,and their clinical effect and patient satisfaction were compared.All the patients were followed up for 3 months to observe the recurrence of each group.Results 1.One month after the treatment,the total effective rate of the laser group,traditional Chinese medicine group and traditional group was 87.5%,47.5%and 25.0%respectively.The total clinical effective rate of the laser group was significantly higher than that of the traditional Chinese medicine group and traditional group(P<0.05).2.One month after the treatment,the patients’satisfaction in the laser group,traditional Chinese medicine group and traditional group was 97.5%,70.0%and 27.5%respectively.The satisfaction in the laser group was significantly higher than that in the traditional Chinese medicine group and traditional group(P<0.05).3.Three months after the treatment,1 case of recurrence was found in the laser group(9.09%),2 cases in the traditional Chinese medicine group(50%),and 1 case in the traditional group(100%).The recurrence rate in the laser group was significantly lower than that in the traditional Chinese medicine group and traditional group(P<0.05).Conclusions With a low recurrence rate and high patient satisfaction,the combination of ultra-pulsed CO_(2) laser and Qubai Decoction is rather effective in treating vulvar leukoplakia and worth being popularized.