308 nm准分子光联合复方倍他米松治疗进展期白癜风疗效及对复发的影响

Efficacy of 308 nm Excimer Laser Combined with Compound Betamethasone in the Treatment of Patients with Advanced Vitiligo and Its Influence on Recurrence

目的:探讨308 nm准分子光联合复方倍他米松治疗白癜风患者的临床效果及对病情复发的影响。方法:选取自2019年6月-2022年12月于安徽医科大学附属宿州医院-宿州市立医院皮肤科门诊就诊的白癜风患者105例,按照随机抛硬币法分为两组,观察组53例,对照组52例。两组均采用308 nm准分子光治疗,观察组在此基础上选择复方倍他米松外敷,治疗3个月后观察皮损面积、抗体水平、色素程度等。治疗结束跟踪观察12个月,检测白癜风复发情况。结果:治疗后,观察组的皮损面积显著低于对照组(P<0.05);治疗后观察组的甲状腺过氧化物酶抗体(Thyroid peroxidase antibody,TPOAb),甲状腺球蛋白抗体(Thyroglobulin antibody,TGAb),甲状腺受体抗体(Thyroid receptor antibody,TYR IgG)水平显著低于对照组(P<0.05);治疗后观察组的3级以上色素恢复程度占比显著高于对照组(P<0.05);治疗3、6、12个月,观察组患者白癜风活动程度(Vitiligo disease activity index,VIDA)评分显著低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。观察组治疗后12个月内白癜风复发率显著低于对照组(P<0.05)。结论:308 nm准分子光联合复方倍他米松比单独使用更能有效地治疗白癜风患者,显著改善皮损,提高自身免疫水平,提升整体色素恢复程度,降低患者远期复发率,具有临床应用价值。

Objective To explore the clinical effect of 308 nm excimer laser combined with compound betamethasone in the treatment of patients with vitiligo and its influence on disease recurrence.Methods 105 patients with vitiligo who were treated in dermatology clinic of Suzhou Hospital of Anhui Medical University(Suzhou Municipal Hospital)from June 2019 to December 2022 were selected and divided into two groups according to random coin tossing method,including 53 cases in observation group and 52 cases in control group.Both groups were treated with 308 nm excimer laser,and the observation group was treated with compound betamethasone on this basis.The skin area,antibodies and pigment degree were observed after 3 months of treatment.End of treatment follow-up observation for 12 months,the recurrence of vitiligo was detected.Results After study and treatment,the skin area in observation group was significantly smaller than that in control group(P<0.05).After treatment,the levels of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)and thyroid receptor antibody(TYR IgG)were significantly lower in observation group than those in control group(P<0.05).The proportion of pigment recovery degree above grade 3 in observation group after treatment was significantly higher than that in control group(P<0.05).After 3,6 and 12 months of treatment,the vitiligo disease activity index(VIDA)score in observation group was significantly lower compared with that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The recurrence rate of vitiligo in observation group within 12 months after treatment was significantly lower than that in control group(P<0.05).Conclusion 308 nm excimer laser combined with compound betamethasone is more effective than single use in the treatment of patients with vitiligo,and the former one can more significantly improve the skin lesions,increase the level of autoimmunity,enhance the overall pigment recovery degree,and reduce the long-term recurrence rate of patients,and it has clinical application value.