窄谱中波紫外线联合0.1%他克莫司软膏治疗白癜风疗效分析

Efficacy of Narrow-band Ultraviolet B Combined with 0.1%Tacrolimus Ointment in Vitiligo

目的:探究窄谱中波紫外线联合0.1%他克莫司软膏治疗白癜风患者疗效及对皮损面积和色素积分的影响。方法:将笔者医院皮肤科于2020年1月-2023年1月收治的96例门诊患者纳为研究对象,根据随机数字法将所有患者分为对照组与观察组,每组各48例,给予对照组患者外涂0.1%他克莫司软膏治疗;观察组在对照组治疗基础上联合窄谱中波紫外线治疗。对比两组患者整体疗效,治疗前后皮损面积(Wood灯下皮损评估)与色素积分、不同部位严重性指数(Psoriasis area and severity index,PASI)与白癜风面积指数(Vitiligo area and severity index,VASI),不良反应发生情况及复发率。结果:观察组总有效率(97.92%)显著高于对照组(85.42%)(P<0.05);治疗后,两组患者皮损面积显著降低(P<0.05),且观察组显著低于对照组(P<0.05);治疗后,两组色素积分显著上升(P<0.05),且观察组显著高于对照组(P<0.05);治疗后,观察组各部位(躯干、四肢、面部)PASI与VASI均显著低于对照组(P<0.05);两组患者治疗期间不良反应发生率[观察组(16.67%) vs.对照组(10.42%)]与复发率[观察组(6.25%)vs.对照组(8.33%)]差异无统计学意义(P>0.05)。结论:窄谱中波紫外线联合0.1%他克莫司软膏可显著改善白癜风患者病情,缓解皮肤损伤,增加皮肤色素沉着,安全有效,值得临床推广。

Objective To explore the efficacy of narrow-band ultraviolet B(NB-UVB)combined with 0.1%tacrolimus ointment in the treatment of patients with vitiligo,and to assess its impact on the skin lesion area and pigmentation score.Methods A total of 96 outpatients admitted to the Department of Dermatology of the author's hospital from January 2020 to January 2023 were included as study subjects.According to the random number table method,the patients were divided into an ointment group and a phototherapy group,with 48 cases in each group.The ointment group was treated with 0.1%tacrolimus ointment applied twice daily for 16 weeks,while the phototherapy group received narrow-band ultraviolet B(NB-UVB)therapy twice a week for 16 weeks in addition to the ointment treatment.The overall efficacy,skin lesion area(assessed under a Wood lamp),pigmentation score,Psoriasis Area and Severity Index(PASI),Vitiligo Area and Severity Index(VASI)of different parts,and occurrence of adverse reactions were compared between the two groups before and after treatment.Results The efficacy in the phototherapy group(97.92%)was significantly higher than that in the ointment group(85.42%)(P<0.05).After treatment,the skin lesion area in both groups was significantly reduced(P<0.05),with a significantly smaller area observed in the phototherapy group compared to the ointment group(P<0.05).The pigmentation scores in both groups significantly increased after treatment(P<0.05),with the phototherapy group showing a significantly higher score than the ointment group(P<0.05).The PASI and VASI scores of different parts in the phototherapy group were significantly lower after treatment compared to the ointment group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the phototherapy group(16.67%)and the ointment group(10.42%)during treatment(P>0.05).Conclusion Narrow-band ultraviolet B(NB-UVB)combined with 0.1%tacrolimus ointment can significantly improve disease outcomes,reduce skin damage,and increase skin pigmentation in patients with vitiligo.The combined treatment is both safe and effective.