高文清

【摘要】 目的 分析他克莫司软膏+窄谱中波紫外线治疗白癜风的疗效和安全性。方法 92例白癜风患者， 随机分为实验组和参照组， 每组46例。参照组给予0.1%他克莫司乳膏治疗， 实验组给予他克莫司乳膏联合窄谱中波紫外线治疗， 比较两组患者治疗效果、皮损色素积分、皮损面积以及不良反应发生情况。结果 实验组治疗总有效率95.65%高于参照组的67.39%， 差异具有统计学意义（χ2=12.1945， P=0.0005<0.05）。治疗后， 实验组患者皮损色素积分（0.79±0.11）分、皮损面积（2.62±0.13）cm2均低于参照组的（1.68±0.18）分、（4.52±0.33）cm2， 差异均具有统计学意义（P<0.05）。两组不良反应发生率比较， 差异无统计学意义（χ2=0.1232， P=0.7256>0.05）。结论 他克莫司软膏+窄谱中波紫外线可有效改善白癜风患者临床症状， 缩小皮损面积， 且不良反应较少， 值得借鉴。

【关键词】 他克莫司软膏;窄谱中波紫外线;白癜风;临床疗效;安全性

DOI：10.14163/j.cnki.11-5547/r.2020.18.014

Efficacy and safety of tacrolimus ointment combined with narrow-band ultraviolet B in the treatment of vitiligo   GAO Wen-qing. Department of Dermatology， Chifeng Hospital， Chifeng 024000， China

【Abstract】 Objective   To analyze the efficacy and safety of tacrolimus ointment combined with narrow-band ultraviolet B in the treatment of vitiligo. Methods   A total of 92 vitiligo patients were randomly divided into experimental group and control group， with 46 cases in each group. The control group was treated by 0.1% tacrolimus ointment， and the experimental group was treated by tacrolimus ointment combined with narrow-band ultraviolet B. The therapeutic effect， skin lesion pigment score， skin lesion area and occurrence of adverse reactions were compared between the two groups. Results   The total effective rate of treatment 95.65% of the experimental group was higher than that of the control group 67.39%， and the difference was statistically significant （χ2=12.1945， P=0.0005<0.05）. After treatment， the skin lesion pigment score （0.79±0.11） points and skin lesion area （2.62±0.13）cm2 of the experimental group were lower than those of the control group （1.68±

0.18） points and （4.52±0.33）cm2， and the difference was statistically significant （P<0.05）. There was no statistically significant difference in incidence of adverse reactions between the two groups （χ2=0.1232， P=0.7256>0.05）. Conclusion   Tacrolimus ointment combined with narrow-band ultraviolet B can effectively improve the clinical symptoms of vitiligo patients and reduce the area of skin lesions with few adverse reactions， which is worthy of reference.

【Key words】 Tacrolimus ointment; Narrow-band ultraviolet B; Vitiligo; Clinical efficacy; Safety

白癜風是皮肤科常见病之一， 通常认为是皮损中功能性黑素细胞缺失， 导致白斑发生， 易诊断难治疗。既往有研究表明：细胞免疫、体液免疫功能障碍与白癜风的发生、发展有着极为密切的联系[1]。他克莫司软膏是临床常用的免疫调节剂， 在白癜风治疗中具有一定成效， 但单一他克莫司并不能取得预期理想的治疗效果， 往往需要辅助其他治疗方案。窄谱中波紫外线通过照射刺激干细胞因子表达， 具有刺激黑素细胞增殖、移行的作用。基于此， 本文回顾性研究本院2017年10月～2019年10月收治的92例白癜风患者， 具体如下。

1 资料与方法

1. 1 一般资料 回顾性分析本院2017年10月～2019年

10月收治的92例白癜风患者， 医院伦理委员会已批准本项研究， 将所有患者随机分为实验组和参照组， 每组46例。实验组女17例， 男29例;年龄22～38岁， 平均年龄……