易清玲 李燕 霍海英 蒲泳君

[摘要]目的：觀察点阵CO2激光联合卤米松乳膏及窄谱中波紫外线（NB-UVB）治疗稳定期白癜风的临床疗效。方法：选取90例稳定期白癜风患者，随机分为实验组和对照组，每组45例。实验组：采用点阵CO2激光+卤米松软膏封包+NB-UVB照射;对照组：采用卤米松乳膏+NB-UVB照射。3个月后比较两组的疗效差异、实验组中不同部位的疗效、皮损面积及不良反应发生情况等。结果：实验组总有效率86.67%，明显高于对照组的68.89%（P<0.05）。实验组中颈部组总有效率（93.75%）明显高于躯干组（86.67%）和肢端组（78.57%），差异具有统计学意义（χ2=2.000，P<0.05）。两组治疗后皮损面积均减少（P<0.05），实验组治疗后皮损面积低于对照组（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）。结论：点阵CO2激光联合卤米松乳膏封包及NB-UVB治疗稳定期白癜风疗效显著且安全。

[关键词]白癜风;点阵激光;NB-UVB;卤米松乳膏

[中图分类号]R758.4+1    [文献标志码]A    [文章编号]1008-6455（2021）11-0051-03

Efficacy Observation of Fractional CO2 Laser Combined with Halometasone Encapsulation and NB-UVB in the Treatment of Stable Vitiligo

YI Qing-ling， LI Yan， HUO Hai-ying， PU Yong-jun

（Department of Dermatology，Mianyang Central Hospital， School of Medicine， University of Electronic Science and Technology of China， Mianyang 621000，Sichuan，China）

Abstract： Objective  To observe the clinical efficacy of fractional CO2 laser combined with halometasone encapsulation and NB-UVB in the treatment of stable vitiligo. Methods  90 patients with vitiligo in stable stage were randomly divided into experimental group and control group， 45 cases in each group. Cases of the experimental group were treated with fractional CO2 laser combined with halometasone encapsulation and NB-UVB， while cases of the control group were treated with halometasone combined with NB-UVB. Clinical efficacy between the two groups， clinical efficacy of different parts in the experimental group， skin lesion area and the adverse reactions were compared after 3 months of treatments. Results The total effective rate of  treatment group  and control group were 86.67% and 68.89%， there was statistically significant difference （P<0.05）.In the experimental group， the total effective rate of neck group （93.75%） was significantly higher than that of trunk group （86.67%）and extremities group（78.57%），and the difference was statistically significant（χ2=2.000，P<0.05）. After treatment， the skin lesion area of the two groups decreased （P<0.05）， and that of the experimental group was smaller than that of the control group （P<0.05）.There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion  The treatment of fractional CO2 Laser combined with halometasone encapsulation and NB-UVB in patients of stable vitiligo is effective and safe.

Key words： vitiligo; fractional laser; NB-UVB; halometasone cream

白癜风是一种常见的后天性色素脱失性皮肤黏膜病，病因与发病机制尚不完全清楚，目前治疗方法种类较多，卤米松乳膏是常使用的外用糖皮质激素，窄谱中波紫外线（NB-UVB）光疗是使用最广泛的物理治疗手段之一，疗效确切且安全[1-2]。点阵CO2激光可在皮肤上形成细小微孔，加大药物吸收，近年来被广泛应用于白癜风的治疗。本研究探讨点阵CO2激光与卤米松乳膏及NB-UVB联合治疗白癜风的疗效与安全性，现将结果报道如下。

1  资料和方法

1.1 一般资料：选取笔者医院门诊2019年8月-2020年10月确诊的90例稳定期白癜风患者为研究对象，随机分为实验组和对照组，每组45例。实验组：男24例，女21例，年龄15～60岁，平均（34.91±11.64）岁;病程12个月～22年，平均（57.74±54.30）个月;皮损面积（35.51±13.02）cm2;皮损部位：颈部16例，躯干15例，四肢14例，3个不同部位组的一般资料比较无显著性差异（P>0.05）;对照组：……