中药联合窄谱中波紫外线对白癜风患者治疗效果及对其免疫功能的影响

目的:探讨中药联合窄谱中波紫外线(NB-UVB)对白癜风的治疗效果及对患者免疫功能的影响。方法:选取2015年4月至2016年10月海南省皮肤病医院收治的白癜风患者98例,随机分为对照组和观察组,每组49例。对照组均进行NB-UVB治疗,观察组在此基础上结合白驳汤治疗,2组均连续治疗3个月。统计2组临床疗效;比较2组治疗前后白癜风病变面积改善情况;检测并比较治疗前后2组T淋巴细胞亚群比例及粒细胞-巨噬细胞集落刺激因子(GM-CSF)及白细胞介素-4(IL-4)、γ-干扰素(IFN-γ)表达和Th1/Th2。结果:治疗后观察组总有效率为81.63%,明显高于对照组的61.22%(P0.05)。治疗后2组白癜风病变面积均减小,且观察组明显小于对照组(P0.05)。治疗后2组CD4+、CD4～+ CD25～+Treg细胞比例及CD4+/CD8～+比值升高,CD8～+细胞比例及GM-CSF水平降低(P0.05),且2组间差异有统计学意义(P0.05)。治疗后2组血清IL-4水平升高,IFN-γ水平及Th1/Th2比值降低(P0.05)。结论:中药联合NB-UVB治疗白癜风疗效显著,可提高患者免疫功能,调节相关细胞因子的表达,延缓了疾病的进展,安全有效。

Clinical Efficacy of Traditional Chinese Medicine with NB-UVB on Vitiligo and Effects on Immune Function in Patients

To explore the clinical efficacy of Traditional Chinese Medicine (TCM) with NB-UVB on vitiligo and the effects on immune function in patients.Methods:A total of 98 patients with vitiligo treated in Hainan Skin Disease Hospital from April 2014 to October 2016 were selected and randomly divided into control group and observation group.Both groups received NB-UVB treatment,and observation group was additionally given Baibo Decoction for 3 months.The clinical efficacy of the 2 groups was statistically analyzed,and the improvement of the area of vitiligo before and after treatment was compared between the 2 groups.The proportion of T lymphocyte subsets and the expression levels of GM-CSF,IFN-prond IL-4 in the 2 groups before and after treatment were detected and compared,and Th1/Th2 was calculated.Results:The total effective rate was 81.63% in observation group after treatment,which was significantly higher than 61.22% of control group (P<0.05).The area of vitiligo lesions in both groups decreased after treatment,and the observation group decreased more significantly than the control group (P<0.01).After treatment,the proportion of CD4+,CD4+CD25+Treg cells and the ratio of CD4+/CD8+ in both groups were increased,and the proportion of CD8+ cells and the content of GM-CSF were decreased (P<0.05 or P<0.01).The difference between the 2 groups was significant (P<0.01).After treatment,serum IL-4 content increased,and IFN-gamma content and Th1/Th2 ratio decreased in both groups (P<0.01).Conclusion:TCM combined with NB-UVB is effective in treating vitiligo,which can improve the immune function of patients,regulate the expression of related cytokines and delay the progression of the disease,which is safe and effective.