护理干预在退白汤联合NB—UVB紫外线照射治疗寻常型白癜风中的应用

目的探讨护理干预在退白汤联合NB-UVB紫外线照射治疗寻常型白癜风中的应用效果。方法将178例寻常型白癜风患者按就诊顺序采用单双号抽签法分为实验组89例和对照组89例;实验组内服退白汤联合NB-UVB紫外线照射,同时配合适当的护理于预;对照组仅内服退白汤联合NB—UVB紫外线照射,两组患者疗程均为3个月。采用统一的疗效评定标准进行疗效和安全性评价。结果实验组有效率75．28％,对照组有效率为60．67％,两组比较差异有统计学意义（χ^2=4．3616,P〈0．05）;实验组治疗寻常型白癜风局限性疗效明显优于治疗散发性疗效,差异有统计学意义（85．42％比63．41％,χ^2=5．7523,P〈0．05）;两组患者总不良反应发生率比较,差异无统计学意义（χ^2=0．0465,P〉0．05）。结论退白汤内服联合NB-UVB紫外线照射并配合适当的护理干预是治疗寻常型白癜风的有效方法。     

自拟白灵方治疗白癜风的疗效观察

目的观察自拟白灵方对白癜风的临床疗效及安全性。方法 251例白癜风患者随机分为三组,治疗组1口服白灵方1帖,每日2次,治疗组2NB-UVB照射治疗,每周2次,治疗组3口服白灵方联合NB-UVB照射治疗。疗程均为3个月,疗程结束时评价疗效及安全性指标。结果治疗组1有效率50.5%,治疗组2有效率53.7%,治疗组3有效率74.4%。组1与组2相比,有效率无显著性差别(P0.05)。组1、组2分别与组3相比,均有显著性差别(P0.05)。结论白灵方在临床疗效与NB-UVB照射作用相当,两者联用时疗效优于单用,二者有很好的协同作用,且无明显不良反应。     

窄谱中波紫外线光疗联合更昔洛韦治疗儿童水痘疗效观察

目的观察窄谱中波紫外线光疗联合更昔洛韦治疗儿童水痘的疗效。方法将60例水痘患儿随机分为两组,治疗组采用更昔洛韦注射液（5mg/kg静滴,1次/d）联合窄谱中波紫外线照射（NB-UVB,波长311nm）隔日一次治疗;对照组单独给予更昔洛韦注射液（5mg/kg静滴,1次/d）治疗。观察两组临床疗效,记录不良反应。结果治疗组总有效率为93.33%,对照组总有效率为73.33%,两组总有效率差异有显著统计学意义（χ^2=5.24,P〈0.05）。未出现严重不良反应。结论 NB-UVB联合更昔洛韦治疗儿童水痘安全有效。     

中药药浴联合NB-UVB照射治疗寻常型银屑病疗效观察及护理

目的观察中药药浴联合窄谱中波紫外线（NB-UVB）照射治疗寻常型银屑病的临床疗效。方法回顾性分析112例寻常型银屑病患者临床资料,治疗组采用中药药浴1次/d,每次20min,NB-UVB隔日照射1次;对照组采用隔日照射NB-UVB1次,两组均外用地米硼酸乳膏2次/d,口服昆明山海棠,每日20g煎后分3次服。2周为1个疗程,2个疗程结束后判断疗效。结果治疗组疗效为94.6%、住院天数为（23.68±9.28）d、不良反应4例,对照组疗效为80.4%、住院天数为（30.57±8.17）d、不良反应12例,差异有统计学意义（P〈0.05）。结论中药药浴联合窄谱中波紫外线照射治疗寻常型银屑病疗效好,能缩短平均住院天数,有效降低NB-UVB治疗的不良反应,患者依从性好。     

阿维A联合窄谱中波紫外线治疗斑块型银屑病疗效观察

目的：观察阿维A胶囊联合窄谱中波紫外线治疗斑块型银屑病的疗效。方法：161例患者随机分为3组,治疗组口服阿维A胶囊,配合NB-UVB照射;对照组1只口服阿维A胶囊;对照组2单独应用NB—UVB照射治疗。结果：治疗3、6、9周时治疗组有效率均高于对照组1和对照组2,组间比较差异均有统计学意义（P〈0.005）。结论：阿维A联合NB-UVB治疗斑块型银屑病,可增加患者对光疗的敏感性,减少光疗的量和治疗时间,同时也减少阿维A的用量,从而减少副作用的发生,在临床中值得推广。     

The use of Janus kinase inhibitors and narrowband ultraviolet B combination therapy in non-segmental vitiligo

Vitiligo is a depigmentation disorder of the skin that occurs secondary to the destruction of melanocytes by an immune-mediated process. Vitiligo clinically presents with depigmented macules and patches, most commonly on the face, acral sites, and genitalia. It can be characterized as generalized or localized based on distribution. The localized form can be further divided into segmental (linear, band-like, or Blaschkoid) and non-segmental vitiligo. The classical treatment of vitiligo includes topical steroids, pulsed oral steroids in unstable vitiligo, phototherapy, a combination of steroid therapy and phototherapy, surgical grafting, as well as intentional depigmentation therapy in severe cases. However, recent advances in understanding the immune mechanisms implicated in the pathogenesis of vitiligo have led to the use of an FDA-approved topical Janus kinase (JAK) inhibitors for vitiligo. Despite this novel therapy advancement, we recommend the addition of narrowband ultraviolet B (NB-UVB) to JAK inhibitors in patients with extensive and progressive lesions, or those not fully responsive to JAK inhibitor monotherapy.     

Comparison of NB-UVB combination therapy regimens for vitiligo: A systematic review and network meta-analysis

Background

Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation.

Objectives

To compare the effectiveness of current NB-UVB combination regimen at the improvement in repigmentation through a systematic review and network meta-analysis.

Methods

We searched the electronic databases for randomized controlled trials related to NB-UVB combination therapy for vitiligo till October 2022. STATA15.0 software was applied to carrying out data analysis.

Results

A total of 28 eligible studies involving 1194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy [OR = 32.35, 95% CI (1.79, 586.05)], Er: YAG laser+ topical 5% 5-FU [OR = 10.74, 95% CI (4.05, 28.49)], needling/micro-needling [OR = 3.42, 95% CI (1.18, 9.88)], betamethasone intramuscular injection [OR = 3.08, 95% CI (1.17, 8.13)], topical tacrolimus [OR = 2.54, 95% CI (1.30, 4.94)], and oral Chinese herbal medicine compound [OR = 2.51, 95% CI (1.40, 4.50)] integrated with NB-UVB were more efficacious in excellent to complete repigmentation response rate (≥75%). Besides, NB-UVB+ Er: YAG laser+ topical 5% 5-FU [OR = 0.17, 95% CI (0.04, 0.67)] and NB-UVB+ needling/micro-needling [OR = 0.24, 95% CI (0.06, 0.88)] were less likely evaluated as ineffective repigmentation response (≤25%).

Conclusions

All combination therapies ranked higher than NB-UVB monotherapy in inducing successful repigmentation and avoiding failed treatment in patients with vitiligo. Comprehensive consideration, NB-UVB+ Er: YAG laser+ topical 5% 5-FU and NB-UVB+ needling/microneedling would be the preferred therapeutic approaches.