火针联合卤米松乳膏治疗稳定期白癜风患者的疗效观察及对CD4+、CD8+、CD4+/CD8+水平的影响

 目的 观察火针联合卤米松乳膏治疗稳定期白癜风的临床疗效，检测对患者CD4⁺、CD8⁺及CD4⁺/CD8⁺水平的影响。方法 选择我院皮肤科及中医科门诊自2018年1月—2019年12月诊治的60例稳定期白癜风患者作为研究对象，随机分成对照组 (30例) 和试验组(30例)，对照组采用卤米松乳膏治疗，试验组予以火针联合卤米松乳膏治疗，比较两组患者治疗前后的白癜风面积评分指数(VASI),观察总有效率以及不良反应发生率。同时检测患者治疗前后CD4⁺、CD8⁺及 CD4⁺/CD8⁺的表达水平。结果两 组患者治疗前的VASI对比无显著差异(P＞0.05)。治疗后，试验组VASI明显低于对照组(9.73±0.56比10.79±1.13，t=4.60,P＜0.05），总有效率明显高于对照组(86.67%比63.33%,X²=4.36,P=0.037）。两组治疗后CD3⁺、CD4⁺、CD4⁺/CD8⁺均高于治疗前，试验组治疗后CD3+为(69.23±5.27)%，CD4⁺ 为(44.03±3.94)%,CD4⁺/CD8⁺比值为 (2.54±0.99)，对照组治疗后CD3⁺为(66.60±7.56)%，CD4⁺为(38.13±6.51)%, CD4⁺/CD8⁺比值为(1.91±0.87)，试验组各指标均高于对照组（均P＜0.05）；治疗后试验组CD8⁺为(19.30±5.55)%，低于对照组的(23.20±8.36)%，差异有统计学意义（P＜0.05）。结论 火针联合卤米松乳膏治疗不仅能有效促进稳定期白癜风患者皮肤恢复正常肤色，提高有效率，且能调节患者T淋巴细胞亚群，提高患者细胞免疫功能。因此火针是一种安全、高效的治疗方法，值得临床推广。

Therapeutic effects of fire-needling combined with halomethasone cream on stable vitiligo and its effect on CD4+, CD8+ and CD4+/CD8+ levels

Objective To evaluate the clinical efficacy of fire needling combined with halomethasone cream in the treatment of stable vitiligo, and its impact on the levels of CD4⁺, CD8⁺ and CD4⁺/CD8⁺, providing a rationale for the clinical use of fire needling. Methods Totally 60 patients with stable vitiligo were randomly divided into the control group (30 cases) and experimental group (30 cases). The control group was treated with halomethasone cream, and the experimental group was treated with fire needling combined with halomethasone cream. The vitiligo area scoring index (VASI), the total effective rate and the incidence of adverse reactions were compared between the two groups before and after the treatment. At the same time, the expression levels of CD4⁺, CD8⁺ and CD4⁺/CD8⁺ before and after the treatment were detected. Results There were no significant differences in skin lesion area and skin pigmentation score between the two groups before the treatment (P>0.05). After the treatment, the incidence of VASI (9.73±0.56) in the experimental group were significantly lower than that in the control group (10.79±1.13, t=4.60, P<0.05). The total effective rate of the experimental group was significantly higher than that in the controls (86.67% vs. 63.33%, X²=4.36, P=0.037). Both treatments increased CD3⁺, CD4⁺, CD4⁺/CD8⁺. After the treatment, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the experimental group were also significantly higher than that in the controls ［(69.23±5.27)% vs. (66.60±7.56)% for CD3⁺, (44.03±3.94)% vs. (38.13±6.51)% for CD4⁺, and (2.54±0.99)% vs. (1.91±0.87)% for CD4⁺/CD8⁺, P<0.05 for all］. After the treatment, CD8⁺ levels were lower in the treatment group than in the controls ［(19.30±5.55)% vs. (23.20±8.36)%, P＜0.05］. Conclusions Treatment of stable vitiligo with fire needling plus halomethasone increases therapeutic efficacy and improve the distribution of circulating T lymphocyte subsets. Therefore, fire needling is safe and effective for stable vitiligo.