308nm准分子激光治疗白癜风概述

白癜风治疗方法较多,308 nm准分子激光凭借起效快、疗效高及副作用小等优势而迅速应用于临床。其治疗白癜风的作用机制不清,可能通过诱导皮损处浸润的淋巴细胞凋亡而取得疗效。联合外用他克莫司软膏或吡美莫司乳膏治疗白癜风效果比单独应用308 nm准分子激光更为显著。     

308‐nm excimer lamp vs. 308‐nm excimer laser for treating vitiligo: a randomized study

Background The 308‐nm excimer laser and 308‐nm excimer lamp have both been shown to be effective in treating vitiligo but a direct comparison has never been performed. Objectives To test the equivalence of these two devices for treating nonsegmental vitiligo. Patients and methods A randomized monocentric study was undertaken. One lesion was treated with the 308‐nm excimer laser and its counterpart with the 308‐nm excimer lamp. Lesions were treated twice weekly with the same dose on both sides for a total of 24 sessions. The evaluation was done by two independent physicians blinded to the treatment on direct light and ultraviolet light photos. Results Twenty patients were included: 17 completed the study and 104 lesions were treated. The two treatments showed similar results in terms of efficacy for a repigmentation of at least 50% (P = 0·006). The lamp induced more erythema than the laser. Conclusions The 308‐nm excimer lamp and laser showed a similar efficacy in treating vitiligo. For the same fluence, the lamp induced more erythema suggesting photobiological differences between the two devices.     

308nm准分子光治疗白癜风疗效评价

目的：评价308nm准分子紫外光治疗白癜风的临床疗效。方法：31例进展期和34例稳定期白癜风患者皮损行308nm准分子紫外光治疗,共照射30次。结果：进展期和稳定期白癜风患者总有效率分别为62．14％、73．52％,无显著性差异（P〉0．05）。头面部及躯干部效果较好,肢端效果最差。结论：308nm准分子紫外光治疗白癜风安全有效,其疗效与皮损部位相关,与进展期或稳定期无关。     

他克莫司软膏联合308 nm准分子激光治疗白癜风临床疗效观察

目的：评价0．1％和0．03％他克莫司软膏联合308nm准分子激光治疗对紫外线治疗抵抗的白癜风皮损的疗效与安全性。方法：采用随机、自身对照的临床试验，每例患者选取紫外线治疗抵抗区域的皮损，随机选取躯体一侧皮损为治疗侧，采用他克莫司软膏联合308nm准分子激光治疗；另一侧为对照侧，仅用308nm准分子激光治疗。2个月后进行疗效判定。结果：联合治疗组有效率为89．0％，对照组为71．6％，两组间疗效比较差异有统计学意义（P〈0．05）。结论：他克莫司软膏联合308nm准分子激光治疗白癜风起效快，疗效好。     

308nm准分子光联合吡美莫司乳膏治疗白癜风疗效观察

目的：评价308 nm准分子光联合吡美莫司乳膏治疗白癜风的疗效和安全性.方法：将150例白癜风患者随机分为3组.治疗组50例,采用308 nm准分子光联合1%吡美莫司乳膏治疗.对照1组50例,采用NB-UVB联合1%吡美莫司乳膏治疗.对照2组50例,单纯外用1%吡美莫司乳膏治疗.3组均连续治疗12～24周,进行临床疗效和不良反应评价.结果：治疗组有效率为92.0%,对照1组为74.0%,对照2组为50.0%.3组患者均未出现严重不良反应.结论：308 nm准分子光联合吡美莫司乳膏治疗白癜风疗效确切,安全性好.     

他克莫司软膏联合308 nm准分子激光治疗小儿面部白癜风的疗效观察

目的 观察他克莫司软膏联合308 nm准分子激光治疗小儿面部白癜风的临床疗效。方法 将98例(269处)面部白癜风患儿,以各所医院为独立单元,按就诊时间顺序分组,对照组49例(131处皮损)单纯使用308 nm准分子激光治疗仪治疗,每周2次;治疗组49例(138处皮损)在使用准分子激光治疗仪治疗基础上加外用他克莫司软膏,每天2次。治疗3个月后对两组患儿的疗效和不良反应进行评价。结果 治疗组有效率为92.03%,不良反应率为6.52%;对照组有效率为79.39%,不良反应率为6.11%,两组有效率比较,差异有统计学意义(χ²=8.85,P<0.01),不良反应率比较差异无统计学意义(χ²=0.02,P>0.05)。结论 他克莫司软膏联合308 nm准分子激光治疗小儿面部白癜风疗效确定、安全无痛,容易被小儿及家长接受,值得进一步推广。     

The 308-nm excimer laser: a promising device for the treatment of childhood vitiligo

Background: Numerous modalities have been used to treat vitiligo in children. Up to now, phototherapy and topical corticosteroids are the most commonly used treatments for adult vitiligo but studies evaluating the efficacy of these treatments in the pediatric population remain insufficient. Objective: This study was a retrospective review to evaluate the efficacy and safety of 308‐nm excimer laser treatment in 30 childhood vitiligo patients. Methods: Thirty vitiligo patients with 40 vitiligo patches were evaluated after the cessation of 308‐nm excimer laser treatment. Results: Seventeen patients (56.7%) with 20 patches (50%) achieved an acceptable degree (>50%) of repigmentation at the end of the treatment, with five patches (12.5%) showing >75% of repigmentation. The treatment response showed anatomical preferences, favoring the face, neck and trunk. However, the treatment response did not correlate to the cumulative dose or duration of treatment. Side effects occurred in nine patients, but were transient and minimal. Conclusion: The results of this study shows that the 308‐nm excimer laser can be an effective and promising device for the treatment of various vitiligo types, other than generalized, in childhood.     

CO2点阵激光联合308 nm准分子激光治疗白癜风疗效和安全性meta分析

目的：评价CO₂点阵激光联合308 nm准分子激光治疗白癜风的临床疗效和安全性。方法：通过检索Cochrane Library、PubMed、Embase、万方、中国知网、维普数据库,收集CO₂点阵激光与308 nm准分子激光联合治疗白癜风相关的文献,运用软件（Revman 5.3）进行Meta分析。结果：13篇临床随机对照实验被纳入,其中1014处皮损给予CO₂点阵激光与308 nm准分子激光联合治疗,1005处皮损给予308 nm准分子激光单独治疗。结果显示：联合疗法总有效率和显效率优于单用308 nm准分子激光;两组不良反应发生率无明显差异。结论： CO₂点阵激光+308 nm准分子激光联合治疗白癜风的疗效优于单独使用308 nm准分子激光,且两种疗法的不良反应没有明显差异。     

308 nm准分子激光治疗白癜风临床疗效观察

目的：观察308nm氯化氙准分子激光治疗白癜风的临床疗效及不良反应。方法：采用Xtrac颠峰准分子激光系统对77例白癜风患者不同部位共292处皮损进行治疗,每周1～2次。并观察疗效,达到3级色素恢复后对相关因素进行分析。结果：经治疗面颈部皮损起效最快,其次为躯干部、四肢,褶皱部最慢;年龄〈18岁患者皮损起效快于年龄〉18岁患者;不同性别、疾病分期、病程、皮肤类型患者的起效快慢差异无统计学意义。结论：308nm准分子激光治疗白癜风疗效好,不良反应少,其疗效与年龄、皮损部位有关。     

308nm准分子激光联合胡椒碱治疗白癜风疗效观察

目的评价308nm准分子激光联合胡椒碱对白癜风的临床疗效和安全性。方法将入选的87例白癜风患者按就诊顺序随机分为2组,共80例患者完成试验观察,治疗组予308nm准分子激光局部照射每周2次,联合胡椒碱酊局部外用2次/d治疗,对照组予308nm准分子激光局部照射每周2次,联合8-甲氧基补骨脂素(8-MOP)溶液局部外用2次/d治疗。治疗时间为4周一疗程,治疗3个疗程,比较2组患者在白癜风皮损复色上的差异。结果治疗组的显效率90%,对照组为77.5%。2组显效率差异有统计学意义(P0.05),治疗中未出现严重的不良反应。结论 308nm准分子激光联合胡椒碱对于治疗白癜风有明显的效果,且无明显不良反应,对白癜风的治疗是一个很好的选择。     

Clinical efficacy of a 308 nm excimer laser for treatment of psoriasis vulgaris

OBJECTIVE: To evaluate the efficacy and safety of a 308 nm excimer laser for the treatment of psoriasis vulgaris patients. METHOD: Forty subjects with psoriasis vulgaris (26 macular type, and 14 chronic plaque type) were treated by a 308 nm excimer laser. The initial dose was based on multiples of a predetermined minimal erythema dose, while the subsequent doses were adjusted on the response to the intervention, which was twice per week for a total of 15 treatments. The therapeutic efficacy and safety were then evaluated. RESULTS: Of the 40 patients who received and completed the entire 15 times of laser radiation, (1) the Psoriasis Area and Severity Index score was improved by 90.19+/-10.12% and 77.34+/-17.04% in macular type and chronic plaque type, respectively (P<0.05) and (2) the average treatment sessions were 13.7 times. The average cumulative doses for all patients were 6.86+/-2.48 J/cm(2), in which it was 5.64+/-1.86 J/cm(2) for macular type and 9.13+/-1.80 J/cm(2) for chronic plaque type, respectively (P<0.05). CONCLUSION: Our clinical data suggest that treatment of psoriasis vulgaris by a 308 nm excimer laser is effective and safe, and it is more efficacious in macular type than in chronic plaque type.     

The effectiveness of topical therapy combined with 308‐nm excimer laser on vitiligo compared to excimer laser monotherapy in pediatric patients

We evaluated the efficiency of using a 308‐nm excimer laser with either tacrolimus, pimecrolimus, or halometasone for the treatment of childhood vitiligo. Patients who received combined treatments had significantly higher rates of repigmentation in comparison with individuals who underwent excimer laser alone therapy. Moreover, patients who received treatment with excimer laser and halometasone had significantly higher rates of repigmentation, even higher than individuals who were treated with tacrolimus combined or pimecrolimus combined. This regimen was more effective on the face, neck, and limbs. We conclude that the use of a combined excimer laser and halometasone cream has a greater therapeutic effect than laser alone.     

308-nm准分子激光联合他克莫司软膏治疗面部白癜风656例疗效评价

目的：评价308nm准分子激光联合他克莫司软膏治疗面部白癜风的疗效。方法：对656例面部白癜风患者照射308nm准分子激光联合外用他克莫司软膏。他克莫司软膏每日2次,308nm准分子激光每周治疗1-2次,共治疗30次。末次治疗后随访1年。结果：1630块白斑中,总有效率为47.12%,病程<2年皮损总有效率为58.10%高于病程≥2年皮损的16.60%,两组差异具有统计学意义(P<0.001)。眼周皮损疗效最佳,总有效率为54.96%,口周皮损疗效最差,总有效率为40.22%,差异有统计学意义（P<0.0001）。结论：308 nm准分子激光联合他克莫司软膏治疗面部白癜风的疗效与病期和皮损部位有关。     

308 nm准分子激光联合富血小板血浆治疗白癜风有效性与安全性Meta分析

目的: 比较308 nm准分子激光联合富血小板血浆(platelet-rich plasma,PRP)与单用308 nm准分子激光治疗白癜风的有效性与安全性.方法: 检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库中关于308 ...     

308nm准分子激光治疗皮肤病的进展

308nm准分子激光是近年应用于皮肤病的一种新型紫外线,具有治疗次数少、累积剂量低、不累及正常皮肤、副作用少等特点,在治疗银屑病、白癜风方面已证实有显著而安全的疗效,对传统的紫外线疗法有效的特应性皮炎、扁平苔癣、蕈样肉芽肿、湿疹等皮肤病也有潜在的应用前景。本文综述了308nm准分子激光在上述皮肤病的应用及进展。     

他克莫司乳膏联合308nm高能准分子光治疗外阴白癜风30例临床疗效观察

目的：观察他克莫司乳膏联合308nm高能准分子光治疗外阴白癜风的临床疗效。方法：外阴白癜风患者60例,随机分为试验组和对照组,每组30例。试验组皮损区每天外用0.1%他克莫司乳膏2次,再给予每周2次308nm高能准分子光治疗;对照组仅给予每周2次308nm高能准分子光治疗,3个月后评价临床疗效。结果：两组有效率分别为90.0%、66.7%,差异有显著统计学意义（χ^2=4.81,P〈0.01）。结论：他克莫司软膏联合308nm高能准分子光治疗外阴白癜风可以促进皮损色素再生和扩散,是一种安全、高效的方法。     

308nm准分子激光联合卡泊三醇软膏治疗斑块状银屑病疗效评价

目的：评价308 nm准分子激光联合卡泊三醇软膏治疗斑块状银屑病的临床疗效.方法：将93例稳定期斑块状银屑病随机分为3组,治疗组（33例） 予308 nm准分子激光照射,每周2次联合外搽卡泊三醇软膏,每日2次;对照1组（30例）外搽卡泊三醇软膏;对照2组（30例）,予308 nm准分子激光照射,方法同治疗组,2个月后判断疗效.结果：治疗组、对照1组和对照2组的有效率分别为90.91%、73.33%、63.33%.3组间疗效比较差异有统计学意义（均P〈0.05）.结论：308 nm准分子激光联合卡泊三醇软膏治疗斑块状银屑病能更好地提高疗效.     

Compound glycyrrhizin tablets combined with the 308 nm excimer laser in the treatment of vitiligo: A systematic review and meta-analysis

Background

Although the 308 nm excimer laser is commonly used to cure vitiligo, its clinical efficacy is limited. Experts have found that the efficacy of compound glycyrrhizin tablets combined with the 308 nm excimer laser in the treatment of vitiligo is significantly enhanced, but the specific research methods and clinical data must be clarified.

Objective

To determine the clinical efficacy of compound glycyrrhizin tablets combined with the 308 nm excimer laser in the treatment of vitiligo.

Methods

Until August 2022, studies were searched in PubMed, the Cochrane Library, the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, and the Wan Fang Database. We also searched for clinical RCTs involving compound glycyrrhizin tablets combined with the 308 nm excimer laser for the treatment of vitiligo. The meta-analysis was conducted in accordance with the Cochrane Handbook's recommendations. Two reviewers regulated the study selection, data extraction, and assessment of bias risk, and consulted a third reviewer as necessary. For the meta-analysis, Review Manager 5.4 was utilized.

Results

Finally, 9 articles and 1052 patients were included. A systematic review compared the efficacy of compound glycyrrhizin tablets combined with the 308 nm excimer laser to that of the 308 nm excimer laser alone: OR = 3.33, p < 0.00001, 95% confidence interval [2.25, 4.92].

Conclusion

In the treatment of vitiligo, compound glycyrrhizin tablets combined with the 308 nm excimer laser are more effective than the 308 nm excimer laser alone, and there are no serious adverse reactions. It is a safe and efficient way of treatment.     

Treatment of oral lichen planus using 308‐nm excimer laser

Oral lichen planus (OLP) is a chronic inflammatory disease, has prolonged courses, repeated attacks and resistance to treatment. The traditional narrow spectrum UVB treatment has an established efficacy on skin lichen planus, and high safety. However, most of ultraviolet phototherapy devices have a huge volume, thereby cannot be used in the treatment of OLP. Lymphocytic infiltration is evident in the lesions of lichen planus, and the direct irradiation of 308‐nm excimer laser can induce apoptosis of the T lymphocytes in skin lesions, thereby has a unique therapeutic effect on the diseases involving T lymphocytes. This study aims to investigate the efficacy of 308‐nm excimer laser in the treatment of OLP. A total of six OLP patients were enrolled into this study, and further pathological diagnosis was conducted, then 308‐nm excimer laser was used in the treatment. The efficacy of 308‐nm excimer laser in the treatment of OLP was satisfactory. The clinical symptoms of five patients were significantly improved. In two patients, the erosion surface based on congestion and the surrounding white spots completely disappeared, and clinical recovery was achieved. Three patients achieved partial remission, that is, the erosion surface healed, congestion and white spot area shrunk by more than 1/2 of the primary skin lesions. In the remaining one patient, the erosion surface had not completely healed after treatment, and congestion and white spot area shrunk by less than 1/2 of the primary skin lesions. Only one patients had developed mild pain during the treatment, and this symptom alleviated by itself. The 308‐nm excimer laser therapy can serve as a safe and effective treatment for OLP.