他克莫司软膏联合308nm准分子激光治疗儿童局限性白癜风

目的:本研究旨在评价0.03%他克莫司软膏和308 nm准分子激光治疗儿童局限性白癜风的安全性和有效性。同时研究308nm准分子激光联合外用0.03%他克莫司软膏对疗效的影响。方法:76个患者入组研究,研究采用随机单盲自身对照试验共15周。入组患者均具有两侧对称病变,进行左/右面部、躯干、手足的比较。按患者2至4个靶病变随机分为两组:A组患者外用0.03%他克莫司软膏,每天两次;B组患者外用0.03%他克莫司软膏每日两次,联合308nm准分子激光治疗,每周两次。研究期间对疗效和安全性因素进行评价。结果:76个患者完成了研究,A组91.3%和B组97.4%的皮损观察到复色。与治疗前相比,A组和B组皮损均明显改善。B组72.3%的皮损获得4级复色,与A组比较有显着性差异(P<0.05)。面颈部的复色率(复色75%以上)明显高于躯干、四肢、手足的复色率(P<0.05)。两组患者未见明显的副作用,两组之间的副作用发生率没有显著差异。结论:0.03%的他克莫司软膏和308 nm准分子激光对于治疗儿童局限性白癜风是安全、有效的,且耐受性良好。联合使用他克莫司软膏和308nm准分子激光显著提高疗效。     

308nm准分子激光联合0.1%他克莫司乳膏治疗白癜风的临床体会

目的:比较应用0.1%他克莫司软膏联合308nm准分子激光与单用308nm准分子激光治疗白癜风的效果。方法:64例白癜风患者,每个部位选择1～2处皮损将自身皮损分为A、B两组,分别108处皮损,A组予308nm准分子激光治疗,2次/周,共30次;B组在激光治疗的基础上外用0.1%他克莫司乳膏,2次/天。治疗过程中记录疗效及不良反应。结果:两组分别108处皮损,所有患者完成了治疗。总有效率:A组65.74%(71/108),B组89.81%(97/108),(χ2=18.10,P<0.05);其中面颈部有效率:A组88.10%(38/42),B组92.86%(39/42)(χ2=0.26,P>0.05);躯干部有效率:A组53.84%(28/52),B组94.23%(49/52)(χ2=22.06,P<0.05);四肢有效率A组50.00%(5/10),B组80.00%(8/10);手足有效率:A组0(0/4),B组25.00%(1/4);平均治疗次数:A组21.8次、B组19.4次,平均出现色素次数:A组7次、B组5.5次。结论:308nm准分子激光联合他克莫司乳膏治疗白癜风起效快、疗效好,副作用少;面颈部单用308nm准分子激光亦可获良效。     

他克莫司软膏联合308nm准分子激光治疗白癜风临床观察

目的:探讨外用0.1%他克莫司软膏联合308nm准分子激光治疗白癜风的疗效及安全性。方法:患者35例,以自身未治疗皮损作为空白对照,每例患者选择两处相近或对称部位的皮损,每周2次以308nm准分子激光进行治疗,共治疗16次。A组皮损同时每天早晚外用0.1%他克莫司软膏,B组单用308nm准分子激光治疗,试验结束时依据治疗前、后皮损的照片进行疗效评价。结果:试验结束时,未治疗的皮损均未出现任何改善,A组有效率为97.1%(34/35),B组为85.7%(30/35),显效率A组为74.3(&/35)、B组为48.6%(17/35),两组间显效率有显著性差(异2χ=4.884,P=0.023),但有效率差异不显著(2χ=2.917,P=0.088)。对18例患者进行随访,3个月内,A组所有治疗皮损均维持稳定或持续好转,而B组有3例皮损出现复发。结论:308nm准分子激光治疗白癜风疗效高、副作用少,联合外用0.1%他克莫司软膏可显著提高其疗效并减少复发。     

308nm准分子激光联合他克莫司软膏治疗白癜风临床分析

目的:分析308nm准分子激光联合他克莫司软膏治疗白癜风的临床疗效。方法:选取笔者科室2012年4月-2014年4月收治的110例白癜风患者为研究对象,随机分成治疗组和对照组,对照组给予他克莫司软膏治疗,治疗组在此基础上联合308nm准分子激光治疗,对比两组患者的治疗效果。结果:治疗组患者的总有效率为94.5%,对照组患者的总有效率为67.3%,治疗组的总有效率显著高于对照组,疗效比较有统计学意义(P0.05);治疗组患者的躯干、面部以及肢体的有效率明显比对照组高,疗效比较有统计学意义(P0.05)。结论:对于白癜风患者而言,采取308nm准分子激光联合他克莫司软膏治疗可取得较高疗效,值得临床推广使用。     

护理干预对他克莫司软膏联合308nm准分子激光治疗白癜风的影响

目的:探讨护理干预在他克莫司软膏联合308nm准分子激光照射治疗白癜风中的应用效果。方法:将120例白癜风患者按就诊顺序采用单双号抽签法分为治疗组60例和对照组60例;治疗组外涂他克莫司软膏联合308nm准分子激光照射同时配合适当的护理干预;对照组仅外涂他克莫司软膏联合308nm准分子激光照射,两组患者疗程均为6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:治疗组显效率为66.7%,对照组显效率为48.3%,差异具有统计学意义(χ2=4.36,P0.05);两组患者满意度比较,差异具有统计学意义(P0.05)。结论:他克莫司软膏外涂联合308nm准分子激光并配合适当的护理干预是治疗白癜风的有效方法,能显著提高疗效和患者满意度,值得推广应用。     

毫火针辅助308nm准分子光联合他克莫司软膏对白癜风患者疗效及免疫功能的影响

目的:探究毫火针辅助308nm准分子光联合他克莫司软膏对白癜风患者免疫功能的影响。方法:选取于笔者医院就诊的136例白癜风患者,随机分为对照组和观察组,每组68例。两组患者均予以308nm准分子光和他克莫司软膏治疗,观察组在此基础上予以毫火针治疗。观察并比较两组患者T淋巴细胞、免疫球蛋白(Ig)、白癜风面积、严重程度评分指数(VASI)及临床疗效。结果:观察组患者临床总有效率为88.24%,显著高于对照组的72.06%(P0.05)。治疗后,两组患者CD4~+、CD4~+/CD8~+、调节性T细胞(CD4~+ CD25~+ Treg)水平均升高,观察组显著高于对照组,差异具有统计学意义(P0.05);两组患者CD8~+、IgG、IgA、IgM、VASI评分水平均降低,观察组患者显著低于对照组,差异具有统计学意义(P0.05)。结论:在308nm准分子光联合他克莫司软膏治疗基础上,予以毫火针治疗能够更有效调节患者免疫功能平衡,促进皮损复色。     

他克莫司软膏联合非剥脱1550nm铒玻璃点阵激光治疗白癜风

目的:观察非剥脱1550nm铒玻璃点阵激光联合他克莫司软膏治疗白癜风的疗效及安全性。方法:两组各选取108例患者,选择皮损部位相近或对称的两处,随机分为对照组和试验组。其中对照组采用外涂他克莫司软膏,试验组采用他克莫司联合非剥脱1550nm饵玻璃点阵激光治疗,观察两组患者皮损恢复情况以及治疗过程中出现的不良反应(包括水疱、红斑、瘙痒和灼热)。结果:疗程结束后对患者临床疗效进行评估,试验组有效率为87.96%,高于对照组的62.96%,差异有统计学意义(P0.05);试验组患者中,面颈部组有效率高于躯干组及肢端组,差异有统计学意义(P0.05);两组患者不良反应(包括水疱、红斑、瘙痒和灼热)发生情况比较,差异无统计学意义。结论:非剥脱1550nm铒玻璃点阵激光与外用他克莫司联合,对治疗白癜风具有协同作用,安全性较好,可显著提高白癜风治疗有效率,值得在临床上推广。     

308nm准分子光联合0.1%他克莫司软膏治疗稳定期白癜风的疗效及安全性分析

目的:分析308nm准分子光联合0.1%他克莫司软膏治疗稳定期白癜风的疗效及安全性。方法:回顾性分析笔者医院收治的121例稳定期白癜风患者,按治疗方式不同分成两组。单一组:50例,予以308nm准分子光治疗;联合组:71例,予以308nm准分子光联合0.1%他克莫司软膏治疗,治疗3个月,比较两组临床疗效、皮肤CT情况、Foxp3 mRNA表达水平以及细胞因子水平,并观察其安全性。结果:治疗3个月,联合组总治愈率为76.06%,显著高于单一组的56.00%(P0.05);联合组部分黑素细胞活跃53例(74.65%),单一组部分黑素细胞活跃16例(32.00%),联合组发生率显著高于单一组(P0.05);两组Foxp3 mRNA表达水平显著上调(P0.05),联合组上调幅度大于单一组(P0.05);两组TNF-α、INF-γ显著降低(P0.05),SCF、bFGF显著升高(P0.05),联合组变化幅度大于单一组(P0.05);两组血常规、肝肾功能无明显异常,治疗期间不良反应发生率无显著性差异(P0.05)。结论:308nm准分子光联合0.1%他克莫司软膏治疗稳定期白癜风临床疗效明确,可显著改善患者皮损症状,上调Foxp3 mRNA表达,调节细胞因子水平,安全有效。     

308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效观察

目的:探讨308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风的疗效及安全性。方法:选取门诊面部白癜风患者180例,随机平均分为三组,共有167例完成了试验观察,A组为治疗组57例,308nm准分子激光(2次/周)联合0.1%糠酸莫米松乳膏(1次/天)治疗;B组为对照1组56例,单用308nm准分子激光治疗(2次/周);C组为对照2组54例,单用0.1%糠酸莫米松乳膏外用治疗(1次/天),疗程均为12周或至皮损完全复色,观察三组治疗方法治疗面部白癜风的疗效及不良反应。结果:A组显效率为75.43%,B组为48.21%,C组为14.81%,A组和B组及C组比较,显效率差异有统计学意义(P<0.05)。三组患者均未出现严重不良反应。结论:308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效好、副作用少,显效率明显高于单独治疗。     

308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效观察

目的:探讨308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风的疗效及安全性。方法:选取门诊面部白癜风患者180例,随机平均分为三组,共有167例完成了试验观察,A组为治疗组57例,308nm准分子激光(2次/周)联合0.1%糠酸莫米松乳膏(1次/天)治疗;B组为对照1组56例,单用308nm准分子激光治疗(2次/周);C组为对照2组54例,单用0.1%糠酸莫米松乳膏外用治疗(1次/天),疗程均为12周或至皮损完全复色,观察三组治疗方法治疗面部白癜风的疗效及不良反应。结果:A组显效率为75.43%,B组为48.21%,C组为14.81%,A组和B组及C组比较,显效率差异有统计学意义(P<0.05)。三组患者均未出现严重不良反应。结论:308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效好、副作用少,显效率明显高于单独治疗。     

308nm准分子激光联合他卡西醇软膏治疗儿童面部白癜风疗效观察

目的:探讨308nm准分子激光联合他卡西醇软膏治疗儿童面部白癜风的疗效。方法:治疗组儿童面部白癜风患者采用Xt rac颠峰准分子激光联合他卡西醇软膏治疗,对照组仅用Xt rac颠峰准分子激光,为期3月,治疗结束后3天进行疗效评价。结果:治疗组显效率77.3%,对照组显效率52.5%,两组差异有统计学意义(χ2=5.69,P<0.05)。结论:308nm准分子激光联合他卡西醇软膏治疗儿童面部白癜风疗效好、副作用小。     

单用308nm准分子激光与联合他卡西醇治疗白癜风的疗效对比观察

目的 比较单用308nm准分子激光疗法治疗白癜风与联合局部应用维生素D3类似物他卡西醇治疗白癜风的疗效和安全性。方法 用单盲、自身对照的方法对78例稳定期泛发性的白癜风患者的自身对称或相邻的皮损采用308nm准分子激光治疗,实验组联合外用他卡西醇软膏,对照组用安慰剂软膏,1个月观察1次,拍照对比疗效,对78例患者进行治疗后评价。结果 不同治疗部位疗效评价：实验组头面、躯干、四肢皮损的总有效率分别为93．5l％,84．16％,42．35％,对照组总有效率分别为90．90％,77．45％,34．15％（P〈0．05）;不同类型的皮损治疗效果比较：实验组寻常型和节段型皮损总有效率分别为86．80％,93．33％,对照组分别为73．81％,84．00％（P〈0．05）;照光次数和累积照光剂量比较：实验组最初色素再生时照光次数和光累积量分别为（16．15±3．22）次和（4．40±5．03）J／cm＾2,对照组分别为（18．56±3．50）次和（6．60-i-1．01）J／cm。（P〈0．05）,显效的患者实验组为（20．36±1．50）次和（7．50±3．54）J／cm＾2,对照组为（21．68±2．40）次和（8．80±9．24）J／cm＾2（P〈0．05）。结论 308nm准分子激光治疗白癜风有效而且安全,联合他卡西醇外用可以提高白癜风患者的治疗反应,增强308nm准分子激光的疗效,缩短色素再生的时间,减少照光的能量。     

308nm准分子激光联合胸腺肽治疗成人头面部白癜风临床观察

目的:探讨口服胸腺肽联合308nm准分子激光治疗白癜风的疗效及安全性。方法:85例患者随机分成两组。实验组44例,308nm准分子激光(2次/周)联合胸腺肽(10mg 2/日)治疗;对照组41例,单纯予308nm准分子激光治疗(2次/周),两组疗程25次。于治疗25次3天后进行疗效评价。结果:治疗结束后,实验组有效率为95.45%(42/44),对照组为87.8%(36/41),显效率实验组为72.73%(32/44),对照组为51.22%(21/41),两组间显效率有显著性差异(χ2=4.182,P=0.041),但有效率差异不显著(χ2=3.316,P=0.375)。对两组各30例患者随访6个月,实验组患者所有治疗皮损均维持稳定或持续好转,而对照组有2例皮损出现复发。结论:308nm准分子激光治疗白癜风疗效高、副作用少,联合口服胸腺肽可显著提高其疗效并减少复发。     

308nm准分子激光治疗眼眶白癜风的疗效观察

目的：评价308nm准分子激光治疗眼眶白癜风的疗效及安全性。方法：采用308nm准分子激光系统治疗83例眼眶稳定期白癜风患者,每周治疗2次,连续治疗10～30次,治疗1.5～3个月后进行疗效评价。结果：治疗10次、20次及30次后眼眶的显效率分别为54.17%、60.6%、88.46%。结论：308nm准分子激光治疗眼眶白癜风是安全有效的。     

Combined Excimer Laser and Topical Tacrolimus for the Treatment of Vitiligo: A Pilot Study

Background. Vitiligo is an acquired skin disorder that is characterized by well-defined, often symmetric white patches. Although current therapeutic modalities are directed toward increasing melanocyte melanin production, few treatment modalities address the immunologic nature of the disease.
Objective. To determine whether excimer laser, a known therapeutic modality, in combination with tacrolimus, a topical immunomodulator, accelerate response time and/or improve the degree of response in patients with this disorder.
Methods. Eight subjects diagnosed with vitiligo were recruited to participate in this institutional review board–approved double-blind, placebo-controlled study. Twenty-four symmetric vitiliginous patches (elbows, knees) from eight subjects received excimer laser treatment three times per week for 24 treatments or 10 weeks. Additionally, topical tacrolimus 0.1% ointment (Protopic) and placebo (Aquaphor) were applied to randomized patches (left or right) twice daily throughout the length of the trial. Vitiliginous patches were monitored with photographs at baseline, every 2 weeks, and 6 months after treatment. Biopsies were performed on subjects with significant results.
Results. Twenty vitiliginous patches from six subjects qualified for evaluation. Fifty percent of patches treated with combination excimer laser and tacrolimus achieved a successful response (75% repigmentation) compared with 20% for the placebo group. Subjects who responded successfully repigmented faster (19%) with combination therapy compared with excimer laser alone. Additionally, three subjects experienced transient hyperpigmentation in lesions treated with combination therapy.
Conclusion. Combining topical immunomodulators with known phototherapeutic modalities may represent a key advancement in the treatment of disease.     

Effectiveness of a 308-nm excimer laser in treatment of vitiligo: a review

Vitiligo is a relatively common acquired disorder, characterized by progressive loss of melanocytes from the epidermis and the epidermal appendages. The disease is associated with considerable morbidity because of a major impact on the quality of life. The treatment for vitiligo is generally unsatisfactory and challenging. There are a variety of therapeutic possibilities including topical corticosteroids, topical calcineurin inhibitors, as well as phototherapy with Psoralen plus UVA (PUVA), narrow-band UVB, and a 308-nm excimer laser and/or lamps. Furthermore, surgical methods encompass grafting and transplantation while depigmentation treatments and psychological support may also be considered. The objective is to assess the effect of the 380-nm excimer laser in the treatment of vitiligo based on the available studies and case series. We searched the relevant literature about vitiligo and excimer laser published between 1990 and 2012 using the MEDLINE database. We reviewed all relevant articles about 308-nm excimer laser and light sources assessing their efficacy in the management of vitiligo as well as their side effects. The value of combination treatment methods was also analyzed. The available studies provide strong evidence that the excimer laser represents the most effective approach to treat vitiligo compared to ordinary phototherapy. Excimer laser is relatively safe and effective for localized disease. UV-sensitive areas respond best as well as a short duration of the disease. More frequent treatments achieve better results. Compared to other treatment modalities, the excimer laser most likely constitutes the treatment of choice for localized vitiligo. Its efficacy can be further improved in combination with other therapies such as corticosteroids, pimecrolimus, or tacrolimus.