他克莫司软膏联合窄谱中波紫外线照射治疗白癜风疗效观察

目的 观察窄谱中波紫外线(NB-UVB)全身照射和他克莫司软膏外用治疗白癜风的临床疗效.方法 对59例白癜风患者进行随机分组,A组采用他克莫司软膏外涂患处,2次/d;B组采用NB-UVB,每周2次;A+B组采用NB-UVB联合他克莫司软膏外用.结果　三组的有效率分别为43.75%、56.25%、76.47%.三组间疗效比较差异有统计学意义(P<0.05).结论　提示NB-UVB全身照射治疗白癜风起效快,联合他克莫司软膏外用治疗,能更好的提高疗效,值得在临床上应用.     

他克莫司软膏联合窄谱中波紫外线治疗小儿白癜风疗效观察

目的 探讨他克莫司软膏联合窄谱中波紫外线(NB-UVB)治疗小儿白癜风的疗效.方法 78例白癜风患者随机分成两组.治疗组35例,外用他克莫司软膏,2次/d,联合NB-UVB光疗,每周2次,疗程20周.对照组43例NB-UVB光疗,用法同上.结果 治疗组有效率为82.86%,对照组为55.81%,两组有效率差异有统计学意义(P＜0.05).治疗组皮损位于面颈部、躯干和四肢者疗效优于对照组(P＜0.05),两组肢端皮损疗效差异无统计学意义(P＞0.05),所有患儿治疗后均未出现严重不良反应.结论 他克莫司软膏联合NB-UVB治疗小儿白癜风疗效满意,面颈部、躯干和四肢白癜风治疗效果优于肢端.     

中药温肾活血消白合剂联合中波紫外线、他克莫司软膏治疗白癜风疗效观察

目的观察自制中药温肾活血消白合剂联合中波紫外线(NB-UVB)、他克莫司治疗白癜风的疗效和安全性。方法将60例白癜风患者随机分成2组。治疗组30例,口服温肾活血消白合剂联合NB-UVB照射、他克莫司软膏外涂;对照组30例,予以NB-UVB照射和他克莫司软膏外涂。治疗12周后评价疗效。结果治疗组有效率为83.33%,对照组56.67%,差异有统计学意义(P0.05);2组不同部位皮损疗效比较,面颈部均优于躯干四肢部,差异有统计学意义(P0.05),肢端疗效较差,2组无统计学意义(P0.05)。结论中药温肾活血消白合剂联合NB-UVB、他克莫司软膏治疗白癜风疗效满意,安全性好。     

他克莫司软膏联合窄谱中波紫外线治疗白癜风疗效观察与分析

目的探讨他克莫司软膏联合窄谱中波紫外线(NB-UVB)治疗白癜风的疗效。方法将入选的87例白癜风患者随机分为3组,每组29例。治疗组给予0.1%他克莫司软膏外用,2次/d,同时联合应用窄谱中波紫外线(NB-UVB)于皮损局部进行照射,每周2次,共治疗3个月。对照组Ⅰ仅给予0.1%他克莫司软膏外用,对照组Ⅱ仅给予NB-UVB照射治疗,治疗方法和疗程同治疗组。结果治疗组有效率为86.2%,明显高于对照组Ⅰ(62.1%)和对照组Ⅱ(58.6%),差异均有统计学意义,(P均0.05)。治疗组治疗面颈部、躯干四肢的有效率明显高于对照组Ⅰ和对照组Ⅱ,差异均有统计学意义,(P均0.05);治疗组治疗肢端的有效率略高于对照组Ⅰ和对照组Ⅱ,差异均无统计学意义(P均0.05)。结论他克莫司软膏联合窄谱中波紫外线治疗白癜风疗效显著,值得推广。     

他克莫司软膏联合308nm准分子激光治疗白癜风临床观察

目的评价0.1%他克莫司软膏联合308nm准分子激光治疗白癜风疗效。方法将50例患者分为2组。A组外用0.1%他克莫司软膏联合308nm准分子激光照射,B组单独外用0.1%他克莫司软膏。于12,16周观察疗效。结果治疗12周后A组有效率为68.4%,B组有效率为41.8%,两组间疗效差异有统计学意义(P<0.01)。16周后A组有效率为75.4%,B组有效率为69.1%,两组间疗效差异无统计学意义(P>0.05)。A,B两组不同分期皮损的有效率比较,差异均有统计学意义(P<0.05),进展期疗效均优于稳定期。结论 A,B两组疗法均有效,进展期疗效优于稳定期,A组皮损较B组起效早且复色时间提前。     

窄谱中波紫外线、中药退白颗粒联合外用0.1%他克莫司软膏治疗面颈部白癜风疗效观察

目的观察窄谱中波紫外线(NB-UVB)、中药退白颗粒联合外用0.1%他克莫司软膏治疗面颈部白癜风的临床疗效,并评价其安全性。方法将48例面颈部白癜风患者随机分成2组,各24例。治疗组给予NB-UVB照射联合退白颗粒内服、0.1%他克莫司软膏外涂,对照组仅给予NB-UVB照射、他克莫司软膏外涂。两组疗程均为12周,治疗8周及12周时,采用统一的疗效评定标准进行疗效评价。结果 8周、12周时,治疗组有效率分别为63.79%、82.76%,对照组有效率分别为45.31%、67.19%,8周、12周时两组间有效率差异均有统计学意义(χ~2=4.18、3.89,P均0.05);进展期两组有效率分别为87.50%、82.86%,无统计学差异(χ~2=0.28,P0.05);稳定期两组有效率分别为76.92%、51.72%,差异有统计学意义(χ~2=4.77,P0.05)。结论窄谱中波紫外线(NB-UVB)、中药退白颗粒联合外用他克莫司软膏治疗面、颈部白癜风起效快、疗效好,不良反应少。     

他克莫司软膏联合窄谱中波紫外线治疗白癜风疗效观察

目的探讨他克莫司软膏联合窄谱中波紫外线(NB-UVB)治疗白癜风的疗效和安全性。方法82例白癜风患者随机分成两组。治疗组43例,外用他克莫司软膏,2次/d,NB-UVB光疗,每周2次,疗程16周。对照组39例单纯予NB-UVB光疗,用法同上。结果治疗组有效率为72.1%,对照组为48.7%,两组有效率差异有显著性(P<0.05)。治疗组皮损位于面颈部、躯干和四肢者疗效优于对照组(P<0.05),两组肢端皮损疗效差异无显著性(P>0.05)。患者均未出现严重不良反应。结论他克莫司软膏联合NB-UVB治疗位于面颈部、躯干和四肢的白癜风疗效好,不良反应少。     

0.1％他克莫司软膏联合窄谱中波紫外线治疗颜面白癜风疗效观察

目的 观察0.1％他克莫司软膏联合窄谱中波紫外线(NB-UVB)联合治疗稳定期颜面白癜风的疗效.方法 82例白癜风患者随机分成2组观察组43例,外用0.1％他克莫司软膏,2次/d,NB-UVB光疗,2次/周,疗程16周.对照组39例,单纯外用0.1％他克莫司软膏,2次/d,疗程16周. 结果 观察组有效率为76.7％,对照组为46.2％,2组有效率(P＜0.05)差异有统计学意义.治疗期间2组患者均未出现严重不良反应.结论 他克莫司软膏联合NB-UVB治疗位面部白癜风疗效满意,不良反应少.     

0.1%他克莫司软膏联合308nm准分子激光治疗面颈部白癜风疗效观察

目的:探讨他克莫司软膏联合308 nm准分子激光治疗面颈部局限型白癜风的临床疗效。方法:将22例患者采用自身左右对照研究,实验侧皮损予0.1%他克莫司软膏外用,每日2次,联合308 nm准分子激光照射,每周2次;对照侧皮损予308 nm准分子激光单独照射,每周2次。疗程为12周,疗程结束后进行疗效观察。结果:实验侧显效率81.82%,对照侧显效率50.00%,两组比较差异有统计学意义(χ2=4.95,P<0.05)。结论:他克莫司软膏联合308准分子激光治疗面颈部白癜风疗效较好,值得临床推广使用。     

308nm准分子激光联合他克莫司软膏治疗面颈部白癜风疗效观察

目的:观察308 nm准分子激光和他克莫司软膏外用治疗面颈部白癜风的临床疗效.方法:将91例白癜风患者随机分为3组:治疗组采用308 nm准分子激光照射联合他克莫司软膏外用;对照1组采用308 nm准分子激光照射,2次/w;对照2组采用他克莫司软膏外涂患处,2次/d.结果:治疗2、4、6个月疗效分别进行比较.治疗6个月后3组有效率分别为93.54%、73.33%和56.67%.3组间疗效比较有统计学差异(P<0.05).结论:308 nm准分子激光照射治疗面颈部白癜风起效较快,如联合他克莫司软膏外用,则能进一步提高疗效.     

Narrow-band UVB phototherapy combined with tacrolimus ointment in vitiligo: a review of 110 patients

BACKGROUND: Narrow-band ultraviolet B (NB-UVB) phototherapy and topical tacrolimus are included among the most innovative approaches to vitiligo. OBJECTIVE: To evaluate the efficacy and tolerability of combined treatment with NB-UVB and topical tacrolimus in vitiligo. METHODS: After informed consent, adult patients with chronic (> 1-year duration) stable vitiligo refractory to conventional treatments were enrolled in an open-labelled prospective study. Treatment regimen consists of once-daily application, in the evening, of tacrolimus 0.03% ointment to the lesions of the face, or tacrolimus 0.1% ointment to the vitiligous patches located on other areas. Concomitant NB-UVB phototherapy was performed twice weekly for 16 weeks. RESULTS: Study population included 110 patients (mean age, 42) with a total of 403 lesions. Within the treatment period, variable repigmentation was evident on more than 70% of lesions. Clinical response (repigmentation more than 50%) was observed in 42% of lesions. Response was strictly dependent on the site, being more frequent for face lesions (73%), followed by limbs (68%) and trunk (53.5%). The therapeutic effect on the extremities and genital areas was quite disappointing. Treatment was well tolerated. CONCLUSIONS: Our preliminary data suggest that the combination of topical tacrolimus with NB-UVB phototherapy can represent an alternative highly effective approach to refractory vitiligo located on the face, trunk and limbs. Long-term safety data and randomized controlled trials on a large number of patients are required.     

Combination of narrow band UVB and topical calcipotriol for the treatment of vitiligo

BACKGROUND: Narrow band ultraviolet B (NB-UVB) phototherapy has been used successfully for the treatment of vitiligo. Recently, topical calcipotriol has also been claimed to be effective, either as monotherapy or as a part of combination therapies. OBJECTIVE: The aim of the present study was to compare the clinical efficacy of NB-UVB and NB-UVB plus topical calcipotriol in the treatment of vitiligo. METHODS: NB-UVB treatment was given to 24 patients with generalized vitiligo three times weekly. Topical calcipotriol cream was only applied to the lesions located on the right side of the body. Treatment was continued for 6 months. Treatment efficacy was evaluated by determining the average response rates of the lesions at 3-month intervals. RESULTS: The average response rates of patients receiving combination of NB-UVB plus calcipotriol and NB-UVB alone were 51 +/- 19.6% and 39 +/- 18.9%, respectively. The median cumulative UVB dose and number of UVB exposures for initial repigmentation were 6345 mj/cm(2) (range; 2930-30980) and 18 (range; 12-67) for the combination therapy, and 8867.5 mj/cm(2) (range; 2500-30980) and 24 (range; 15-67) for the narrow band UVB therapy, respectively. CONCLUSIONS: These findings indicate that concurrent topical calcipotriol potentates the efficacy of NB-UVB in the treatment of vitiligo. This combination not only provides earlier pigmentation with lower total UVB dosage and less adverse UVB effects, but also reduces the duration and cost of treatment as well.     

驱白巴布期片联合他克莫司软膏治疗白癜风疗效观察

目的：评价驱白巴布期片联合他克莫司软膏治疗白癜风的疗效及安全性。方法240例白癜风患者随机分成3组,试验组给予驱白巴布期片口服,联合0.1%他克莫司软膏外用,对照组1给予驱白巴布期片口服,对照组2给予0.1%他克莫司软膏外用,3个月和6个月后评价疗效及安全性。结果治疗3个月和6个月后试验组与对照组比较差异有统计学意义（P＜0.05）,对照组1与对照组2有效率比较差异无统计学意义（P＞0.05）。3组患者均以面部疗效最好,躯干次之,四肢疗效最差。患者均未出现严重不良反应。结论驱白巴布期片联合他克莫司软膏治疗白癜风疗效好,不良反应少。 Abstract     

308 nm准分子激光联合他克莫司乳膏治疗儿童面颈部白癜风疗效观察

目的 评价308 nm准分子激光联合0.03%他克莫司乳膏治疗儿童面颈部白癜风的疗效及安全性。 方法 68例儿童面颈部白癜风（年龄 ≤ 14岁）,根据皮损部位分为皮损组（包括面颈部）;腔口组（包括口周、眼周）;均给予308 nm准分子激光照射,每周1 ～ 2次,20次1个疗程;联合外用0.03%他克莫司乳膏,每日2次,疗程结束后分别进行疗效评价,并观察红斑反应及照射累积量对疗效的影响。结果 20次治疗结束后,皮损组显效率78.4%,腔口组显效率54.8%,皮损组显效率优于腔口组（P < 0.05）。两组在治疗过程中红斑反应持续48 h以上的平均次数分别是皮损组5.84次、腔口组9.12次。腔口组红斑反应持续48 h以上的平均次数明显多于皮损组（P < 0.01）。两组在完成10次和20次治疗后的平均照射累积量分别是：皮损组4215 mJ/cm2（10次）、10 453 mJ/cm2（20次）;腔口组3364 mJ/cm2（10次）、7430 mJ/cm2（20次）,皮损组平均照射累积量均大于腔口组（P < 0.01）。结论 308 nm准分子激光联合0.03%他克莫司乳膏治疗儿童面颈部白癜风是安全、有效的,面颈部疗效好于面部腔口部位,且后者红斑反应重于前者。     

NB-UVB联合复方卡力孜然酊治疗白癜风的临床观察

目的观察窄谱中波紫外线(NB-UVB)联合复方卡力孜然酊治疗白癜风的临床疗效及安全性。方法将入选的158例白癜风患者按就时间顺序随机分为3组:A组51例,外用复方卡力孜然酊,3次/d,搽药后日光照射10～15min;B组52例,予NB-UVB照射,强度9.13mW/cm2,开始每2天1次,8周后改为每3天1次;C组55例,予NB-UVB治疗仪联合复方卡力孜然酊治疗,方法同前两组。3组患者疗程均为16周,疗程结束,比较3组患者的疗效。结果疗程结束时C组的有效率为81.13%,明显高于A组(56.00%)和B组(50.00%),差异有显著性意义(P均<0.05),但A、B两组有效率差异无统计学意义(P>0.05)。3组患不同部位皮损比较,面颈部疗效最好,A组有效率为74.19%,B组为75.00%和C组为93.93%躯干、四肢疗效次之,A、B和C有效率分别为66.61%、55.56%和87.18%,手足皮损疗效最差,A、B、C组有效率分别为0%、0%、16%,三部位均C组疗效优于A、B组,差异有统计学意义(P均<0.05)。结论NB-UVB联合复方卡力孜然酊治疗白癜风有较好的疗效,安全,不良反应少。     

Topical tacrolimus and the 308-nm excimer laser: a synergistic combination for the treatment of vitiligo

OBJECTIVE: To compare the efficacy of combined tacrolimus and 308-nm excimer laser therapy vs 308-nm excimer laser monotherapy in treating vitiligo. DESIGN: Comparative, prospective, randomized, intraindividual study. PATIENTS: Fourteen patients, aged 12 to 63 years, with Fitzpatrick skin types II to IV. INTERVENTION: For each patient, 4 to 10 target lesions were chosen. The treatment applied to each target lesion was randomized by drawing lots. Each lesion was treated twice a week by the 308-nm excimer laser, for a total of 24 sessions. Initial fluences were 12 mcal/cm(2) (50 mJ/cm(2)) less than the minimal erythemal dose in vitiliginous skin. Then, fluences were increased by 12 mcal/cm(2) every second session. Moreover, topical 0.1% tacrolimus ointment was applied twice daily on target lesions receiving the combined tacrolimus and excimer laser treatment (group A). Group B target lesions received only excimer laser monotherapy. For each treated lesion, the untreated lesion on the opposite side served as the control. Tolerance was evaluated by a visual analog scale, and secondary events were recorded at each session. MAIN OUTCOME MEASURE: Treatment efficacy, which was blindly evaluated by 2 independent physicians by direct and polarized light photographs taken before and after treatment. RESULTS: Forty-three lesions were treated (23 in group A and 20 in group B). All patients completed the study. Repigmentation was observed in all group A lesions (100%) and in 17 (85%) of the 20 group B lesions. Repigmentation was not observed in the untreated lesions (control group). A repigmentation rate of 75% or more was obtained in 16 (70%) of the 23 group A lesions and in 4 (20%) of the 20 group B lesions. In UV-sensitive areas (the face, neck, trunk, and limbs, with the exception of bony prominences and extremities), 10 (77%) of 13 group A lesions had a repigmentation rate of 75% or more vs 4 (57%) of 7 group B lesions. In classically UV-resistant areas, 6 (60%) of 10 group A lesions had a repigmentation rate of 75% or more vs 0 of the 13 group B lesions. The mean number of sessions necessary for an improvement of repigmentation was 10 in group A and 12 in group B. Adverse effects have been limited, and tolerance was excellent. CONCLUSIONS: The combination treatment of 0.1% tacrolimus ointment plus the 308-nm excimer laser is superior to 308-nm excimer laser monotherapy for the treatment of UV-resistant vitiliginous lesions (P<.002). The efficacy and the good tolerance of the 308-nm excimer laser in monotherapy for treating localized vitiligo were also confirmed, but this treatment regimen should be proposed only for UV-sensitive areas.     

NB-UVB联合中成药白灵片和白灵酊治疗白癜风疗效观察

目的观察窄谱中波紫外线(NB-UVB)联合中成药(白灵片和白灵酊)治疗白癜风的疗效。方法将128例白癜风患者随机分成3组:A组43例,口服白灵片,外搽白灵酊;B组40例,予窄谱中波紫外线照射治疗;C组为联合治疗组45例,予NB-UVB联合白灵片和白灵酊治疗,方法同前2组。疗程16周,疗程结束,比较3组疗效。结果 C组有效率为77.78%,明显高于A组(53.49%)和B组(57.50%),差异有统计学意义(P均<0.05),A、B两组有效率差异无统计学意义。结论 NB-UVB联合中成药(白灵片和白灵酊)治疗白癜风疗效好,安全,不良反应少。     

Tacalcitol and narrow-band phototherapy in patients with vitiligo

BACKGROUND: Vitiligo is a skin disease characterized by loss of normal pigmentation in the skin. Several treatments exist but none is really effective. Recently, perturbations of calcium homeostasis in vitiliginous epidermis have been described. AIM: Based on these findings, the aim of this prospective, randomized, open-label study was to compare the effectiveness of narrow-band ultraviolet B (NB-UVB) phototherapy alone and the combination of NB-UVB and topical application of the vitamin D(3) analogue tacalcitol in the treatment of vitiligo. METHODS: In total, 32 subjects with generalized vitiligo and symmetrical lesions were enrolled in the study. Subjects were instructed to apply tacalcitol ointment daily to the lesion on the side randomly selected to receive combination therapy. All subjects received NB-UVB phototherapy on a twice-weekly schedule. RESULTS: Addition of topical tacalcitol to NB-UVB treatment improved the extent of repigmentation and increased the response rate in patients with vitiligo compared with NB-UVB treatment alone. CONCLUSION: Application of tacalcitol ointment in combination with twice-weekly NB-UVB phototherapy is an effective alternative treatment for patients with generalized vitiligo.