疏肝活血法联合窄谱中波紫外光治疗气滞血瘀型白癜风的疗效观察

目的 观察口服疏肝活血中药联合窄谱中波紫外线照射治疗气滞血瘀型白癜风方面的疗效和安全性。方法 将90 例白癜风患者随机分为联合组、光疗组及中药组,每组各30 例。联合组口服该院舒肝活血中药配方颗粒,2 次/d。并且用311 nm 窄谱中波紫外光照射治疗,每周照射1、2 次。光疗组：照射311 nm 窄谱中波紫外光,每周照射1、2 次。中药组：口服该院疏肝活血中药配方颗粒,2 次/d。每3 个月进行1 次白癜风白斑复色率疗效评价、中医证候评分改善疗效评价及肝肾功能评测。共观察3 个疗程。结果联合组白斑疗效总有效率均高于光疗组和中药组（P <0.05）;疗效与患者白斑部位、病程有相关性,与患者年龄无相关性;联合组中医证候改善总有效率均高于光疗组,与中药组无差异（P >0.05）。结论 应用疏肝活血法联合窄谱中波紫外光治疗气滞血瘀型白癜风能获得满意疗效,可在临床推广应用。     

UVB photolysis of hydrocortisone 21-acetate

Hydrocortisone 21-acetate (HCA) in methanol solution undergoes photodegradation under UVB light, as monitored by HPLC. Five main photoproducts have been isolated and characterized by means of NMR and mass spectroscopy. One of them derives from a Norrish I photoreaction which cleaves the C17-C20 bond of the steroid yielding the andro-derivative, a second product comes from a Yang-type photorearrangement which links C18 to C20 yielding a cyclobutane adduct. The former photoproduct, in turn, undergoes further photolysis giving rise to various photoproducts, of which three have been characterized. The first is a stereoisomer of the andro-derivative, the others arise from the opening of the five-membered ring. HCA also proved photounstable in the solid state and in a commercial formulation for topical use, thus confirming the requirements of the Pharmacopeias for light protection of this drug. Indeed, experiments on LPS-stimulated THP-1 cells demonstrated the loss of anti-inflammatory activity when HCA was UVB-photodegraded. The radical mechanism involved in HCA photolysis seems also responsible for the in vitro photohemolytic effect and lipid peroxidation induced by HCA in combination with UVB light.     

补骨脂汤联合中波高能紫外线照射治疗白癜风临床研究

目的:探讨补骨脂汤联合中波高能紫外线照射治疗白癜风的临床研究。方法:选取白癜风患者114例,按随机数字表法分组,对照组57例予以西医常规治疗,研究组57例予以补骨脂汤联合中波高能紫外线照射治疗,测量并记录两组患者炎症因子、T细胞亚群及NK细胞状况,补体及免疫球蛋白水平,同时对比临床疗效及不良反应。结果:对照组治疗有效率77.19%,研究组有效率91.23%,两组比较,差异具有统计学意义(P0.05);与对照组比较,研究组治疗后血清白细胞介素-6(interleukin-6,IL-6)水平降低,血清白细胞介素-10(interleukin-10,IL-10)、血清抗黑素细胞抗体及转化生长因子-β(transforming growth factor-β,TGF-β)水平升高,治疗后CD3+、CD4+及CD4+/CD8+水平升高,治疗后免疫球蛋白G(Immunoglobulin G,Ig G)、免疫球蛋白A(Immunoglobulin A,Ig A)及补体3(complement-3,C3)、补体4(complement-4,C4)水平降低,差异具有统计学意义(P0.05)。结论:补骨脂汤联合中波高能紫外线照射治疗可以提高白癜风患者的疗效及细胞免疫功能。     

Narrowband UVB phototherapy for psoriasis: Results with fixed increments by skin type (as opposed to percentage increments)

Many authors currently advocate 10-20% dosage increments between phototherapy sessions when treating psoriasis with narrowband ultraviolet B (UVB). However, such regimens are associated with a risk of significant erythema. In order to reduce this risk, a fixed increment regimen was developed using increments ranging from 30 mJ/cm2 for skin type II to 150 mJ/cm2 for type VI. Starting doses, also based on skin type, range from 180 to 400 mJ/cm2. Data from 20 patients with moderate to severe plaque psoriasis [13 male, 7 female, age range 17-74, skin types II (3), III (10), IV (3), V (1), VI (3)] completing 27 courses of phototherapy of more than 3 weeks' duration between 8/96 and 12/97 were compared. Complete, or near-complete clearing occurred in 8/13 courses (62%) with a frequency of attendance (during the initial 24 sessions) of >2.5 sessions per week, 4/8 (50%) with a frequency of 2.0-2.5, and 1/6 (17%) with a frequency of <2.0. In the subset of patients taking low-dose oral retinoids, rates of clearing were higher. Overall, 10 of 20 patients (50%) cleared, usually within 24-30 sessions. The average maximum dosage in such cases was 1400 mJ/cm2. There were only 13 instances of minor erythema, and 1 instance of severe erythema resulting in desquamation and requiring interruption of treatment. This was due to the inadvertent administration of an excessive 300 mJ/cm2 increment to a type VI patient. In summary, using a conservative fixed increment regimen, clearing of psoriasis is possible while minimizing the risk of serious erythema. Results are enhanced when patients attend 3 phototherapy sessions per week.     

健脾祛湿汤联合NB-UVB治疗慢性湿疹临床研究

目的：观察健脾祛湿汤联合NB-UVB治疗慢性湿疹的临床疗效。方法：80例确诊患者,随机分为2组各40例,对照组以NB-UVB治疗;治疗组在对照组基础上加用健脾祛湿汤,每日1付,水煎服。2组均为10d1个疗程,治疗60d后统计疗效。结果：治疗组有效率为97.5%,对照组为80.0%,两组比较差异有统计学意义（P〈0.05）。结论：健脾祛湿汤联合NB-UVB治疗慢性湿疹安全有效。