蔡瑞康教授治疗白癜风经验及艾灸疗法治疗肢端白癜风临床疗效观察
|
摘要
白癜风是一种常见的后天性色素障碍性皮肤病,症状为皮肤出现局限性或泛发性色素脱失,病理示皮损处黑色素细胞减少或消失,此病易于诊断,难于治疗,有碍容貌,影响患者身心健康。临床发病率呈上升趋势,病因复杂,尚未完全明了,通常认为是多种因素综合作用的结果。尽管治疗方法很多,但迄今尚未找到一个大家公认的理想治疗方案,中西医结合、内外兼治显示了强大的优势,光敏药、光源的改进,丰富了白癜风的光化学疗法,近代中医从补益肝肾、筛选具有激活酪氨酸酶活性、光敏性等中药入手,取得了较好的成绩。蔡瑞康教授在治疗白癜风方面有着丰富的临床经验,他经过长期临床实践总结出来的综合疗法,被认为是一种符合绝大多数患者,且行之有效的方法。
论文包括文献综述和临床研究两部分。
文献综述共两篇,第一篇综述白癜风的中医学研究进展；第二篇综述白癜风的现代医学研究进展。
临床研究分为两部分,
临床研究一：目的：观察蔡瑞康教授综合疗法治疗白癜风的临床疗效,总结蔡老治疗白癜风的经验。临床疗效：治疗6月后,总有效率66.6%,治愈率9.0%,其中头颈部疗效最好,总有效率82.5%,治愈率11.6%,躯干部次之,总有效率61.9%,治愈率5.3%,四肢部疗效最低,总有效率25.0%,治愈率12.5%。
临床研究二：目的：观察艾灸治疗肢端白癜风的临床疗效。临床疗效：治疗6个月后,总有效率2.4%,说明艾灸治疗肢端白癜风收效不佳。
总结讨论：蔡老认为白癜风病因病机可归为“两点”：肝肾不足、肺卫不固为本；风邪侵袭、气滞血瘀为标。治疗上采取中西医结合、内外兼治的综合疗法。中药主要辨证采取补益肝肾,养血活血祛风的白斑汤加减,另在组方用药时注意筛选具有激活酪氨酸酶活性、光敏性、免疫抑制性、富含微量元素功效的中药；西药主要通过免疫调节剂,补充微量元素及维生素起到辅助治疗作用；另局部外用家用小型黑光灯照射,除肢端白癜风收效不佳外,其它部位白癜风取得了良好的临床疗效,艾灸疗法治疗肢端白癜风收效不佳。
Vitiligo is a common obstacle to acquired skin pigment. Its main symptoms are the limitations of skin pigment or generalized loss. Pathology shows the melanoma cells,in lesions department, reduction or disappearance. The disease is easy to diagnose, but difficult to treatment. It is not conducive to appearance, physical and mental health of affected patients. Clinical upward trend in the incidence, etiology complex, not yet fully understood, usually considered a variety of factors. Despite the treatment, but so far have not yet found a well-recognized treatment programs, combining Chinese and Western medicine, treatment with both within and outside shows the advantages of a powerful, photosensitive drug, the light source to improve and enrich photochemotherapy of vitiligo.The modern traditional Chinese medicine from the liver and kidney tonic, Screening of tyrosinase activity with the activated, photosensitive, such as traditional Chinese medicine approach, has achieved fairly good results. Professor Cai Ruikang in the treatment of vitiligo has extensive experience in clinical practice over a long period, he summed up the triple therapy, which is considered to be a way with the vast majority of patients, and effective.
The thesis includes literature review and clinical study.
Literature review includes two parts. The first part is about vitiligo progress of traditional chinese medical research,the second part is about vitiligo progress of modern medical research.
The clinical study one:Purpose:Observe the clinical efficacy of combined treatment of Cai Ruikang for the treatment of vitiligo and sum up the experience of Mr. Cai's treatment of vitiligo. Clinical efficacy:By the end of 6 months, the total effective rate has been up to 66.6%, cure rate up to 9%.Head and neck showed the best effect, whose total effective rate has reached up to 82.5%, cure rate up to 11.6%.The department of trunk are better than limbs,their cure rates were 61.9%, cure rate up to 5.3%. The limbs illustrated the worst effect, whose total effective rate has reached up to 25.0%, cure rate up to 12.5%.
The clinical study two:Purpose:Investigate the clinical effecacy of moxibustion in treating acral vitiligo. Clinical effecacy:By the end of 6 months, the total effective rate has been up to 2.4%, which proves that the moxibustion does not have good response.
Summar y and discussion:Professor Cai Ruikang summe up the etiology and pathogenesis of vitiligo to"two points":the root is insufficient liver and kidney, lung non-solid-based guardian,the branch is wind xie attack, qi and blood stasis. He adopt a treatment of traditional Chinese and western medicine, internal and external methods virtue, and pay much attention to the theory "wind first rule of blood, blood from the anti-style". The main benefit to take traditional Chinese medicine differentiation of liver and kidney, nourishing and activating-blood spot Qufeng decoction. In the other side, filter with activated tyrosinase activity, photosensitivity, immunosuppression, and rich in trace elements in the effectiveness of Chinese medicine. Western medicine through the immunomodulator, added trace elements and vitamins play a role in adjuvant therapy. Another small black household local external irradiation and achieved a good clinical efficacy except in acral vitiligo. The moxibustion treatment of acral vitiligo does not have good response.
论文包括文献综述和临床研究两部分。
文献综述共两篇,第一篇综述白癜风的中医学研究进展；第二篇综述白癜风的现代医学研究进展。
临床研究分为两部分,
临床研究一：目的：观察蔡瑞康教授综合疗法治疗白癜风的临床疗效,总结蔡老治疗白癜风的经验。临床疗效：治疗6月后,总有效率66.6%,治愈率9.0%,其中头颈部疗效最好,总有效率82.5%,治愈率11.6%,躯干部次之,总有效率61.9%,治愈率5.3%,四肢部疗效最低,总有效率25.0%,治愈率12.5%。
临床研究二：目的：观察艾灸治疗肢端白癜风的临床疗效。临床疗效：治疗6个月后,总有效率2.4%,说明艾灸治疗肢端白癜风收效不佳。
总结讨论：蔡老认为白癜风病因病机可归为“两点”：肝肾不足、肺卫不固为本；风邪侵袭、气滞血瘀为标。治疗上采取中西医结合、内外兼治的综合疗法。中药主要辨证采取补益肝肾,养血活血祛风的白斑汤加减,另在组方用药时注意筛选具有激活酪氨酸酶活性、光敏性、免疫抑制性、富含微量元素功效的中药；西药主要通过免疫调节剂,补充微量元素及维生素起到辅助治疗作用；另局部外用家用小型黑光灯照射,除肢端白癜风收效不佳外,其它部位白癜风取得了良好的临床疗效,艾灸疗法治疗肢端白癜风收效不佳。
Vitiligo is a common obstacle to acquired skin pigment. Its main symptoms are the limitations of skin pigment or generalized loss. Pathology shows the melanoma cells,in lesions department, reduction or disappearance. The disease is easy to diagnose, but difficult to treatment. It is not conducive to appearance, physical and mental health of affected patients. Clinical upward trend in the incidence, etiology complex, not yet fully understood, usually considered a variety of factors. Despite the treatment, but so far have not yet found a well-recognized treatment programs, combining Chinese and Western medicine, treatment with both within and outside shows the advantages of a powerful, photosensitive drug, the light source to improve and enrich photochemotherapy of vitiligo.The modern traditional Chinese medicine from the liver and kidney tonic, Screening of tyrosinase activity with the activated, photosensitive, such as traditional Chinese medicine approach, has achieved fairly good results. Professor Cai Ruikang in the treatment of vitiligo has extensive experience in clinical practice over a long period, he summed up the triple therapy, which is considered to be a way with the vast majority of patients, and effective.
The thesis includes literature review and clinical study.
Literature review includes two parts. The first part is about vitiligo progress of traditional chinese medical research,the second part is about vitiligo progress of modern medical research.
The clinical study one:Purpose:Observe the clinical efficacy of combined treatment of Cai Ruikang for the treatment of vitiligo and sum up the experience of Mr. Cai's treatment of vitiligo. Clinical efficacy:By the end of 6 months, the total effective rate has been up to 66.6%, cure rate up to 9%.Head and neck showed the best effect, whose total effective rate has reached up to 82.5%, cure rate up to 11.6%.The department of trunk are better than limbs,their cure rates were 61.9%, cure rate up to 5.3%. The limbs illustrated the worst effect, whose total effective rate has reached up to 25.0%, cure rate up to 12.5%.
The clinical study two:Purpose:Investigate the clinical effecacy of moxibustion in treating acral vitiligo. Clinical effecacy:By the end of 6 months, the total effective rate has been up to 2.4%, which proves that the moxibustion does not have good response.
Summar y and discussion:Professor Cai Ruikang summe up the etiology and pathogenesis of vitiligo to"two points":the root is insufficient liver and kidney, lung non-solid-based guardian,the branch is wind xie attack, qi and blood stasis. He adopt a treatment of traditional Chinese and western medicine, internal and external methods virtue, and pay much attention to the theory "wind first rule of blood, blood from the anti-style". The main benefit to take traditional Chinese medicine differentiation of liver and kidney, nourishing and activating-blood spot Qufeng decoction. In the other side, filter with activated tyrosinase activity, photosensitivity, immunosuppression, and rich in trace elements in the effectiveness of Chinese medicine. Western medicine through the immunomodulator, added trace elements and vitamins play a role in adjuvant therapy. Another small black household local external irradiation and achieved a good clinical efficacy except in acral vitiligo. The moxibustion treatment of acral vitiligo does not have good response.
引文
[1]丁毅,乔立新,张兴国.复方白黑丸治疗白癜风的临床疗效观察[J].中国医药导报,2008,5(3)： 80.
[2]王宗宽,张志国.中医中药结合免疫疗法治疗白癜风53例[J].中国现代医生,2007,45(19)：93-94,封3.
[3]洪文学,蔡建红,景 军.艾灸的热辐射光谱特性研究[J].应用光学,2004,25(4)：1-3.
[4]邓海平,沈雪勇,丁光宏.艾灸与经络穴位红外辐射特性[J].中国针灸,2004,24(2)：105-107.
[5]沈雪勇,周 愉,魏建子,等.传统艾灸与替代物灸和人体穴位红外辐射光谱比较[J].红外与毫米波学报,2003,22(2)：123-126.
[6]黄秋风译.艾的燃烧温度与机体内的温度变化(Ⅰ)-施灸局部的皮下基层内温度[J].国外医学·中医中药分册,1989,11(5)：48.
[7]董新民,董全声,先茂全,等.不同灸法对穴位温度影响的对比观察[J].中国针灸,1999,19(1)：22.
[8]董泉声.灸法及灸法退热与穴位皮肤感受器的关系[J].中国学术期刊文摘,1996,2(7)： 115.
[9]杨华元,刘堂义.艾灸疗法的生物物理机制初探[J].中国针灸,1996,16(10)：17-18.
[10]KobayashiK. Induction ofHeart-Shock Protein(hsp) byMoxibustion[J]. Am JChin. Med,1995,23 (3-4):327.
[11]陆静译.运用电子灸诱导纯蛋白衍生物反应性淋巴细胞[J].国外医学·中医中药分册,1995,17(3)：61.
[12]赵建新,贾春生,田元祥.近十年日本灸法实验研究进展[J].中国针灸,1999,19(8)： 507.
[13]刘屏荣译.灸疗对机体防御功能的影响[J].国外医学·中医中药分册,1989,11(5)：41.
[14]程棕鹏,熊毕文.艾灸治疗皮肤缺损的临床体会[J].上海针灸杂志,2000,19(3)：18.
[15]任秦有,赵宁侠,郭瑞林.艾灸百会穴对中风偏瘫病人甲皱微循环的影响[J].浙江中医学院学报,2004,28(3)：48-49.
[16]李爱华,万志杰.艾灸改善微循环的研究进展[J].中医药学报,2003,31(2)：27.
[17]郭瑞林,赵宁侠,任秦有,等.艾灸对30例健康人甲皱微循环及血液流变学的影响[J].第四军医大学学报,2002,23(12)：1112-1114.
[18]邓倩萍,姜小英.艾灸对老年心脑血管患者血液流变学的影响[J].针灸临床杂志,2005,21(4)：43-44.
[19]张栋,王淑友,马惠敏,等.激光多普勒血流成像技术对针灸效果的观察[J].上海针灸杂志,2004,23(5)：37-40.
[20]唐照亮,宋小鸽,王宁新,等.艾灸活血化瘀作用机制的研究[J].安徽中医学院学报,2004,23(2)：24-27.
[21]潘秋兰,张莉梅,张玉兰.艾灸对正常老年人甲皱微循环的影响[J].中国临床康复,2004,8(12)：2337-2343.
[22]赵宁侠,郭瑞林,任秦有,等.艾灸健康人百会穴对大脑中动脉血流速度的影响[J].中国针灸,2003,23(11)：679-680.
[23]姜小英.艾灸足三里、关元穴对血液流变性的影响[J].四川中医,2001,19(3)：75.
[24]陈文,谭敏,梁立安,等.艾灸足三里、悬钟对缺血性中风脑血管功能的影响及其临床意义[J].中国针灸,2006,26(3)：161-165.
[25]张蕊,仇裕丰.不同灸位、刺激量施灸对小鼠耳廓微循环的影响[J].针灸临床杂志,2006,22(9)：46-47.
[26]袁民,傅莉萍,陈雪华.艾灸对荷瘤小鼠免疫功能的影响[J].针刺研究,,2005,28(2)：115-118.
[27]张丽束,林志商,曾锡坤,等.艾灸对慢性粒细胞白血病的免疫调节功能的探讨[J].中华现代临床医学杂志,2005,3(6)：487-489.
[28]唐照亮,宋小鸽,章复清,等.艾灸抗炎免疫作用机制的实验研究[J].安徽中医学院学报,2004,23(2)：31-35.
[29]崔瑾,申定珠,熊芳丽.针灸膈俞对白细胞共同抗原及免疫功能的影响[J].四川中医,2006,24(2)：100-102.
[30]田华张,陈俊玲.艾灸强壮穴对慢性疲劳综合征患者免疫功能的影响[J].深圳中西医结合杂志,2006,16(4)：226-227.
[31]裴建,陈汉平.“艾灸血清”对免疫活性细胞功能的影响[J].上海针灸杂志,1999,18(1)：38-40.
[32]李晓泓,韩毳,张露芬,等.艾灸“大椎”穴抗应激作用的实验研究[J].中国行为医学科学,2002,11(5)：495-497.
[33]唐照亮,宋小鸽,王宁新,等.艾灸对佐剂性关节炎大鼠滑膜细胞凋亡及病理组织的观察[J].中医药学刊,2004,22(2)：226-227.
[34]刘旭光,黄迪君,郝 亮,等.艾灸对类风湿性关节炎大鼠下丘脑-垂体-肾上腺皮质轴的影响[J].中国中医基础医学杂志,2003,9(2)：57-59.
[35]高希言,封丽华,李卫红,等.艾灸督脉穴对亚急性衰老小鼠自由基与免疫器官的影响[J].河南中医学院学报,2003,(5)：22-24.
[36]杜艳军,宋 杰,孙国杰.艾灸对老年大鼠Caspase-3蛋白在凋亡信号转导通路中的影响[J].湖北中医杂志,2006,28(7)：3-4.
[37]杜艳军,孙国杰.艾灸对老年大鼠神经元线粒体超微形态计量学的研究[J].中华实用中西医杂志,2005,18(23)：1862-1863.
[38]梁欣,吕明庄,贺志光.耳针、艾灸对D—半乳糖致衰老大鼠血清褪黑素含量及其昼夜节律性的影响[J].中国针灸,2004,24(8)：573-577.
[39]艾双春,钟蓝,廖方正,等.电热隔药灸对老年人性激素的影响[J].中国针灸,2002,22(3)：168-170.
[40]冯起国,邓国伟.艾灸内关对家兔动脉粥样硬化作用的研究[J].辽宁中医杂志,2002,29(1)：48-49.
[41]易受乡,王履华,王慧珠.熏脐灸对脾虚患者胃电调整作用的临床观察[J].上海针灸杂志,1994,13(5)：195-197.
[42]彭丽辉,冯玲媚,陈筑芳,等.艾灸对高血压病患者血压及NO,ET,SOD,MDA的影响[J].中国针灸,2004,24(3)：157-159.
[43]吴中朝,王玲玲,徐兰凤,等.艾灸对高血脂症调脂作用的研究[J].上海针灸杂志,1997,16(6)：5-6.
[44]Norris A, Todd C, Graham A, et al.The expression of the c-kit receptor by epidermal malanoeytes may be reduced in vitiligo[J]. Br J Dermato,1996,134: 299-360.
[45]马惠群,张宪旗,牟宽厚,等.单味中药对黑素细胞黏附和迁移的影响[J].中国皮肤性病学杂志,2004,18(9)：526-528.
[46]马惠群,冯捷,张宪旗,等.补骨脂白芷对黑素迁移和黏附影响的比较[J].现代中西医结合杂志,2005,14(7)：850-851.
[47]王军,韩瑞玲,罗顺德,等.8-甲氧补骨脂脂质体对小鼠黑素瘤细胞黑素生成影响的研究[J].广东药学院学报,2004,29(5)：509-510.
[48]牟宽厚,张宪旗,冯捷,等.复方中药对黑素细胞黏附和迁移的影响[J].中国麻风皮肤病杂志,2008,24(7)：532-534.
[49]许爱娥,王遂泉.常用中药对酪氨酸酶的激活作用[J].中国皮肤科杂志,1998,31(1)：48.
[50]雷铁池,朱文元,夏明玉,等.89味中药乙醇提取物对酪氨酸酶活性的上调作用[J].临床皮肤科杂志,1999,28(3)：147-149.
[51]刘之力,涂彩霞,任凤,等.56味中药乙醇提取物对酪氨酸酶活性影响及动物致色素作用的研究[J].中华皮肤科杂志,2001,34(4)：284-285.
[52]刘之力,李雅莉,刘俐,等.六种中药复方乙醇提取物对酪氨酸酶活性作用及动物致色素作用研究[J].中国皮肤科杂志,2005,19(10)：588-591.
[53]李洪武,朱文元,夏明玉.赤芍等5味上调酪氨酸酶活性中药乙醇提取液对棕黄色豚鼠背部皮肤的增色作用[J].临床皮肤科杂志,2001,30(2)：69-71.
[54]刘璋,胡佑伦,韩瑞玲.黑素细胞生成过程中黄芩的调节作用[J].武汉大学学报(医学版),2005,26(1)：66-67.
[55]韩瑞玲,罗顺德,何文.甲氧沙林脂质体对小鼠黑素瘤细胞黑素生成影响的研究[J].临床皮肤科杂志,2004,33(10)：594-596.
[56]杨柳,邓燕.调和气血复方对体外培养黑素细胞和酪氨酸酶活性影响的实验研究[J].中华实用中西医杂志,2004,4(17)：2528-2529.
[58]程东庆,尉晓东,王遂泉,等.复方中药对小鼠B-16黑素瘤细胞株黑素合成和酪氨酸酶的激活作用[J].中华皮肤科杂志,2000,33(3)：173-174.
[58]李洪武,朱文元.治疗白癜风复方中药体外对蘑菇酪氨酸酶活性的作用[J].临床皮肤科杂志,2000,29(3)：133-135.
[59]Ferguson CA, Kidson SH.The regulathion of tyrcsinase gene transcription[J]. pigment Cell Res,1997,10(3):127-138.
[60]王辉,王莒生,王萍,等.中药滋肾补肝方对鼠B16黑素瘤细胞酪氨酸酶mRNA表达的调节[J].中国皮肤性病学杂志,2003,17(4)：230-231.
[61]李永伟,许爱娥,Ruth Halaban.单味中药提取物对体外培养的黑素细胞酪氨酸酶基因和c-kit基因表达的激活作用[J].中华皮肤科学杂志,2004,37(10)：598-600.
[62]李永伟,许爱娥,尉晓冬,等.女贞子对黑素细胞的黑素合成、细胞增殖和c-kit基因表达的影响[J].中国中西医结合皮肤性病病学杂志,2005,4(3)：150-152.
[63]成爱华,韩梅海.黑素再生中药对体外培养的黑素细胞酪氨酸酶基因和c-kit基因表达的影响[J].中国临床医学,2008,15(1)：123-125.
[64]李永伟,许爱娥,Ruth Halaban.加味桃红四物汤对黑素细胞酪氨酸酶和酪氨酸激酶受体基因蛋白表达的影响[J].中华皮肤科杂志,2004,37(12)：727-729.
[1]Schallreuter ku, Lemke R.Brandt 0,et Vitiligo and other diseases: Coexistence or true association [J].Dermatology,1994,188:269
[2]Westerhof W, d'Ischia M. Vitiligo puzzle:the pieces fall in place [J]. Pigment Cell Res,2007,20(5):345-359.
[3]Nyholt DR.All LODs are not created equal[J]. Am J Hum Genet,2000,67:282-288
[4]Ta tan HB,Akar A, Orkunoglu FE,et al. Association of HLA class Iantigens and HLA class II alleles with vitiligo in a Turkish population[J]. Pigment Cell Res,2004,17 (2):181-184.
[5]Pehlivan S, Ozkinay F,Alper S,et al.Association between IL4(-590),ACE(I)/(D),CCR5(Delta32),CTLA4(+49)and IL1-RN(VNTR inintron 2) gene polymorphisms and vitiligo [J]. Eur J Dermatol,2009,19 (2):126-128.
[6]Jin SY,Park HH, Li GZ,et al. Association of angiotensin convertingenzyme gene I/D polymorphism of vitiligo in Korean population[J]. Pigment Cell Res,2004,17:84-86.
[7]Casp CB, She JX,McCormack WT. Genes of the LMP/TAP cluster areassociated with the human autoimmune disease vitiligo[J]. GenesImmun,2003,4:492-499.
[8]Casp CB,She JX,McCormack WT. Genetic association of the catalase gene(CAT)with vitiligo susceptibility [J]. Pigment Cell Res,2002,15 (1):62-66.
[9]Manga P, Sato K, Ye L, et al. Mutational analysis of the modulation of tyrosinase by tyrosinase-related proteins 1 and 2 in vitro[J]. Pigment Cell Res,2000,13(5):364-374.
[10]Sarangarajan R, Zhao Y, Babcock G,et al. Mutant alleles at the brown locus encoding tyrosinase-related protein-1 (TRP-1)affect proliferation of mouse melanocytes in culture[J]. Pigment Cell Res,2000,13(5):337-344.
[11]Eapen BR. VIT1 gene and vitiligo[J]. Indian J Dermatol Venereol Leprol,2004,70 (3):184-1845.
[12]Li M, Gao Y, Li C, et al. Association of COX2 functional polymorphisms and the risk of vitiligo in Chinese populations [J].J Dermatol Sci,2009,53(3):176-181.
[13]Le Poole IC,Luiten RM. Autoimmune etiology of generalized vitiligo[J]. Curr Dir Autoimmun,2008,10:227-243.
[14]Blomhoff A, Kemp EH, Gawkrodger DJ,et al.CTLA4 polymorphisms are associated with vitiligo, in patients with concomitant autoimmune diseases [J]. Pigment Cell Res,2005,18(1):55-58.
[15]Kitamura R, Tsukamoto K, Harada K, et al. Mechanisms underlying the dysfunction of melanocytes in vitiligo epidermis:role of SCK/KIT protein interactions and the downstream effector, MITF-M [J].J Pathol,2004,202(4):463-475.
[16]Gunduz K,Ozturk G, Terzioglu E,et al.T cell subpopulations and IL-2R in vitiligo [J]. J Dermatol,2005,124(1):144-150.
[17]Lee DJ,Modlin RL. Breaking tolerance-another piece added to the vitiligo puzzle[J].J Invest Dermatol,2005,124 (1):xiii-xv.
[18]Ruiz-Arguelles A,Brito GJ, Reyes-Izquierdo P, et al.Apoptosis of melanocytes in vitiligo results from antibody penetration[J].J Autoimmun,2007,29(4):281-286.
[19]Schall-reuter KU, Gibbons NC, Zothner C, et al. Hydrogen peroxide-mediated oxidative stress disrupts calcium binding on calmodulin:more evidence for oxidative stress in vitiligo[J]. Biochem Biophys Res Commun,2007,360 (1):70-75.
[20]Jimenez-Cervantes C,Martinez-Esparza M, Perez C, et al. Inhibition of melanogenesis in response to oxidative stress:transient downregulation of melanocyte differentistion markers and possible involvement of microphthalmia transcription factor [J].J Cell Sci,2001,114(Pt 12):2335-2344.
[21]Boissy RE,Manga P. On the etiology of contact/occupational vitiligo [J]. Pigment Cell Res,2004,17 (3):208-214.
[22]Hirobe T. Role of keratinocyte-derived factors involved in regulating the proliferation and differentiation of mammalian epidermal melanocytes[J]. Pigment Cell Res,2005,18 (1):2-12.
[23]Lee AY, Kim NH, Choi WI, et al. Less keratinocyte-derive factors related to more keratinocyte apoptosis in depigmented than normally pigmented suction-blistered epidermis may cause passive melanocyte death in vitiligo[J]. J Invest Dermatol,2005,124 (5):976-983.
[24]叶冬青,徐元勇,童志才,等.白癜风危险因素1：1配比病例对照研究[J].皮肤病与性病,2003,3(2)：2-4.
[25]Gauthier Y, Cario Andre M, Taieb A. A critical appraisal of vitiligo etiologic theories. Is melanocyte loss a melanocyttorrhagy[J]Pigment Cell Res,2003,16 (4):322-332.
[26]Radakovic-Fijan S,Furnsinn-Friedl AM,Honigsmann H,et al. Oral dexamethasone pulse treatment for vitilig[J].J Am Acad Dermatol,2001,44(5):814-817.
[27]朱文元.白癜风与黄褐斑[M].南京：东南大学出版社,2002：158-211.
[28]Arroyo MP,Tift L. Vitiligo therapy:where are we now[J]. JDrugs Dermatol,2003,2 (4):404-408.
[29]McNeely W, Goa KL.5-Methoxypsoralen. A review of its effects in psoriasis and vitiligo[J]. Drugs,1998,56(4):667-690.
[30]Plettenberg H, Assmann T,Ruzicka T. Childhood vitiligo and tacrolimus:immunomodulating treatment for an autoimmune disease[J]. Arch Dermatol,2003,139 (5):651-654.
[31]Molokhia MM, Portnoy B. Neutron activation analysis of trace elements in skin. VII. Copper and zinc in vitiligo, moles and seborrhoeic warts [J].Br J Dermatol,1973,88(4):347-353.
[32]张其亮.医学美容学[M].上海：上海科学技术出版社,1996：479.
[33]Kumaran MS, Kaur I, Kumar B. Effect of topical calcipotriol, betamethasone dipropionate and their combination in the treatment of localized vitiligo[J]. J Eur Acad Dermatol Venereol,2006,20(3):269-273.
[34]Ermis 0, Alpsoy E, CetinL, et al. Is the efficacy of psoralen plus ultraviolet A therapy for vitiligo enhanced by concurrent topical calcipotriol?A placebo-controlled double-blind study[J].Br J Dermatol,2001,145 (3):472-475.
[35]赵建林.氮介制剂治疗白癜风135例临床观察[J].临床皮肤科杂志,1996,25(5)：284.
[36]赵辨.临床皮肤病学[M].2版.南京：江苏科学技术出版社,1988：935.
[37]Maresca V, Roccella M, Roccella F, et al. Increased sensitivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo[J]. J Invest Dermatol,1997,109(3):310-313.
[38]刘智声.中西医结合治疗白癜风185例临床观察[J].岭南皮肤科杂志,2003,10(2)：121.
[16]Prota G,Vincensi MR,Napolitano A,et al. Latanoprost stimulates eumelanogenesis in iridial melanocytes of cynomolgus monkeys[J]. Pigment Cell Res,2000,13(3):147-150.
[39]Parsad D,Pandhi R, Dogra S, et al.Topical prostaglandin analog(PGE2) in vitiligo-a preliminary study [J].Int J Dermatol,2002,41(12):942-945.
[40]Fitzpatrick TB.Mechanisms of phototherapy of vitiligo[J]. Arch Dermatol,1997,133(12):1591-1592.
[41]Lyengar B. The hair follicle:a specialised uv receptor in the human skin [J].Biol Signals Recept,1998,7:188-194
[42]Abdel-Naser MB, Hann SK, Bystryn JC. Oral psoralen with UVA therapy releases circulating growth factor (s) that stimulates cell proliferation[J]. Arch Dermatol,1997,133:1530-1533.
[43]Said A,Makki S,Muret P, et al.Psoralens percutaneous permeation across the human whole skin and the epidermis[J]. J Dermatol Sci,1997,14:136-144.
[44]E1-Mofty AM, el-Sawalhy H,el-Mofty M. Clinical study of a new preparation of 8-mop in photochemotherapy [J]. Int J Dermatol,1994,33:588-592.
[45]McNeely W, Goa KL.5-Methoxypsoralen. A review of its effects in psoriasis and vitiligo[J]. Drugs,1998,56(4):667-690.
[46]Parsad D, Saini R, Verma N. Combination of PUVAsol and topical calcipotriol in Vitiligo[J]. Dermatology,1998,197:167-170.
[47]SugaY,Butt KI,Takimoto R,et al.Successful treatment of vithligo with PUVA-pigmented autologous epidermal grafting [J].Int J Dermatol,1996,35:518-522.
[48]Westerhof W, NieuweboerK L, Mulder PG,et al. Left-righe comparison study of the combination of Fluticasons propirnate and UVA Vs either Fluticasons propionate or UVA alone for the long-term treatment of vitiligo[J]. Arch Dermatol,1999,135:1061-1066.
[49]Grimes PE. Vitiligo, an overview of therapeutic approaches[J]. Dermatol Clin,1993,11:325-338.
[50]Westerhof W, Nieuweboerk L. Treatment of vitiligo with UV-B radiation Vs topical psoralen plus UV-A[J]. Arch Dermatol,1997,133:1525-1528.
[51]Schallreuter KU. Successful treatment of oxidative stress in vitiligo[J].Skin pharmacol Appl Skin physiol,1999,12:132-138.
[52]Yohn JJ,Morelli JG, Walchak SJ,et al. Cultured human keratinocytes synthesize and secrete endothelin-1[J]. J Invest DerL-phenylalanine and UVA irradiation in the treatment of vitiligo [J]. Dermatology,1994,188:215-218.
[53]Camacho F,Mazuecos J.Treatment of vitiligo with oral and topical phenylalanine:6 years of experience [J]. Arch Dermatol,1999,135:216-217.
[54]Droke LA. Dinehart SM. Farmer ER,et al. Guidelines of care for vitiligo:American Academy of Dermatol[J],1996,35:620-626.
[55]Bech-Thomsen N, Wulf HC. Treatment with topical khellin in combination with ultraviolet A or solar-sinulated radiation is carcinogenic to lightly pigmentet hairless mice [J]. Photodermatol Photoimmunol Photomed,1996,11:204-208.
[56]Cho S,Kang HC, Hahm JH. Characteris-tics of vitiligo in Korean children[J].Pediatr Dermatol,2000,17:189-193.
[2]王宗宽,张志国.中医中药结合免疫疗法治疗白癜风53例[J].中国现代医生,2007,45(19)：93-94,封3.
[3]洪文学,蔡建红,景 军.艾灸的热辐射光谱特性研究[J].应用光学,2004,25(4)：1-3.
[4]邓海平,沈雪勇,丁光宏.艾灸与经络穴位红外辐射特性[J].中国针灸,2004,24(2)：105-107.
[5]沈雪勇,周 愉,魏建子,等.传统艾灸与替代物灸和人体穴位红外辐射光谱比较[J].红外与毫米波学报,2003,22(2)：123-126.
[6]黄秋风译.艾的燃烧温度与机体内的温度变化(Ⅰ)-施灸局部的皮下基层内温度[J].国外医学·中医中药分册,1989,11(5)：48.
[7]董新民,董全声,先茂全,等.不同灸法对穴位温度影响的对比观察[J].中国针灸,1999,19(1)：22.
[8]董泉声.灸法及灸法退热与穴位皮肤感受器的关系[J].中国学术期刊文摘,1996,2(7)： 115.
[9]杨华元,刘堂义.艾灸疗法的生物物理机制初探[J].中国针灸,1996,16(10)：17-18.
[10]KobayashiK. Induction ofHeart-Shock Protein(hsp) byMoxibustion[J]. Am JChin. Med,1995,23 (3-4):327.
[11]陆静译.运用电子灸诱导纯蛋白衍生物反应性淋巴细胞[J].国外医学·中医中药分册,1995,17(3)：61.
[12]赵建新,贾春生,田元祥.近十年日本灸法实验研究进展[J].中国针灸,1999,19(8)： 507.
[13]刘屏荣译.灸疗对机体防御功能的影响[J].国外医学·中医中药分册,1989,11(5)：41.
[14]程棕鹏,熊毕文.艾灸治疗皮肤缺损的临床体会[J].上海针灸杂志,2000,19(3)：18.
[15]任秦有,赵宁侠,郭瑞林.艾灸百会穴对中风偏瘫病人甲皱微循环的影响[J].浙江中医学院学报,2004,28(3)：48-49.
[16]李爱华,万志杰.艾灸改善微循环的研究进展[J].中医药学报,2003,31(2)：27.
[17]郭瑞林,赵宁侠,任秦有,等.艾灸对30例健康人甲皱微循环及血液流变学的影响[J].第四军医大学学报,2002,23(12)：1112-1114.
[18]邓倩萍,姜小英.艾灸对老年心脑血管患者血液流变学的影响[J].针灸临床杂志,2005,21(4)：43-44.
[19]张栋,王淑友,马惠敏,等.激光多普勒血流成像技术对针灸效果的观察[J].上海针灸杂志,2004,23(5)：37-40.
[20]唐照亮,宋小鸽,王宁新,等.艾灸活血化瘀作用机制的研究[J].安徽中医学院学报,2004,23(2)：24-27.
[21]潘秋兰,张莉梅,张玉兰.艾灸对正常老年人甲皱微循环的影响[J].中国临床康复,2004,8(12)：2337-2343.
[22]赵宁侠,郭瑞林,任秦有,等.艾灸健康人百会穴对大脑中动脉血流速度的影响[J].中国针灸,2003,23(11)：679-680.
[23]姜小英.艾灸足三里、关元穴对血液流变性的影响[J].四川中医,2001,19(3)：75.
[24]陈文,谭敏,梁立安,等.艾灸足三里、悬钟对缺血性中风脑血管功能的影响及其临床意义[J].中国针灸,2006,26(3)：161-165.
[25]张蕊,仇裕丰.不同灸位、刺激量施灸对小鼠耳廓微循环的影响[J].针灸临床杂志,2006,22(9)：46-47.
[26]袁民,傅莉萍,陈雪华.艾灸对荷瘤小鼠免疫功能的影响[J].针刺研究,,2005,28(2)：115-118.
[27]张丽束,林志商,曾锡坤,等.艾灸对慢性粒细胞白血病的免疫调节功能的探讨[J].中华现代临床医学杂志,2005,3(6)：487-489.
[28]唐照亮,宋小鸽,章复清,等.艾灸抗炎免疫作用机制的实验研究[J].安徽中医学院学报,2004,23(2)：31-35.
[29]崔瑾,申定珠,熊芳丽.针灸膈俞对白细胞共同抗原及免疫功能的影响[J].四川中医,2006,24(2)：100-102.
[30]田华张,陈俊玲.艾灸强壮穴对慢性疲劳综合征患者免疫功能的影响[J].深圳中西医结合杂志,2006,16(4)：226-227.
[31]裴建,陈汉平.“艾灸血清”对免疫活性细胞功能的影响[J].上海针灸杂志,1999,18(1)：38-40.
[32]李晓泓,韩毳,张露芬,等.艾灸“大椎”穴抗应激作用的实验研究[J].中国行为医学科学,2002,11(5)：495-497.
[33]唐照亮,宋小鸽,王宁新,等.艾灸对佐剂性关节炎大鼠滑膜细胞凋亡及病理组织的观察[J].中医药学刊,2004,22(2)：226-227.
[34]刘旭光,黄迪君,郝 亮,等.艾灸对类风湿性关节炎大鼠下丘脑-垂体-肾上腺皮质轴的影响[J].中国中医基础医学杂志,2003,9(2)：57-59.
[35]高希言,封丽华,李卫红,等.艾灸督脉穴对亚急性衰老小鼠自由基与免疫器官的影响[J].河南中医学院学报,2003,(5)：22-24.
[36]杜艳军,宋 杰,孙国杰.艾灸对老年大鼠Caspase-3蛋白在凋亡信号转导通路中的影响[J].湖北中医杂志,2006,28(7)：3-4.
[37]杜艳军,孙国杰.艾灸对老年大鼠神经元线粒体超微形态计量学的研究[J].中华实用中西医杂志,2005,18(23)：1862-1863.
[38]梁欣,吕明庄,贺志光.耳针、艾灸对D—半乳糖致衰老大鼠血清褪黑素含量及其昼夜节律性的影响[J].中国针灸,2004,24(8)：573-577.
[39]艾双春,钟蓝,廖方正,等.电热隔药灸对老年人性激素的影响[J].中国针灸,2002,22(3)：168-170.
[40]冯起国,邓国伟.艾灸内关对家兔动脉粥样硬化作用的研究[J].辽宁中医杂志,2002,29(1)：48-49.
[41]易受乡,王履华,王慧珠.熏脐灸对脾虚患者胃电调整作用的临床观察[J].上海针灸杂志,1994,13(5)：195-197.
[42]彭丽辉,冯玲媚,陈筑芳,等.艾灸对高血压病患者血压及NO,ET,SOD,MDA的影响[J].中国针灸,2004,24(3)：157-159.
[43]吴中朝,王玲玲,徐兰凤,等.艾灸对高血脂症调脂作用的研究[J].上海针灸杂志,1997,16(6)：5-6.
[44]Norris A, Todd C, Graham A, et al.The expression of the c-kit receptor by epidermal malanoeytes may be reduced in vitiligo[J]. Br J Dermato,1996,134: 299-360.
[45]马惠群,张宪旗,牟宽厚,等.单味中药对黑素细胞黏附和迁移的影响[J].中国皮肤性病学杂志,2004,18(9)：526-528.
[46]马惠群,冯捷,张宪旗,等.补骨脂白芷对黑素迁移和黏附影响的比较[J].现代中西医结合杂志,2005,14(7)：850-851.
[47]王军,韩瑞玲,罗顺德,等.8-甲氧补骨脂脂质体对小鼠黑素瘤细胞黑素生成影响的研究[J].广东药学院学报,2004,29(5)：509-510.
[48]牟宽厚,张宪旗,冯捷,等.复方中药对黑素细胞黏附和迁移的影响[J].中国麻风皮肤病杂志,2008,24(7)：532-534.
[49]许爱娥,王遂泉.常用中药对酪氨酸酶的激活作用[J].中国皮肤科杂志,1998,31(1)：48.
[50]雷铁池,朱文元,夏明玉,等.89味中药乙醇提取物对酪氨酸酶活性的上调作用[J].临床皮肤科杂志,1999,28(3)：147-149.
[51]刘之力,涂彩霞,任凤,等.56味中药乙醇提取物对酪氨酸酶活性影响及动物致色素作用的研究[J].中华皮肤科杂志,2001,34(4)：284-285.
[52]刘之力,李雅莉,刘俐,等.六种中药复方乙醇提取物对酪氨酸酶活性作用及动物致色素作用研究[J].中国皮肤科杂志,2005,19(10)：588-591.
[53]李洪武,朱文元,夏明玉.赤芍等5味上调酪氨酸酶活性中药乙醇提取液对棕黄色豚鼠背部皮肤的增色作用[J].临床皮肤科杂志,2001,30(2)：69-71.
[54]刘璋,胡佑伦,韩瑞玲.黑素细胞生成过程中黄芩的调节作用[J].武汉大学学报(医学版),2005,26(1)：66-67.
[55]韩瑞玲,罗顺德,何文.甲氧沙林脂质体对小鼠黑素瘤细胞黑素生成影响的研究[J].临床皮肤科杂志,2004,33(10)：594-596.
[56]杨柳,邓燕.调和气血复方对体外培养黑素细胞和酪氨酸酶活性影响的实验研究[J].中华实用中西医杂志,2004,4(17)：2528-2529.
[58]程东庆,尉晓东,王遂泉,等.复方中药对小鼠B-16黑素瘤细胞株黑素合成和酪氨酸酶的激活作用[J].中华皮肤科杂志,2000,33(3)：173-174.
[58]李洪武,朱文元.治疗白癜风复方中药体外对蘑菇酪氨酸酶活性的作用[J].临床皮肤科杂志,2000,29(3)：133-135.
[59]Ferguson CA, Kidson SH.The regulathion of tyrcsinase gene transcription[J]. pigment Cell Res,1997,10(3):127-138.
[60]王辉,王莒生,王萍,等.中药滋肾补肝方对鼠B16黑素瘤细胞酪氨酸酶mRNA表达的调节[J].中国皮肤性病学杂志,2003,17(4)：230-231.
[61]李永伟,许爱娥,Ruth Halaban.单味中药提取物对体外培养的黑素细胞酪氨酸酶基因和c-kit基因表达的激活作用[J].中华皮肤科学杂志,2004,37(10)：598-600.
[62]李永伟,许爱娥,尉晓冬,等.女贞子对黑素细胞的黑素合成、细胞增殖和c-kit基因表达的影响[J].中国中西医结合皮肤性病病学杂志,2005,4(3)：150-152.
[63]成爱华,韩梅海.黑素再生中药对体外培养的黑素细胞酪氨酸酶基因和c-kit基因表达的影响[J].中国临床医学,2008,15(1)：123-125.
[64]李永伟,许爱娥,Ruth Halaban.加味桃红四物汤对黑素细胞酪氨酸酶和酪氨酸激酶受体基因蛋白表达的影响[J].中华皮肤科杂志,2004,37(12)：727-729.
[1]Schallreuter ku, Lemke R.Brandt 0,et Vitiligo and other diseases: Coexistence or true association [J].Dermatology,1994,188:269
[2]Westerhof W, d'Ischia M. Vitiligo puzzle:the pieces fall in place [J]. Pigment Cell Res,2007,20(5):345-359.
[3]Nyholt DR.All LODs are not created equal[J]. Am J Hum Genet,2000,67:282-288
[4]Ta tan HB,Akar A, Orkunoglu FE,et al. Association of HLA class Iantigens and HLA class II alleles with vitiligo in a Turkish population[J]. Pigment Cell Res,2004,17 (2):181-184.
[5]Pehlivan S, Ozkinay F,Alper S,et al.Association between IL4(-590),ACE(I)/(D),CCR5(Delta32),CTLA4(+49)and IL1-RN(VNTR inintron 2) gene polymorphisms and vitiligo [J]. Eur J Dermatol,2009,19 (2):126-128.
[6]Jin SY,Park HH, Li GZ,et al. Association of angiotensin convertingenzyme gene I/D polymorphism of vitiligo in Korean population[J]. Pigment Cell Res,2004,17:84-86.
[7]Casp CB, She JX,McCormack WT. Genes of the LMP/TAP cluster areassociated with the human autoimmune disease vitiligo[J]. GenesImmun,2003,4:492-499.
[8]Casp CB,She JX,McCormack WT. Genetic association of the catalase gene(CAT)with vitiligo susceptibility [J]. Pigment Cell Res,2002,15 (1):62-66.
[9]Manga P, Sato K, Ye L, et al. Mutational analysis of the modulation of tyrosinase by tyrosinase-related proteins 1 and 2 in vitro[J]. Pigment Cell Res,2000,13(5):364-374.
[10]Sarangarajan R, Zhao Y, Babcock G,et al. Mutant alleles at the brown locus encoding tyrosinase-related protein-1 (TRP-1)affect proliferation of mouse melanocytes in culture[J]. Pigment Cell Res,2000,13(5):337-344.
[11]Eapen BR. VIT1 gene and vitiligo[J]. Indian J Dermatol Venereol Leprol,2004,70 (3):184-1845.
[12]Li M, Gao Y, Li C, et al. Association of COX2 functional polymorphisms and the risk of vitiligo in Chinese populations [J].J Dermatol Sci,2009,53(3):176-181.
[13]Le Poole IC,Luiten RM. Autoimmune etiology of generalized vitiligo[J]. Curr Dir Autoimmun,2008,10:227-243.
[14]Blomhoff A, Kemp EH, Gawkrodger DJ,et al.CTLA4 polymorphisms are associated with vitiligo, in patients with concomitant autoimmune diseases [J]. Pigment Cell Res,2005,18(1):55-58.
[15]Kitamura R, Tsukamoto K, Harada K, et al. Mechanisms underlying the dysfunction of melanocytes in vitiligo epidermis:role of SCK/KIT protein interactions and the downstream effector, MITF-M [J].J Pathol,2004,202(4):463-475.
[16]Gunduz K,Ozturk G, Terzioglu E,et al.T cell subpopulations and IL-2R in vitiligo [J]. J Dermatol,2005,124(1):144-150.
[17]Lee DJ,Modlin RL. Breaking tolerance-another piece added to the vitiligo puzzle[J].J Invest Dermatol,2005,124 (1):xiii-xv.
[18]Ruiz-Arguelles A,Brito GJ, Reyes-Izquierdo P, et al.Apoptosis of melanocytes in vitiligo results from antibody penetration[J].J Autoimmun,2007,29(4):281-286.
[19]Schall-reuter KU, Gibbons NC, Zothner C, et al. Hydrogen peroxide-mediated oxidative stress disrupts calcium binding on calmodulin:more evidence for oxidative stress in vitiligo[J]. Biochem Biophys Res Commun,2007,360 (1):70-75.
[20]Jimenez-Cervantes C,Martinez-Esparza M, Perez C, et al. Inhibition of melanogenesis in response to oxidative stress:transient downregulation of melanocyte differentistion markers and possible involvement of microphthalmia transcription factor [J].J Cell Sci,2001,114(Pt 12):2335-2344.
[21]Boissy RE,Manga P. On the etiology of contact/occupational vitiligo [J]. Pigment Cell Res,2004,17 (3):208-214.
[22]Hirobe T. Role of keratinocyte-derived factors involved in regulating the proliferation and differentiation of mammalian epidermal melanocytes[J]. Pigment Cell Res,2005,18 (1):2-12.
[23]Lee AY, Kim NH, Choi WI, et al. Less keratinocyte-derive factors related to more keratinocyte apoptosis in depigmented than normally pigmented suction-blistered epidermis may cause passive melanocyte death in vitiligo[J]. J Invest Dermatol,2005,124 (5):976-983.
[24]叶冬青,徐元勇,童志才,等.白癜风危险因素1：1配比病例对照研究[J].皮肤病与性病,2003,3(2)：2-4.
[25]Gauthier Y, Cario Andre M, Taieb A. A critical appraisal of vitiligo etiologic theories. Is melanocyte loss a melanocyttorrhagy[J]Pigment Cell Res,2003,16 (4):322-332.
[26]Radakovic-Fijan S,Furnsinn-Friedl AM,Honigsmann H,et al. Oral dexamethasone pulse treatment for vitilig[J].J Am Acad Dermatol,2001,44(5):814-817.
[27]朱文元.白癜风与黄褐斑[M].南京：东南大学出版社,2002：158-211.
[28]Arroyo MP,Tift L. Vitiligo therapy:where are we now[J]. JDrugs Dermatol,2003,2 (4):404-408.
[29]McNeely W, Goa KL.5-Methoxypsoralen. A review of its effects in psoriasis and vitiligo[J]. Drugs,1998,56(4):667-690.
[30]Plettenberg H, Assmann T,Ruzicka T. Childhood vitiligo and tacrolimus:immunomodulating treatment for an autoimmune disease[J]. Arch Dermatol,2003,139 (5):651-654.
[31]Molokhia MM, Portnoy B. Neutron activation analysis of trace elements in skin. VII. Copper and zinc in vitiligo, moles and seborrhoeic warts [J].Br J Dermatol,1973,88(4):347-353.
[32]张其亮.医学美容学[M].上海：上海科学技术出版社,1996：479.
[33]Kumaran MS, Kaur I, Kumar B. Effect of topical calcipotriol, betamethasone dipropionate and their combination in the treatment of localized vitiligo[J]. J Eur Acad Dermatol Venereol,2006,20(3):269-273.
[34]Ermis 0, Alpsoy E, CetinL, et al. Is the efficacy of psoralen plus ultraviolet A therapy for vitiligo enhanced by concurrent topical calcipotriol?A placebo-controlled double-blind study[J].Br J Dermatol,2001,145 (3):472-475.
[35]赵建林.氮介制剂治疗白癜风135例临床观察[J].临床皮肤科杂志,1996,25(5)：284.
[36]赵辨.临床皮肤病学[M].2版.南京：江苏科学技术出版社,1988：935.
[37]Maresca V, Roccella M, Roccella F, et al. Increased sensitivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo[J]. J Invest Dermatol,1997,109(3):310-313.
[38]刘智声.中西医结合治疗白癜风185例临床观察[J].岭南皮肤科杂志,2003,10(2)：121.
[16]Prota G,Vincensi MR,Napolitano A,et al. Latanoprost stimulates eumelanogenesis in iridial melanocytes of cynomolgus monkeys[J]. Pigment Cell Res,2000,13(3):147-150.
[39]Parsad D,Pandhi R, Dogra S, et al.Topical prostaglandin analog(PGE2) in vitiligo-a preliminary study [J].Int J Dermatol,2002,41(12):942-945.
[40]Fitzpatrick TB.Mechanisms of phototherapy of vitiligo[J]. Arch Dermatol,1997,133(12):1591-1592.
[41]Lyengar B. The hair follicle:a specialised uv receptor in the human skin [J].Biol Signals Recept,1998,7:188-194
[42]Abdel-Naser MB, Hann SK, Bystryn JC. Oral psoralen with UVA therapy releases circulating growth factor (s) that stimulates cell proliferation[J]. Arch Dermatol,1997,133:1530-1533.
[43]Said A,Makki S,Muret P, et al.Psoralens percutaneous permeation across the human whole skin and the epidermis[J]. J Dermatol Sci,1997,14:136-144.
[44]E1-Mofty AM, el-Sawalhy H,el-Mofty M. Clinical study of a new preparation of 8-mop in photochemotherapy [J]. Int J Dermatol,1994,33:588-592.
[45]McNeely W, Goa KL.5-Methoxypsoralen. A review of its effects in psoriasis and vitiligo[J]. Drugs,1998,56(4):667-690.
[46]Parsad D, Saini R, Verma N. Combination of PUVAsol and topical calcipotriol in Vitiligo[J]. Dermatology,1998,197:167-170.
[47]SugaY,Butt KI,Takimoto R,et al.Successful treatment of vithligo with PUVA-pigmented autologous epidermal grafting [J].Int J Dermatol,1996,35:518-522.
[48]Westerhof W, NieuweboerK L, Mulder PG,et al. Left-righe comparison study of the combination of Fluticasons propirnate and UVA Vs either Fluticasons propionate or UVA alone for the long-term treatment of vitiligo[J]. Arch Dermatol,1999,135:1061-1066.
[49]Grimes PE. Vitiligo, an overview of therapeutic approaches[J]. Dermatol Clin,1993,11:325-338.
[50]Westerhof W, Nieuweboerk L. Treatment of vitiligo with UV-B radiation Vs topical psoralen plus UV-A[J]. Arch Dermatol,1997,133:1525-1528.
[51]Schallreuter KU. Successful treatment of oxidative stress in vitiligo[J].Skin pharmacol Appl Skin physiol,1999,12:132-138.
[52]Yohn JJ,Morelli JG, Walchak SJ,et al. Cultured human keratinocytes synthesize and secrete endothelin-1[J]. J Invest DerL-phenylalanine and UVA irradiation in the treatment of vitiligo [J]. Dermatology,1994,188:215-218.
[53]Camacho F,Mazuecos J.Treatment of vitiligo with oral and topical phenylalanine:6 years of experience [J]. Arch Dermatol,1999,135:216-217.
[54]Droke LA. Dinehart SM. Farmer ER,et al. Guidelines of care for vitiligo:American Academy of Dermatol[J],1996,35:620-626.
[55]Bech-Thomsen N, Wulf HC. Treatment with topical khellin in combination with ultraviolet A or solar-sinulated radiation is carcinogenic to lightly pigmentet hairless mice [J]. Photodermatol Photoimmunol Photomed,1996,11:204-208.
[56]Cho S,Kang HC, Hahm JH. Characteris-tics of vitiligo in Korean children[J].Pediatr Dermatol,2000,17:189-193.