CO_2点阵激光联合他克莫司软膏治疗白癜风的疗效观察
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摘要
目的 探讨CO_2点阵激光联合他克莫司软膏治疗白癜风的临床疗效。方法选择2016年6月至2017年2月本院收治的90例白癜风患者,采用随机数字表法分为对照组和观察组,每组45例。对照组给予他克莫司软膏治疗,观察组给予CO_2点阵激光联合他克莫司软膏治疗。比较两组白癜风治疗总有效率,白斑消退时间、色素消退时间,干预前后患者症状积分、焦虑自评量表(self-rating anxiety scale,SAS)评分、生活质量(quality of life,QOL)评分,以及不良反应发生率。结果观察组白癜风治疗总有效率高于对照组(95.56%vs 68.98%),差异有显著性(P<0.05);观察组白斑消退时间、色素消退时间分别为(15.24±1.45)、(13.21±1.61)天,均明显短于对照组[分别为(20.54±2.12)、(17.35±2.57)天],差异有显著性(P<0.05);干预前两组症状积分、SAS评分、QOL评分差异无显著性(P>0.05),而干预后观察组症状积分、SAS评分、QOL评分均明显优于对照组,差异有显著性(P<0.05)。对照组出现1例轻度白斑烧灼、1例轻微刺痛,观察组出现1例浅表瘢痕、1例轻微刺痛,两组不良反应发生率均为4.44%,差异无显著性(P>0.05)。结论CO_2点阵激光联合他克莫司软膏治疗白癜风疗效确切,可加速白斑和色素消退,提高治疗效果,缓解患者焦虑情绪,有助于改善患者生存质量,值得推广。
Objective To investigate the efficacy of CO_2 laser combined with tacrolimus ointment in the treatment of vitiligo. Method Taken from June 2016 to February 2017, 90 patients with vitiligo were grouped by digital table. The control group was given tacrolimus ointment and the observation group was given CO_2 laser and tacrolimus ointment. The total effective rate of vitiligo in both groups was compared;the time of leukoplakia and the time of pigment extinction; the score of symptom before and after treatment, the score of self-rating anxiety scale(SAS) and quality of life(QOL); the incidence of adverse reactions. Result The total effective rate of vitiligo in the observation group was higher than that in the control group(P< 0.05); the leukopenia time and the pigment extinction time in the observation group were shorter than those in the control group(P<0.05); before the intervention, symptom scores, SAS scores and QOL scores were similar(P>0.05); symptom score, SAS score and QOL score in observation group were better than those in control group after intervention(P<0.05).In the control group, 1 case had slight white spot cauterization and 1 case had mild stinging. In the observation group, 1 case had superficial scar and 1 case had mild stinging. Conclusion The efficacy of CO_2 laser combined with tacrolimus ointment in the treatment of vitiligo can accelerate the extinction of leucoderma and pigment, improve the therapeutic effect and relieve the anxiety of the patients with fewer complications, which is helpful to improve the quality of life of patients and is worth promoting.
Objective To investigate the efficacy of CO_2 laser combined with tacrolimus ointment in the treatment of vitiligo. Method Taken from June 2016 to February 2017, 90 patients with vitiligo were grouped by digital table. The control group was given tacrolimus ointment and the observation group was given CO_2 laser and tacrolimus ointment. The total effective rate of vitiligo in both groups was compared;the time of leukoplakia and the time of pigment extinction; the score of symptom before and after treatment, the score of self-rating anxiety scale(SAS) and quality of life(QOL); the incidence of adverse reactions. Result The total effective rate of vitiligo in the observation group was higher than that in the control group(P< 0.05); the leukopenia time and the pigment extinction time in the observation group were shorter than those in the control group(P<0.05); before the intervention, symptom scores, SAS scores and QOL scores were similar(P>0.05); symptom score, SAS score and QOL score in observation group were better than those in control group after intervention(P<0.05).In the control group, 1 case had slight white spot cauterization and 1 case had mild stinging. In the observation group, 1 case had superficial scar and 1 case had mild stinging. Conclusion The efficacy of CO_2 laser combined with tacrolimus ointment in the treatment of vitiligo can accelerate the extinction of leucoderma and pigment, improve the therapeutic effect and relieve the anxiety of the patients with fewer complications, which is helpful to improve the quality of life of patients and is worth promoting.
引文
[1]柳君如,张峻岭,程琳,等.他克莫司软膏联合308nm准分子激光治疗白瘢风临床观察[J].中国皮肤性病学杂志,2012,26(5):465-466.
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[7]张欣忠.超脉冲CO_2激光联合点阵铒激光治疗面部凹陷性瘢痕与增生性瘢痕的疗效比较[J].医学美学美容(中旬刊),2013,24(8):66-67.
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[9]周李燕,李静波,高以红,等.超脉冲CO_2点阵激光治疗痤疮凹陷性瘢痕的疗效分析[J].中国美容医学,2014,23(13):1089-1091.
[10]雷晋,郝振明,禹丽峰,等.超脉冲二氧化碳点阵激光结合中药治疗增生性瘢痕的临床观察[J].中华烧伤杂志,2015,31(3):164-167.
[11]王文鑫,朱海军.点阵激光联合得宝松治疗局限型白瘢风的临床观察[J].中国实用医药,2016,11(30):191-192.
[12]刘涛,丁街生,李志武,等.超脉冲CO_2点阵激光联合外用药治疗顽固性白癜风的疗效评价[J].中国麻风皮肤病杂志,2017,33(11):657-659.
[2]谢亚宁.他克莫司软膏联合308nm准分子激光治疗白癜风疗效观察[J].中国麻风皮肤病杂志,2012,28(12):874,876.
[3]马科党,李美红.白癜风患病人群常见自身免疫性疾病调查研究[J].中国医学前沿杂志(电子版),2015,7(8):120-122.
[4]王莉,徐薇,刘娟,等.局部光化学疗法与甲氧沙林治疗白瘢风30例自身对照研究[J].中国医刊,2010,45(12):60-61.
[5]张小超.他克莫司软膏联合308nm准分子激光治疗白瘢风临床观察[J].中国保健营养,2016,26(4):9-10.
[6]袁超.李丽.他克莫司软膏联合308nm准分子激光治疗白瘢风临床疗效观察[J].中国医疗美容,2015,5(1):75-76.
[7]张欣忠.超脉冲CO_2激光联合点阵铒激光治疗面部凹陷性瘢痕与增生性瘢痕的疗效比较[J].医学美学美容(中旬刊),2013,24(8):66-67.
[8]晏丹,黄泽春,李慧等.超脉冲CO_2激光联合中医综合疗法防治早期增生性瘢痕[J].中华医学美学美容杂志,2010,16(5):317-319.
[9]周李燕,李静波,高以红,等.超脉冲CO_2点阵激光治疗痤疮凹陷性瘢痕的疗效分析[J].中国美容医学,2014,23(13):1089-1091.
[10]雷晋,郝振明,禹丽峰,等.超脉冲二氧化碳点阵激光结合中药治疗增生性瘢痕的临床观察[J].中华烧伤杂志,2015,31(3):164-167.
[11]王文鑫,朱海军.点阵激光联合得宝松治疗局限型白瘢风的临床观察[J].中国实用医药,2016,11(30):191-192.
[12]刘涛,丁街生,李志武,等.超脉冲CO_2点阵激光联合外用药治疗顽固性白癜风的疗效评价[J].中国麻风皮肤病杂志,2017,33(11):657-659.