Objective To compare the efficacy and safety of excimer laser 308 nm phototherapy alone and the combination of excimer laser 308 nm and topical application of vitamine D3 alanogue tacalcitol in the treatment of vitiligo. Methods Seventy-eight patients with vitiligo were enrolled in the single-blind clinical trial, treated with excimer laser 308 nm. The lesions were devided into two groups: patients in the experimental group were instructed to use tacalcitol ointment and the control group were applied with placebo ointment. The lesions were evaluated once per month and photos taken for analyses of clinical effects. Results The results in different locations were compared, the effective rates of the experimental group in cephalofacial site, trunk and limbs were 93.51%, 84.16 % and 42.35 %, respectively. The effective rates of control group in opposite and adjacent sites were 90.9 %, 77.45 % and 34.15 %, respectively (P ＜ 0.05). The comparison of results in different types of lesions indicated that the effective rate of the experimental group in vitiligo vulgaris and segmental vitiligo were 73.81% and 84.00 %, respectively. The effective rate of control group in vulgaris and segmental vitiligo were 86.8 %, 77.45 % and 34.15 %, respectively (P ＜0.05 ). The comparison of results in radiation times and doses of phototherapy showed that the radiation time and dose on the time of initial pigment regeneration were (16. 15 ± 3.22)times and (4.40 ± 5.03)J/cm2 in the experimental group, while ( 18.56 ± 3.50) times and ( 6.60 ± 1.01 ) J/cm2 ( P ＜ 0.05 ) in the control group, the time and dose on the time of apparent effect were ( 20. 36 ± 1.50 ) times and ( 7.50 ± 3.54 ) J/cm2 in the experimental group, and (21.68 ± 2.40) times and( 8.80 ± 9.24)J/cm2 (P ＜ 0.05 ) in the control group. Conclusion Application of tacalcitol ointment in combination with twice-weekly 308 nm excimer laser light phototherapy is an effective alternative treatment for patients with generalized vitiligo.%目的 比较单用308 nm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308 nm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93.51%,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/cm2,对照组分别为(18.56±3.50)次和(6.60±1.01)J/cm2(P＜0.05),显效的患者实验组为(20.36±1.50)次和(7.50±3.54)J/cm2,对照组为(21.68±2.40)次和(8.80±9.24)J/cm2(P＜0.05).结论 308 nm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308 nm准分子激光的疗效,缩短色素再生的时间,减少照光的能量.
展开▼
