摘要
目的探讨308 nm准分子激光联合复方甘草酸苷片治疗寻常型白癜风的临床疗效。方法采用前瞻性研究方法选取2016年1月至2018年12月沈阳市第七人民医院收治的500例寻常型白癜风患者,按照简单随机化方法分为两组:对照组和观察组,每组各250例。对照组患者予以308 nm准分子激光治疗,观察组患者在此基础上加用复方甘草酸苷片。比较两组患者的临床疗效,外周血Th17/Treg亚群(CD3+CD8^-IL-17A^+Th17、CD4^+CD25^+Foxp3^+Treg)水平血清巨噬细胞游走抑制因子(MIF)、细胞间黏附分子-1(ICAM-1)、内皮素-1(ET-1)、干细胞因子(SCF)水平和不良反应发生情况。结果观察组患者的显效率(92.40%)明显高于对照组(76.00%),差异具有统计学意义(P <0.05);治疗后,观察组患者CD3^+CD8^-IL-17A+Th17水平(0.76%±0.25%)低于对照组(0.88%±0.30%),CD4^+CD25^+Foxp3^+Treg(0.88%±0.30%)水平高于对照组(0.09%±0.03%)差异均有统计学意义(P <0.05);治疗后,观察组患者MIF、ICAM-1水平(20.23±6.34μg/L,327.83±26.73 ng/ml)均低于对照组(25.83±7.59μg/L,408.62±32.04 ng/ml)差异具有统计学意义(P<0.05);治疗后,观察组患者ET-1、SCF水平(753.32±91.08 pg/ml,378.49±35.22pg/ml)均高于对照组的(701.85±80.31pg/ml,345.28±30.94pg/ml),差异具有统计学意义(P<0.05);观察组患者的不良反应发生率(9.60%)与对照组(10.80%)相比,差异无统计学意义(P>0.05)。结论 308nm准分子激光联合复方甘草酸苷片治疗寻常型白癜风疗效显著,其机制可能与纠正外周血Th17/Treg紊乱、下调MIF和ICAM-1表达、上调ET-1和SCF有关。
Objective To investigate the clinical efficacy of 308 nm excimer laser combined with compound glycyrrhizin tablets in the treatment of vitiligo vulgaris.Methods 500 patients with vitiligo vulgaris admitted to Shenyang Seventh People s Hospital from January 2016 to December 2018 were randomly divided into two groups:control group and observation group,250 cases in each group.Patients in the control group were treated with 308 nm excimer laser,and patients in the observation group were treated with 308 nm excimer laser combined with compound glycyrrhizin tablets.The clinical efficacy,peripheral blood Th17/Treg subgroups(CD3^+CD8^-IL-17 A^+Th17,CD4^+CD25^+Foxp3^+Treg) levels,serum macrophage migration inhibitory factor(MIF) level,intercellular adhesion molecule-1(ICAM-1) level,endothelin-1(ET-1) level,stem cell factor(SCF) level and adverse reactions of the two groups were compared.Results The effective rate of the observation group(92.40%)was higher than that of the control group(76.00%),and the difference was statistically significant(P <0.05);After treatment,the level of CD3^+CD8-IL-17 A^+Th17 [(0.76±0.25) %] in the observation group was lower than that in the control group [(0.88±0.30) %],and the level of CD4^+CD25^+Foxp3^+Treg [(0.88±0.30) %] was higher than that in the control group [(0.09±0.03)] %,and the differences were statistically significant(P<0.05);After treatment,the MIF and ICAM-1 levels in the observation group [(20.23±6.34) μg/L,(327.83±26.73) ng/ml,respectively] were lower than those in the control group [(25.83±7.59)μg/L,(408.62±32.04) ng/ml],and the differences were statistically significant(P <0.05).After treatment,the ET-1 and SCF levels in the observation group [(753.32±91.08) pg/ml,(378.49±35.22) pg/ml] were higher than those in the control group [(701.85±80.31) pg/ml,(345.28±30.94) pg/ml],and the differences were statistically significant(P <0.05).The incidence of adverse reactions in the observation group was 9.60% compared with 10.80%in the control group,but the difference was not statistically significant(P> 0.05).Conclusion The combination of 308 nm excimer laser and compound glycyrrhizin tablets has a significant effect on the treatment of vitiligo vulgaris,and its mechanism may be related to the correction of peripheral blood Th17/Treg disorders,down-regulation of MIF and ICAM-1 expression,and up-regulation of ET-1 and SCF.
作者
姚放
张慧娟
王鸿飞
YAO Fang;ZHANG Hui-juan;WANG Hong-fei(Department of Dermatology,Shenyang 7th People's Hospital,Shenyang Liaoning 110003,China)
出处
《临床和实验医学杂志》
2020年第3期303-307,共5页
Journal of Clinical and Experimental Medicine
基金
辽宁省科学技术计划项目(编号:2015020552)
