| Objective:Vitiligo treatment is the current dermatologist's problem,in order to seek a cost-effective and adverse reactions to small treatment methods,the teacher combined TCM(Traditional Chinese Medicine)Syndrome Differentiation theory with modern medical research,and self-made traditional Chinese medicine hot side combined with 308nm accurate Molecular light and1%pimecrolimus cream for the treatment of vitiligo,to investigate the effectiveness and safety of this method by observing the change of white spot area before and after treatment in patients with vitiligo,at the same time,discussing the mechanism of action of the three treatment of vitiligo and the synergy of the combination of drugs separately to provide new methods and new ideas for the treatment of vitiligo.methods:1.After long-term clinical observation found that traditional Chinese medicine combined with heat 308nm excimer laser and 1%pimecrolimus cream can achieve good clinical efficacy of vitiligo.This study uses a completely random design as a control method for clinical trials.The experimental cases all come from the vitiligo patients who came to the Dermatology Clinic of Hebei Provincial Hospital of Traditional Chinese Medicine from November 2015 to June 2017.A total of 81 experimental cases were obtained after vitiligo patients who met the criteria of this experiment and excluded inappropriate vitiligo patients,81 patients were randomly divided into three groups,of which 26 cases in the Herbal compress group(HG),26cases in the 308nm group(308G)and combination group were given different treatments.There was no significant difference(P>0.05)in the gender ratio,age distribution,course of disease,phase composition,and before treatment of the leukasmus area among the three groups,so there is comparable.2.In the 308nm group,308 nm excimer light was irradiated at the white spot(Hiram UV308,Japan Niuwei Medical Technology Co.,Ltd.),twice a week,and the dosage was adjusted according to the specific reaction;Topical 1%pimecrolimus cream(trade name:Ainingda,Beijing Novartis Pharmaceutical Co.,Ltd.),twice a day.Patients in the Herbal conpress group were treated with traditional Chinese medicine heat treatment,which mainly composed of:Angelica 20g,Salvia miltiorrhiza 15g,safflower 12g,Millettia9g,red peony 9g,psoralen 20g,white peony 12g,sand seed 20g,wind 12g,white peony9 g,turmeric 20 g,calcined natural copper 9 g,packaged with water and fried hot,the temperature is maintained at about 42°C),once day,each time last 30 min.The conbination group applied a Chinese herbal compress,a 308nm excimer light and a 1%pimecrolimus cream to the rash.3months for a course of treatment,after a course of treatment to determine the efficacy.3.Observed and calculated the changes of leukasmus area before and after treatment in three groups of patients,and determine the efficacy according to the standard set by the National Color Diseases Group in 2003.The cases were divided into cured,effective,effective and ineffective,and calculate the efficiency rate and the overall efficiency rate after treatment.Detailed records of patients in the course of treatment of adverse reactions(such as:burning sensation,itching,pain,erythema,blisters,etc.),in order to evaluate the safety of the traditional Chinese medicine heatsurgery combined with 308 excimer light and pimecrolimus cream in the treatment of vitiligo.The final data using statistical software SPSS21.0 to analyse.Results:After 81 patients received treatment for 1 course of treatment,a total of78 cases were collected after selecting and removing from the treated cases,of which 26 cases in the HG,26 cases in the 308G and 26 casas in the CG.1.After treatment in the three groups,the average area of leukasmus in the HG was 22.72±7.94cm~2,which was smaller than the average of34.57±2.50cm~2 before treatment.The average area of leukasmus in the 308G after the treatment was 21.54±9.1cm~2,which was smaller than the average of34.36±3.16cm~2 before treatment,The average area of leukasmus after treatment in the CG was 13.4(7.15)cm~2,the area before treatment was34.86±2.11cm~2 and it was singnificantly reduced after treatment than before treatment.After statistical analysis,the difference among the three groups before and after treatment was significant(P<0.01),indicating that three groups have curative effect;2.After treatment,the average area of leukasmus in the HG was22.72±7.94cm~2,which was consistent with the average value of 21.54±9.1cm~2in the 308G,statistical analysis showded that the diference was not stastistically significant(P>0.05);The effect of the CG was significant compared with the other two groups,and the difference was statistically significant(P<0.01),indicating that the therapeutic effect of the CG was significantly better than other two groups.3.26 cases of CG after treatment,1 patient was cured,8 was markedly effective,13 was effective,4 was ineffective,the efficiency rate was 34.62%,and the overall efficiency rate was 84.62%.26 cases of 308G after treatment,2 cases were cured,7 cases were markedly effective,12 cases were effective,5 cases were ineffective,the efficiency rate was 34.62%,and the overall efficiency ratea was 80.77%.26 cases of CG after treatment,5 cases were cured,9 cases were markedly effective,12 cases were effective,0 cases were ineffective,the efficiency rate was 58.85%,and the overall efficiency rate was100%.The HG and 308G had the same apparent efficiency,and the difference was not statistically significant(P>0.05);The efficiency rate and overall efficiency rate of this experiment,the CG was significantly higher than the two proups.4.During the course of treatment,slight adverse reactions occurred in the local skin of one patient in the HG,one patient in the 308G and one patient in the CG,which were untreated,recovered spontaneously,and could continue to be treated.The difference was not statistically significant(P>0.05).There is no difference in safety among the three groups.Conclusion:This study used a completely randomized,cross-referenced method,three groups of patients were given different treatment options.After one course of treatment,the changes of leukasmus area before and after treatment were observed and calculated in the three groups of patients.After statistical analysis of the obtained data,it was found that the efficacy of HG was consistent with that of 308G,and the difference was not statistically significant;The effect of CG was significantly better than the other two groups,which can reduce the leukasmus area and has a small adverse reaction,economical and practical,and can improve the patient's life treatment.It is suitable for further promotion in clinical practice. |
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