| Objective: Vitiligo is a depigmentation disease,which seriously affect the patient's everyday life.There are different kinds of treatment for vitiligo,in which the combination therapy of physical therapy with medication is the main treatment method in addition to surgery.Chinese medicine is a traditional therapy,including Yiqiqubai granules are made in our hospital for the treatment of vitiligo.Although Yiqiqubai granules has been used as a clinical treatment for vitiligo for decades,it has not been systematically studied for its clinical efficacy;308nm excimer light has become one of the main physical treatment for vitiligo recently,and has better efficacy and safety compared to the traditional phototherapy,but the standard of clinical treatment is still a blank.Therefore,this study is divided into three parts:(1)To discuss the clinical efficacy of Yiqiqubai granules and the effect of the clinical course on VIDA score.(2)To discuss the clinical efficacy of 308 nm excimer light and the effect of age on the clinical efficacy.(3)To discuss both combination therapy whether it can further improve the clinical efficacy and recommended suitable combination therapy.Methods:(1)Vitiligo patients were randomly divided into treatment group and control group in total of 100 cases.The treatment group were treated with Yiqiqubai granules 15 g,twice daily;the control group were treated with the Baishipian 5 tablets,three times daily administration.Evaluate the clinical efficacy and the effect of the clinical course on VIDA score after completing the treatment.(2)Using Alma Lasers Harmony XL excimer light system to treat 100 cases of vitiligo patients that separate to four groups on the bases of the different parts of lesion,the total treatment are 50 times,treating 1~2 space times / week.According to the individual's response,evaluate the clinical efficacy and analyse the correlation between age and times of treatment after the end completion of the last treatment.(3)220 cases of patients with vitiligo were divided into 3 groups,group A(n=60),group B(n=100)and group C(n=60).According to the selected time,combined with the random number table,group A cured by using 308 nm excimer light,group B treated with Yiqiqubai granule,group C treated with Yiqiqubai granule combined with 308 nm excimer light.The clinical efficacy of treatments in the three groups were assessed with the white spot area integral,color score,color-reverse rate and quality of life.Results:(1)Yiqiqubai granule therapy effective rate of 60.0%,compound-piece set of Baishipian treatment effective rate of 54.0%,no significant difference between two treatments.When clinical courses were within 24 months in two groups,they can both decrease VIDA score after treatment,the difference was not statistically significant;When clinical course were more than 24 months,the VIDA difference between before and after treatment in Yiqiqubai group was significantly higher than Baishipian group,the difference was statistically significant.(2)After completing the treatment,9 cases were cured,23 cases were markedly effective,31 cases were effective,47 cases were ineffective;the total markedly effective rate was 32.0%,total effective rate was 63.0%;Treatments for head,face,neck and torso were better than those for limbs,treatments for limbs were better than those for extremities and joints.Relationship between age and treatment time,patient age 1~30 year-old patient had no significant difference in time of early pigmentation.In patients over 30 years of age the number needed to treat increases significantly with the increase of age.(3)The total effective rate of group C(combined treatment)was significantly higher than that of group A(308nm excimer light)and B(Yiqiqubai granule).Effective rates of the three groups with advanced stage disease were higher than those in the stable period.Efficiency of the advanced stage of the patients in group B was significantly higher than those in stable period.The score of area of white spot in group C were significantly lower than those in group A and B;the pigment score in group C was significantly higher than that in group A and B;The color-reverse rate of group C was significantly higher than that of group A and B.Conclusion:(1)Yiqiqubai granules clinical efficacy is effective and stable,and efficacies in patients with longer clinical course are still effective.(2)308nm excimer light for patients with age between 1~30 year old,lesions located at head,face and neck and torso have the best clinical effect.(3)The combination therapy can further improve the clinical efficacy,shorten the course of treatment,worthy of clinical application. |
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