Oral Qubaifangji Plus Autologous Epidermal Transplantation In The Therapy Of Vitiligo

Vitiligo is a pigmentation disorder disease, the clinical presentation is circumscribed or generalized depigmented macule, melanin decreases or loses in epidermis. Tyrosinase decrease can reduce the synthesis of melanin, which is a key enzyme in this process. It is reported that some kinds of TCM(traditional Chinese medicine) can activate tyrosinase, and enhance proliferation of melanocytes and synthesis of melanin. Autologous epidermal grafting is an ideal modality of vitiligo in recent years, which has good results in treating stable vitiligo patients, but pigmentation expands slowly after transplantation. According to theories of Chinese medicine and drug effect, we developed qubaifangji, which is composed of Chinese herbs that can activate tyrosinase and enhance animal pigmentation. Objective of this research is to observe clinical effect of oral qubaifangji combined with autologous epidermal grafting in treating vitiligo. Methods: 164 vitiligo out-patients were divided into two groups: group A and group B. 102 cases in group A were randomized into two subgroups: 52 cases in baishiwan control subgroup were treated with baishiwan, 2.5g, tid, po; 50 cases in qubaifangji subgroup were treated with qubaifangji ,one dosage, qd, decorted with water. One course of both subgroups lasted two months. In group B, 62 cases of stable vitiligo outpatients were randomized into two subgroups: 32 cases in autologous epidermal transplantation subgroup were used suction blister transplantation and 187 grafts were operated; 30 cases in qubaifangji/ autologous epidermal grafting subgroup took qubaifangji orally, and 190 grafts were operated. Therapeutic effect in both subgroups was evaluated after two months. Results: 1. Clinical effect comparision between qubaifangji subgroup and baishiwan subgroup: among 50 cases in qubaifangji subgroup, 4 cases were cured(8%), 15 cases markedly effective(30%), 16 cases effective(32%) and 15 cases ineffective(30%), markedly effective rate is 38%, total effective rate is 70%; among 52 cases in baishiwan subgroup, 1 case was cured(1.9%), 9 cases markedly effective(17.3%), 13 cases effective(25%) and 29 cases ineffective(55.8%), markedly effective rate is 19.23%, total effective rate is 44.23%. The therapeutic effect in qubaifangji subgroup is superior to that in baishiwan subgroup, difference of markedly effective rate and total effective rate are significiant. 2. Clinical effect comparision between qubaifangji/autologous epidermal grafting subgroup and autologous epidermal grafting subgroup: 191 grafts were operated in qubifangji/autologous epidermal grafting subgroup, 60 grafts were cured (31.4%), 63 grafts markedly effective(33%), 59 grafts effective(30.9%) and 9 grafts ineffective(4.7%), markedly effective rate is 64.4%;187 grafts were operated in autologous epidermal grafting subgroup, 49 grafts were cured (26.2%), 50 grafts markedly effective(26.7%), 76 grafts effective(40.6%) and 12 grafts ineffective(6.4%), markedly effective rate is 52.9%. The therapeutic effect in qubaifangji/autologous epidermal grafting subgroup is superior to that in autologous epidermal grafting subgroup, difference of markedly effective rate is significant. Conclusion: 1. Qubaifangji has better therapeutic effect in treating vitiligo, which can activate tyrosinase and promote animal pigmention. 2. The combination of qubaifangji and autologous epidermal grafting may further expand pigmention, which has fast and good result and safety.