毫火针辅助308nm准分子光联合他克莫司软膏对白癜风患者疗效及免疫功能的影响

[摘要]目的：探究毫火針辅助308nm准分子光联合他克莫司软膏对白癜风患者免疫功能的影响。方法：选取于笔者医院就诊的136例白癜风患者，随机分为对照组和观察组，每组68例。两组患者均予以308nm准分子光和他克莫司软膏治疗，观察组在此基础上予以毫火针治疗。观察并比较两组患者T淋巴细胞、免疫球蛋白（Ig）、白癜风面积、严重程度评分指数（VASI）及临床疗效。结果：观察组患者临床总有效率为88.24%，显著高于对照组的72.06%（P<0.05）。治疗后，两组患者CD4+、CD4+/CD8+、调节性T细胞（CD4+ CD25+ Treg）水平均升高，观察组显著高于对照组，差异具有统计学意义（P<0.05）;两组患者CD8+、IgG、IgA、IgM、VASI评分水平均降低，观察组患者显著低于对照组，差异具有统计学意义（P<0.05）。结论：在308nm准分子光联合他克莫司软膏治疗基础上，予以毫火针治疗能够更有效调节患者免疫功能平衡，促进皮损复色。

[关键词]308nm准分子光;毫火针;他克莫司软膏;免疫功能;白癜风

[中图分类号]R758.4+1    [文献标志码]A    [文章编号]1008-6455（2021）03-0102-04

Effect of Millifire Needle Assisted 308nm Excimer Laser Combine with Tacrolimus Ointment on Immune Function of Patients with Vitiligo

REN Hu

（Department of Dermatology and Beauty，the Third People's Hospital of Mianyang City · Sichuan Mental Health Center， Mianyang 621000， Sichuan， China）

Abstract： Objective  To investigate the effect of of millifire needle assisted 308 excimer laser conbine with tacrolimus ointment on immune function of patients with vitiligo. Methods  136 patients with vitiligo in our hospital were randomly divided into the control group and the observation group， with 68 cases in each group. Both groups of patients were treated with 308 nm excimer laser and tacrolimus ointment， and the observation group was treated with millifire needle on this basis. The levels of T lymphocyte and immunoglobulin （Ig）， the vitiligo area， the score of VASI and the clinical efficacy were observed and compared between the two groups. Results  The total clinical effective rate of patients in the observation group was 88.24%， significantly higher than that in the control group （72.06%， P<0.05）. After treatment， the levels of CD4+ and CD4+/CD8+， regulatory T cells （CD4+ CD25+ Treg） in the two groups all increased， and those in the observation group were significantly higher than those in the control group， the differences were statistically significant （P<0.05）. The levels of CD8+， IgG， IgA ， IgM and the score of VASI in the two groups all decreased， and those in the observation group were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion  On the basis of 308 nm excimer laser combined with tacrolimus ointment， milli-fire needle therapy can more effectively regulate the immune function balance of patients and promote skin lesion recoloration.

Key words： 308 nm excimer laser; milli-fire needle; tacrolimus ointment; immune function;vitiligo

白癜风是一种常见的后天性皮肤色素脱失性疾病，主要是患者黑素细胞功能损伤引起的，常见颜面、指背、腕及生殖器周围等，多发于青年女性[1]。关于白癜风的发病机制尚不明确，目前临床以免疫调节治疗为主，多采用激光联合外用膏药涂抹，但疗效不尽人意[2]。308nm准分子光是一种中波紫外线，较传统的窄谱紫外线对患处皮肤具有选择性的特点，更具安全性，但白癜风治疗病程长，病情易反复，且激光治疗难度也随复发次数而增加[3]。他克莫司软膏是一种局部免疫调节剂，能够调节患者免疫功能，促进黑色素的生成，是临床治疗白癜风的常用药物[4]。近年来，火针在临床治疗疱疹、黄褐斑等多种皮肤疾病中有显著进展，具有针刺和温热灸双重作用，毫火针与火针具有相同功效，但针直径小，患者疼痛及损伤更小[5]。但目前毫火针在白癜风治疗中应用较少，故本次研究设立对照组和观察组，均予以308nm准分子光和他克莫司软膏常規治疗，观察组在此基础上予以毫火针，比较并分析两组患者免疫功能、皮损色素积分及临床疗效，现将结果报道如下。……