阿法骨化醇联合308nm准分子光治疗寻常型进展期白癜风的临床效果分析

田秘 洪丽明 汪伟

[摘要]目的：探究阿法骨化醇联合308nm准分子光治疗寻常型进展期白癜风的临床疗效。方法：选取2018年12月-2019年6月笔者医院收治的62例寻常型进展期白癜风患者为研究对象，通过随机数字表法分成激光治疗组（31例）和联合组（31例）。两组均予以308nm准分子光治疗，联合组则在此基础上予以阿法骨化醇口服治疗。两组均连续治疗5周。观察两组治疗后的临床疗效，统计两组治疗期间不良反应发生情况。结果：治疗后，联合组总有效率为93.55%，显著高于激光治疗组的74.19%（P<0.05）。联合组不良反应发生率为6.45%，治疗组为12.90%，两组不良反应发生率比较，差异无统计学意义（P=0.668）。结论：阿法骨化醇联合308nm准分子光可调节寻常型进展期白癜风患者皮损症状，有效改善皮肤微环境，安全性高，疗效显著。

[关键词]寻常型进展期白癜风;阿法骨化醇;308nm准分子激光;不良反应

[中图分类号]R758.4+1    [文献标志码]A    [文章编号]1008-6455（2021）07-0065-03

Clinical Value of Alfacalcidol Combined with 308nm Excimer Laser in the Treatment of Advanced Vitiligo

TIAN Mi1，HONG Li-ming2，WANG Wei1

（1.Department of Dermatology and Venereology;2.Emergency ICU，the First Affiliated Hospital of Hainan Medical College， Haikou 510000， Hainan，China）

Abstract： Objective  To explore the clinical value of alfacalcidol combined with 308 nm excimer laser in the treatment of advanced vitiligo. Methods  Between December 2018 and June 2019， 62 patients with vitiligo of ordinary progression admitted to our hospital were randomly divided into the laser treatment group （31 cases） and the combined group （31 cases）. Both groups were treated with 308 nm excimer laser， while the combined group was treated with alfacalcidol orally on this basis. Both groups were treated continuously for 5 weeks. The clinical effects of the two groups after treatment， and the occurrence of adverse reactions during treatment were observed. Results  After treatment， the total effective rate in the combined group was 93.55%， significantly higher than74.19% in the laser treatment group（P<0.05）. The incidence of adverse reactions was 6.45% in the observation group and 12.90% in the control group， but there was no significant difference between the two groups （P=0.668）. Conclusion  Alfacalcidol combined with 308 nm excimer laser can effectively improve the skin microenvironment， has high safety and remarkable curative effect.

Key words： vitiligo of common progressive stage; alfacalcidol; 308 nm excimer laser; adverse reaction

尋常型进展期白癜风为临床常见类型[1]，现阶段其治疗方法及药物种类众多，但疗效不一，且相同疗法下不同类型白癜风患者间疗效亦存在较大差异。308nm准分子光治疗为近年来兴起的寻常型进展期白癜风的临床常用疗法之一，但其作为物理疗法，仅能局部改善患者皮肤状态，多需联合药物治疗白癜风患者[2]。既往研究指出[3]，1，25-二羟基维生素D3[1，25-（OH）2D3]与寻常型进展期白癜风的发生发展密切相关，符梦思等[4]研究指出，维生素D可通过调节神经、免疫等对寻常型进展期白癜风患者产生治疗效果。阿法骨化醇是一种可在肝脏羟化成有活性的1，25-（OH）2D3的药物[5]，据此推测，其可对寻常型进展期白癜风患者产生治疗作用，但相关临床报道甚少。本研究采用阿法骨化醇联合308nm准分子光治疗寻常型进展期白癜风，旨在进一步探究其对寻常型进展期白癜风患者的作用机制及疗效，并为临床治疗提供依据，现报道如下。……