中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (1): 36-39.doi: 10.35541/cjd.20190512

• 论著 • 上一篇    下一篇

他克莫司治疗白癜风一年的临床疗效观察

徐永平1    胡文婷2    许爱娥2   

  1. 1浙江省义乌市皮肤病医院皮肤科  322000；2安徽医科大学附属杭州市第三人民医院皮肤科  310009
  • 收稿日期:2019-04-22 修回日期:2019-11-14 发布日期:2019-12-31
  • 通讯作者: 许爱娥 E-mail:xuaiehz@msn.com
  • 基金资助:
    国家自然科学基金（81271758、81472887、81773335、81602755）；卫生部科学研究基金——浙江省医药卫生重大科技计划项目（WKJ2012-2-036）；杭州市重大科技创新项目（20122513A02）；浙江省义乌市一般科研计划项目（17-1-30）

Evaluation of efficacy of tacrolimus in the one-year treatment of vitiligo

Xu Yongping1, Hu Wenting2, Xu Ai′e2   

  1. 1Department of Dermatology, Yiwu Dermatology Hospital, Yiwu 322000, Zhejiang, China; 2Department of Dermatology, The Third People′s Hospital of Hangzhou, Hangzhou 310009, China 
  • Received:2019-04-22 Revised:2019-11-14 Published:2019-12-31
  • Contact: Xu Ai′e E-mail:xuaiehz@msn.com
  • Supported by:
    National Natural Science Foundation of China （81271758, 81472887, 81773335, 81602755）; Scientific Research Fund of Ministry of Health -- Major Science and Technology Projects of Zhejiang Province （WKJ2012-2-036）; Major Science and Technology Innovation Projects of Hangzhou （20122513A02）; General Research Projects of Yiwu （17-1-30）

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摘要： 【摘要】 目的 观察长期使用他克莫司软膏治疗白癜风的疗效。方法 收集2016年1月至2018年2月在义乌市皮肤病医院及杭州市第三人民医院皮肤科白癜风门诊首诊并持续随访的白癜风患者156例，男70例，女86例；成年患者114例，6 ~ 18岁患儿42例。外用他克莫司软膏2次/d治疗6个月，每月随访1次，观察并记录色素开始再生时间、患者白癜风面积及严重程度评分（VASI），计算VASI改善率。治疗6个月时，将显效的患者随机分为常规治疗组（2次/d）和间隔治疗组（每3日 1次），继续观察6个月，比较两种方法对最终疗效的影响。采用Mauchly球形检验法、随机区组的方差分析法分析治疗前及治疗1 ~ 6个月的VASI评分差异。结果 156例患者治疗前、治疗1 ~ 6个月的VASI值［M（P25，P75）］分别为2（0.6，5）、2（2，5）、1.6（0.575，4.5）、1.2（0.5，4.0）、0.4（1.15，3.5）、0.75（0.3，2.575）、0.6（0.2，2.2），不同治疗时间点的VASI值差异有统计学意义（F = 6.14，P < 0.05），VASI值总体呈下降趋势。在6个月治疗期内，平均起效时间（2.2 ± 0.6）个月。98例（62.8%）显效，达显效时间为（5.2 ± 0.6）个月。显效患者中46例完成6个月的后续治疗，治疗第12个月，常规治疗组复色率（73.3% ± 18.2%）与间隔治疗组（72.0% ± 16.2 %）间差异无统计学意义（t = 0.42，P > 0.05）。结论 使用他克莫司治疗白癜风6个月时疗效显著，皮损治疗显效后每3日1次或2次/d的长期疗法均可维持较好疗效。

关键词: 白癜风, 治疗, 他克莫司, 长疗程

Abstract: 【Abstract】 Objective To evaluate the efficacy of long-term treatment with tacrolimus ointment in patients with vitiligo. Methods A total of 156 patients with vitiligo (70 males and 86 females) were enrolled into this study, who were firstly diagnosed with vitiligo and continuously followed up in Department of Dermatology, Yiwu Dermatology Hospital and the Third People′s Hospital of Hangzhou between January 2016 and February 2018. Of the 156 patients, 114 were adults, and 42 were children aged 6 - 18 years. All the patients received 6-month treatment with tacrolimus ointment twice a day. They were followed up once a month, the time to initial repigmentation and vitiligo area severity index （VASI） were recorded, and VASI improvement rate was calculated. After 6-month treatment, the patients achieving marked improvement were divided into conventional treatment group and interval treatment group to be treated with tacrolimus ointment twice a day and once every 3 days respectively for another 6 months, and final efficacy of the 2 protocols was compared. Mauchly′s test of sphericity, randomized block analysis of variance and Bonferroni method were used to analyze differences among pre-treatment VASI scores, and 1- to 6-month post-treatment VASI scores. Results Among the 156 patients, the pre-treatment, and 1-, 2-, 3-, 4-, 5- and 6-month post-treatment VASI scores ［M（P25, P75）］ were 2 （0.6, 5）, 2 （2, 5）, 1.6 （0.575, 4.5）, 1.2 （0.5, 4.0）, 0.4 （1.15, 3.5）, 0.75 （0.3, 2.575）, 0.6 （0.2, 2.2） respectively. Additionally, there was a significant difference in the VASI score among the above time points （F = 6.14, P < 0.05）, and the VASI score showed a gradual decreasing trend over time. During the initial 6-month treatment, the average time to initial repigmentation was 2.2 ± 0.6 months. Of the 156 patients, 98 （62.8%） received marked improvement, and the time to marked improvement was 5.2 ± 0.6 months. Of the 98 patients who received marked improvement, 46 completed another 6-month treatment. After 12-month treatment, there was no significant difference in the repigmentation rate between the conventional treatment group （73.3% ± 18.2%） and interval treatment group （72.0% ± 16.2 %, t = 0.42, P > 0.05）. Conclusions The initial 6-month topical tacrolimus therapy showed marked efficacy for vitiligo. After the marked improvement of skin lesions, good efficacy can be maintained by long-term treatment with topical tacrolimus once every 3 days or twice a day.

Key words: Vitiligo, Therapy, Tacrolimus, Long-term treatment 

引用本文

徐永平 胡文婷 许爱娥. 他克莫司治疗白癜风一年的临床疗效观察[J]. 中华皮肤科杂志, 2020,53(1):36-39. doi:10.35541/cjd.20190512

Xu Yongping, Hu Wenting, Xu Ai′e. Evaluation of efficacy of tacrolimus in the one-year treatment of vitiligo[J]. Chinese Journal of Dermatology, 2020, 53(1): 36-39.doi:10.35541/cjd.20190512