中华皮肤科杂志 ›› 2018, Vol. 51 ›› Issue (10): 749-751.doi: 10.3760/cma.j.issn.0412-4030.2018.10.010

• 研究报道 • 上一篇    下一篇

医院与家用窄谱中波紫外线治疗白癜风的疗效观察

雷杰豪,樊奇敏,许爱娥   

  1. 310009 杭州，浙江中医药大学附属杭州第三医院皮肤科
  • 收稿日期:2017-12-14 修回日期:2017-12-29 出版日期:2018-10-15 发布日期:2018-10-03
  • 通讯作者: 许爱娥 E-mail:xuaiehz@msn.com
  • 基金资助:
    国家自然科学基金（81773335、81472887、81271758）；卫生和计划生育委员会科学研究基金-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）

Efficacy of home versus hospital narrow-band ultraviolet B phototherapy for vitiligo

Lei Jiehao, Fan Qimin, Xu Ai′e   

  1. Department of Dermatology, Hangzhou Third Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 310009, China
  • Received:2017-12-14 Revised:2017-12-29 Online:2018-10-15 Published:2018-10-03
  • Contact: Xu Ai′e E-mail:xuaiehz@msn.com
  • Supported by:
    National Natural Science Foundation of China （81773335, 81472887, 81271758）; Scientific Research Fund of the Ministry of Health -- Major Science and Technology Project of Zhejiang Province （WKJ2012-2-036）; Major Science and Technology Innovation Projects of Hangzhou （20122513A02）

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摘要： 目的 比较医院与家用窄谱中波紫外线（NB?UVB）治疗白癜风的疗效及患者接受度。方法 2016年8月至2017年9月在杭州市第三人民医院皮肤科门诊收集80例白癜风患者，随机分为家用光疗组和医院光疗组，每周照射2次，疗程均为36次。疗程结束后评估两组疗效、不良反应及患者接受度。结果 最终完成治疗家用光疗组39例，医院光疗组37例。家用光疗组面颈、躯干、四肢治疗有效率分别为62.5%、48.6%、42.3%，医院光疗组分别为66.7%、55.9%、48.6%。两组相应部位疗效、皮损初始复色累积剂量、疗程结束累积剂量比较，差异均无统计学意义。家用光疗组不良反应发生率（61.5%）显著高于医院光疗组（24.3%，P＜0.05），家用光疗组单次治疗耗时（27.95 min）短于医院光疗组（129.73 min，P＜0.05）。家用光疗组接受度随疗效增加评分升高（β = 0.483，t = 4.573，P＜0.001），随治疗耗时的增加降低（β = -0.569，t = -5.831，P＜0.001）；医院光疗组接受度随疗效增加上升（β = 0.758，t = 7.547，P＜0.001），但与治疗耗时无显著相关性（β = -0.204，t = -2.030，P = 0.05）。结论 家用光疗和医院光疗两者可互为补充，针对不同患者选择合适的治疗方法，可增强患者依从性，是提高疗效的必要条件。

关键词: 白癜风, 紫外线, 光疗法, 家庭, 医院

Abstract: Objective To compare the efficacy and acceptance of home versus hospital narrow-band ultraviolet B （NB-UVB） phototherapy for vitiligo. Methods Eighty patients with vitiligo were collected at the Department of Dermatology of Hangzhou Third Hospital from August 2016 to September 2017, and randomly and equally divided into two groups to be treated with home （home NB-UVB group） or hospital NB-UVB phototherapy （hospital NB-UVB group） twice a week for 36 sessions. After the treatment, the efficacy, adverse reactions and patient acceptance were evaluated. Results Finally, 39 patients in the home NB-UVB group and 37 in the hospital NB-UVB group completed the treatment. The response rates in the face and neck, trunk and extremities were 62.5%, 48.6% and 42.3% respectively in the home NB-UVB group, and were 66.7%, 55.9% and 48.6% respectively in the hospital NB-UVB group. There were no significant differences in the response rate, cumulative dosage required for initial repigmentation and cumulative dosage at the end of treatment at the same body site between the 2 groups. The incidence of adverse reactions was significantly higher in the home NB-UVB group than in the hospital NB-UVB group （61.5% vs. 24.3%, P < 0.05）, and the duration of a single treatment was significantly shorter in the home NB-UVB group than in the hospital NB-UVB group （27.95 min vs. 129.73 min, P < 0.05）. Multiple linear regression analysis showed that the patient acceptance in the home NB-UVB group significantly increased along with the improvement of efficacy （β = 0.483, t = 4.573, P < 0.001）, but decreased along with the increase of treatment duration （β = -0.569, t = -5.831, P < 0.001）. However, the patient acceptance in the hospital NB-UVB group significantly increased along with the improvement of efficacy （β = 0.758, t = 7.547, P < 0.001）, but was not correlated with the treatment duration （β = -0.204, t = -2.030, P = 0.05）. Conclusions The home and hospital NB-UVB phototherapy can complement each other for the treatment of vitiligo. Appropriate therapy should be chosen for different patients, so as to enhance patient compliance, which is an essential condition for the improvement of efficacy.

Key words: Vitiligo, Ultraviolet rays, Phototherapy, Family, Hospitals

中图分类号: 

  • R75