【摘要】 目的:探讨退白颗粒联合窄谱中波紫外线(NB-UVB)治疗寻常型白癜风的临床疗效,同时检测联合疗法治疗前后对患者血清Th1/Th2相关细胞因子IFN-γ、IL-2、IL-4、IL-18表达水平的影响和临床意义。方法:选取60例寻常型白癜风患者,给予退白颗粒内服联合NB-UVB皮损局部照射治疗,疗程为3个月,观察患者临床疗效;另选志愿者30例作为健康对照组。采用双抗体酶联免疫吸附法对健康对照组及白癜风患者治疗前后血清中IFN-γ、IL-2、IL-4、IL-18表达水平进行检测。结果:退白颗粒联合NBUVB治疗寻常型白癜风的有效率,进展期88.24%与稳定期61.54%、皮损面积<5%87.10%与≥5%65.52%、病程<1年87.50%与≥1年64.29%分别配对比较(P均<0.05)。治疗前:进展期和稳定期患者、皮损面积<5%和≥5%患者、病程<1年和≥1年患者IFN-γ、IL-2表达水平均明显高于健康对照组,且进展期高于稳定期、皮损面积≥5%高于<5%、病程<1年高于≥1年;IL-4、IL-18表达水平均低于健康对照组,且进展期低于稳定期、皮损面积≥5%低于<5%、病程<1年低于≥1年。治疗后:进展期患者IFN-γ、IL-2和稳定期患者IFN-γ以及皮损面积<5%和≥5%、病程<1年和≥1年患者IFN-γ、IL-2水平均明显下调;进展期患者IL-4、IL-18和稳定期患者IL-4以及皮损面积<5%和≥5%、病程<1年和≥1年患者IL-4、IL-18水平均明显上调。结论:IFN-γ、IL-2、IL-4、IL-18表达水平异常可能参与了寻常型白癜风的发病,中药退白颗粒联合NB-UVB可能通过调节上述细胞因子的表达水平对该病发挥治疗作用。更多还原

【Abstract】 Objective: To research clinical efficiency of traditional Chinese medicine Tuibai granules combined with narrow UVB( NB-UVB) in the treatment of vitiligo vulgaris,meanwhile,detecting the influence on Th1 / Th2 related cytokines IFN-γ,IL-2,IL-4 and IL-18 expression level of serum of patients before and after the combination therapy treatment and its clinical significance. Methods: 60 cases of patients with vitiligo vulgaris were treated with Tuibai granules orally combined with NB-UVB local radiation therapy with the treatment course of 3 months.And then,observe the clinical efficiency. Another 30 cases of volunteers were chosen as healthy control group. The expression levels of IFN-γ,IL-2,IL-4,IL-18 in serum of healthy control group and vitiligo patients were detected by double antibody enzyme-linked immunosorbent assay before and after the treatment. Results: Efficiency rates of Tuibai granules combined with NB-UVB: 88. 24% in progressive stage,and61. 54% in stable stage,87. 10% in skin lesion area < 5% and 65. 52% in ≥5%,disease course < 1 year with 87. 50% and ≥1 year with64. 29%. The differences of above index paired compared respectively were all statistically significant( P all < 0. 05). Before treatment: The expression levels of IFN-γ,IL-2 of progressive stage and stable stage,skin lesion area < 5% and ≥5% patients,disease course < 1year and≥1year patients,were all higher than healthy control group( P all < 0. 01). Progressive stage were higher than stable stage,skin lesion area≥5% were higher than < 5%,disease course < 1year higher than ≥1year( P all < 0. 01). All expression levels of IL-4,IL-18 were lower than healthy control group( P all < 0. 01),progressive stage lower than stable stage,skin lesion area≥5% lower than < 5%,disease course< 1year lower than ≥1year( P all < 0. 01). After treatment: The expression levels of IFN-γ,IL-2 of progressive stage,and IFN-γlevel of stable stage,IFN-γ,IL-2 levels of skin lesion area < 5% and ≥5%,disease course < 1year and ≥1year,were all regulated down significantly( P < 0. 05 or P < 0. 01). The expression levels of IL-4,IL-18 of progressive stage,and IL-4 level of stable stage,IL-4,IL-18 levels of skin lesion area < 5% and ≥5%,disease course < 1 year and ≥1 year,were all regulated up significantly( P < 0. 05 or P < 0. 01). Conclusions: Abnormal expression levels of IFN-γ,IL-2,IL-4,IL-18 might be involved in the pathogenesis of vitiligo,and the combination of Tuibai granules and NB-UVB might play a therapeutic role by regulating the expression levels of these cytokines.更多还原