摘要
目的:观察桂枝汤加味治疗气血不和型儿童白癜风的临床疗效及对T淋巴细胞亚群、免疫球蛋白和补体的影响。方法:将134例符合要求的患儿,采用SAS软件生成,随机按数字表法分为观察组与对照组各67例。对照组采用0.03%他克莫司软膏,适量外涂,2次/d。观察组在对照组治疗的基础上服用桂枝汤加味,1剂/d。两组疗程均连续治疗3个月。进行治疗前后白癜风面积评分指数(VASI),黑素指数(MCI),皮肤病生活质量(DIQL)调查量表和气血不和证评分,并评估复色情况;检测治疗前后T淋巴细胞亚群(CD3+,CD4+,CD8+,CD4+/CD8+),补体(C3,C4)和免疫球蛋白(Ig G,Ig M,Ig A)水平。结果:观察组临床疗效总有效率为84.13%,高于对照组的63.49%(χ2=6.938,P<0.01);治疗后观察组VASI指数低于对照组(P<0.01),DIQL和气血不和证评分均低于对照组(P<0.01),MCI指数高于对照组(P<0.01);观察组患儿复色率(62.83±11.47)%高于对照组的(53.78±10.29)%(P<0.01);与健康对照组比较,白癜风患儿外周血免疫球蛋白Ig G,Ig A水平均明显下降,白癜风患儿外周血T淋巴细胞亚群CD3+,CD4+,CD4+/CD8+水平均有下降,CD8+水平升高(P<0.01);Ig M,C3和C4水平差异均无统计学意义;治疗后观察组患儿治疗后Ig G,Ig A水平均显著升高(P<0.01),并高于同期对照组(P<0.01),Ig M,C3和C4水平变化均无统计学意义;观察组患儿CD3+,CD4+,CD4+/CD8+均较治疗前升高(P<0.01),并高于治疗后对照组水平(P<0.05);CD8+下降,并低于治疗后对照组水平(P<0.05)。结论:桂枝汤加味治疗气血不和型儿童白癜风,能缩小皮损面积,增加白斑黑素含量,提高复色率,改善了患儿生活质量,有明显的临床疗效,其作用机制可能与调节自身免疫失衡有关,值得临床进一步的研究。
Objective： To observe the clinical effect of modified Guizhitang on children with vitiligo（ Qiblood circulation） andits effect onlevels of T lymphocyte subsets,immunoglobulin and alexin. Method： One hundred and thirty-four patients were randomly divided into control group 67 cases and observation group 67 cases by random number table. Patients in control group were given 0. 03% tacrolimus ointment,2 times/day. In addition to the therapy of control group,patients in observation group were also given modified Guizhitang,1 dose/day. And 3 months were a course of treatment. Before and after treatment,vitiligo area score index（ VASI）,Melanin content index（ MCI）,survey scale of quality of life in skin disorder（ DIQL）,and score of Qi-blood circulation were graded,and color recovery was recorded. Levels of CD3＋,CD4＋,CD4＋/CD8＋and CD8＋for T lymphocyte subsets,C3,C4 foralexin,Ig G,Ig M and Ig A for immunoglobulin were detected. Result： The total effect rate in observation group was 84. 13%, which washigher than 63. 49% in control group（ χ2= 6. 938,P〈0. 01）. After treatment,VASI,scores of Qi-blood circulation and DIQL in observation group were lower than those in control group（ P〈0. 01）,and MCI was higher than that in control group（ P〈0. 01）. Rate of color recovery was（ 62. 83 ± 11. 47）,which was higher than（ 53. 78 ± 10. 29） in control group（ P〈0. 01）. Compared with healthy control group,among children with vitiligo,levels of Ig G and Ig A,CD3＋,CD4＋and CD4＋/CD8＋decreased,level of CD8＋increased（ P〈0. 01）. With no statistical significance among levels of Ig M,C3 and C4. After treatment,levels of Ig G and Ig A in observation group increased,which were higher than those in control group（ P〈0. 01）. And levels of CD3＋,CD4＋,CD4＋/CD8＋in observation group increased（ P〈0. 01）,which were higher than those in control group（ P〈0. 05）. And level of CD8＋decreased,whichwas lower than that in control group（ P〈0. 05）.Conclusio
作者
罗光浦
王天晶
任盈盈
朱清华
LUO Guang-pu WANG Tian-jing REN Ying-ying ZHU Qing-hua(Dermatology Hospital of Southern Medical University, Guangzhou 510103, China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2017年第22期188-193,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
广东省科技计划项目公益研究与能力建设资金专项(2014A020221016)
