| Vitiligo is a common acquired depigmented skin disorder, which caused by regional melanocytes depletion. Case rate is about 0.5%~4% of the population. Case rate has no difference between male and female. It can occur in any ages and any body part of skin and mucosa, especially on the skin which is exposed to the sunlight or rubed easily.The exact mechanism of vitiligo is still not comlpletely known, though there are some theories about its pathogenesis. Theories might involve autoimmunity, psycho-neuro chemistry, melanocyte self-destroy and heredity. Autoimmunity and psycho-neuro chemistry are more popular at present, especially the autoimmunity theory get more and more support of experimental results.Vitiligo has no rational symptom, but it is often on the exposure part. Patients have big stress and are eager for treatment. As the development of economy, acceleration of living pace and aggravation of environment, incidence rate of vitiligo is rising unceasingly. The treatment is a big problem. As etiopathogenisis is not clear, it is easy to diagnose but difficult to cure. Generally we use combining therapy which combines partial with entire therapy. Visible effect can be seen only after 3 months treatment. Nowadays the domestic and foreign therapis mainly include: PUVA, NBUVB, laser, drug for external use, surgical option and immunoregulant such as corticosteroids and so on. But no matter lesions local injection or systemic administration of corticosteroids will lead to great side effects. Currently surviving controversy, we hope to find other immunomodulator which has fewer side effects. Compound glycyrrhizin is a compound preparation which has Glycyrrhizin-an active ingredient isolated from the licorice root (Glycyrrhiza) as its main component. Research shows that glycyrrhizin has effects of anti-virus, anti-inflammatory, anti-allergy, as well as the glucocorticoid-like, but has fewer glucocorticoid-like side effects. It also has immunoregulatory role in regulating T cell activation, promoting differentiation of T lymphocytes, inducing IIFN-γinduced and activating NK cells, thus reduces the damage of melanocytes directly and recover the function of melanocytes.This study is divided into two parts. The first part is experimental study with guinea pigs. Animal model of vitiligo was established by chemical decolorization, with 5% H2O2 0.5ml/time, 2/day on the black skin for 50 days. The animal models are separately treated with SNMC and nothing. After 10 days decolorization, we applied intragastric administration to these guinea pigs with SNMC, observing the change of skin melanin content, to discuss the influence of SNMC on skin melanin formation. The result showed that under macroscopic observation, the melanin recovery between SNMC group and model group had significant difference (P<0.05). In the Lillie staining sections, melanin reduced in the spinous layer and the hair follicles of model group, while melanin increased in basal cells, spinous layer and the hair follicles of SNMC group. Compared with model group, SNMC group has significant difference (P<0.01). The second part is observing the clinical therapeutic effects of SNMC. 49 patients with vitiligo were randomly divided into treatment group and control group. 26 patients in treatment group had taken SNMC continuously for 3 months at a dose of 2 tablets with 3 times per day, meanwhile, 0.05% nitrogen mustard had been used locally with 2 times per day. While 23 other patients in control group had only been treated with 0.05% nitrogen mustard with 2 times per day. Course of treatment lasted 3 months. We chose a target lesion on each patient to observe the change of lesion and adverse reaction in 1, 2, 3 months separately. Through comparing the therapeutic effects between two groups, to evaluate the efficacy and safety of SNMC in treating vitiligo. Result showed that after 1 month, total effective rate in treatment group was 23.08% as compared with 8.70% in control group. There was significant difference between the two groups (P<0.05). After 2 months, total effective rate in treatment group was 42.31% as compared with 17.39% in control group. There was significant difference between the two groups (P<0.05). After 3 months, total effective rate in treatment group was 57.69% as compared with 30.43% in control group. There was significant difference between the two groups (P<0.05). Furthermore, total effective rate in both groups were increasing as time passed. No evident adverse reactions were found. Thus we can arrive at the conclusion that SNMC can promote melanin formation in epidermal basal cells, spinous layer and the hair follicles of animal model of vitiligo. SNMC has good efficacy in treating vitiligo and without evident adverse reactions. The therapeutic effect is improved as the time of treatment gets longer.In short, this study indicates SNMC can promote melanin formation through various mechanisms. As a drug to treat depigmentation disease without evident adverse reactions, it is worth further clinical research and clinical application.
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