Clinical And Experimental Study Of The Narrow-band Ultraviolet Combined With Traditional Chinese Treatment Of Vitiligo

BACKGROUND:Vitiligo is an acquired skin disorder caused by the disappearance of pigment cells from the epidermis. Vitiligo can be cosmetically disfiguring and it is a stigmatizing condition, leading to serious psychologic problems in daily life. The cause is unknown, but might involve genetic factors, autoimmunity, neurologic factors, toxic metabolites. Many treatment have been used to stoping progression and achieving repigmentation in order to repair the morphology and functional deficiencies of the depigmented.Recently, Narrow band Ultraviolet B(NB-UVB)has been reported to be effective therapy for vitiligo . However, reports on its efficacy in Chinese patients with vitiligo are lacking. Chinese traditional medicine has been reported to be effective therapy for vitiligo,too. Baibo pill combined with baidian pill have been used to curing vitiligo for 20 years in our hospital.But whether NB-UVB combinded with baibo pill and baidian pill has possible additive effect were not known .OBJECTIVE:Through clinical and experiment study,we observed the efficacy and safety of NB-UVB phototherapy and compare it with NB-UVB phototherapy combined with baibo pill and baidian pill in patients with vitiligo to observing whether has it possible additive effect.METHODS:51 patients were divided into NB-UVBgroup(n=18,mail=9,female= 9,target patch=46) and NB-UVB combined with baidian pill and baibuo pill group (NB-UVB+,n=33,male=15,female=18,target patch=105).All patients received NB-UVB treatment 2 times per week with an initial dose of 0.3J/cm2.The dose was increased 0.1 J/cm2 per treatment untile 50% repigment was observed or persistent erythema or pruritus developed. In additional NB-UVB+ group take Baibuo pill 5g Bid and Baidian pill 5g Bid , children take 3/5 adult's dosage.29 guinea pigs were divided into model group(n=9), NB-UVB group(n=ll) and NB-UVB+group(n=10).All guinea pigs were treated by external using 3% H2O2 one time everyday . NB-UVB group and NB-UVB+goup's guinea pigs received NB-UVB treatment 5times per week with an initial dose of 0.3J/cm2. The dose was increased0.1 J/cm2 per treatment .After 7 treatments, The dose was increased 0.2 J/cm2 per treatment untile the doseage amount to 3.0 J/cm2. In additional NB-UVB+ group's guinea pigs take Baibuo pill 0.7g/Kg-d and Baidian pill 0.7g/Kg-d .Evaluating target patchs repigmention and observing the melain change of the epidermis and hair follicle when experiment was completed.RESULTSrNBUBV group accept treatment for 2(n=l 5),3(n=12),4(n=l 0) ,5(n=3)months, target patchs are 41,36,27,4. NB-UVB+group patients accepted treatment for 2(n=26),3(n=17),4(n=12),5(n=6) mnoths target patchs are 79,52,37,20. After 3 months treatment ,NB-UVB group has 4 cases acquired at least 50% repigment(4/12 33.33%)and NB-UVB+ group has 6 cases acquired similar curative effect(6/17 35.30%).Two group's curative effect shows no statistical different in different period. As in other treatment modalities, the face showed good repigmentation, whereas hands and feet responded poorly. A fewer mild adverse effects were encountered such as erythema and pruritus (NB-UVB group 6/18 33. 33%, NB-UVB+ group!4/33 42. 42%) ,it could disappeared by itself. Two group's adverse effects arising ratio shows no statistical different X2 =0. 404, P>0.05 XOutcom of the experiment support the clinical study's result.NB-UVB phototherapy combined with baibo pill and baidian pill and simple NB-UVB phototherapy all can restrain H2O2's depigmenttion to guinea pig.But two methods have not statistical different.CONCLUSIONS: According to our results, the treatment of patients with vitiligo with NB-UVB radiation is efficient and has fewer mild adverse effects. NB-UVB phototherapy combined with baibo pill and baidian pill seems no additive effect in treating vitiligo.