| Objective:To observe the clinical efficacy and safety of patients with liver and kidney deficiency vitiligo with Baidianling combined with NB-UVB.Through Baidianling intervene the guinea pig model of vitiligo prepared by H2O2 chemical decolorization,evaluate the effect of different concentrations of baidianling on guinea pig model of vitiligo,in order to prove the effect of baidianling.Methods: This study is divided into two parts:clinical observation and experimental study.1.In clinical observation,We selected 2016.3-2017.3 who was diagnosed as liver and kidney deficiency type vitiligo in Department of dermatology clinic of Hubei Provincial Traditional Chinese Medical Hospital.90 patients were randomly divided into three groups:the treatment group,the control group A,and the control group B,30 cases in each group.The treatment group was dealt by external application of baidianling,Bozhi tablets orally combined with NB-UVB irradiation,the basic medicine composition of baidianling:psoralen 30 g,semen 20 g,angelica 20 g,plum 20 g,15g Rhizoma Drynariae,Radix Polygoni Multiflori 20 g,safflower 12 g,shikonin 12 g,Tribulus 15 g.The control group A was dealt with external application of Halometasone Cream,Bozhi tablets orally combined with NB-UVB irradiation.The control group B was dealt with oral Bozhi tablets combined with NB-UVB irradiation.The observation duration was in total 16 weeks,patients with vitiligo were routinely examined by assays of blood,urine,stool,liver and kidney function before and after treatment,the VASI score and total efficiency of the three groups were compared at the end of 4,8,12,16 weeks respectively.4 weeks meant a course of treatment.2.In experimental study,36 black colored guinea pigs were randomly divided into 6 groups: normal group,model group,positive drug group,low dose group,middle dose group and high dose group,6 rats were chosen in each group.Sodium sulfide was used to remove the black skin area of guinea pig neck and back by 4×4cm2,and H2O2 chemical decolorization method was used to prepare the guinea pig model.After the molds were completed,they were respectively be given 5%?10%?15% concentration of Baidianling,Compound Kaliziran tincture and Normal saline for 30 days,1ml/times,2times a day.After the end of the experiment,the effect of various drugs in the treatment of vitiligo animal model was observed by the naked eye;The content/activity of TYR ? MAO and MDA in serum was respectively detected by the kit of blood from the abdominal aorta.Results:1.90 patients were enrolled in the trial at the beginning,cases completed and 8 cases terminated in the trial at the end.After 2 courses of treatment,the total effective rate in the treatment group,the control group A and the control group B was 71.43%,51.85%,40.74%,respectively.The curative effect of the treatment group compared with the control group A and the control group B had statistically significant difference(P<0.05).After 4 courses of treatment,the total effective rate in the treatment group,the control group A and the control group B was 82.14%,70.37%,51.85%,respectively.The curative effect of the treatment group compared with the control group A and the control group B had statistically significant difference(P<0.05).Compared with the VASI score of each group before treatment and after treatment,the difference was statistically significant(P<0.05),and the VASI score after treatment was lower than that before treatment,indicating that the treatment in each group was effective.Compared with the VASI score of the three groups,the effect rate of the treatment group were distinctly better than that of the control group A and the control group B(P<0.05).During the treatment,no serious adverse reactions were found in all the groups.2.In the normal group,the skin color of guinea pig was black,the color of the model group was pale,the positive drug group and the Baidianling group were brown and black,the higher the concentration of the Baidianling group,and the deeper the color gradually.The total effective rate was respectively 50%,66.67% and 83.33% in the Baidianling low,middle and high dose group.The TYR content in plasma of guinea pigs in the Baidianling low,middle and high dose groups was significantly increased,MAO and MDA activities were significantly decreased,and the higher the concentration,the more obvious the TYR content was increased,the more obvious the MAO and MDA activities were decreased.At high magnification,we observed that the acanthosis of each group was thickened,the stratum corneum proliferation was obvious,the melanin was dyed dark green to black,and the black of basal layer and spinous layer of model group were obviously missing.The melanin of each medication group basically returned to normal level.Conclusion:1.The patient's condition in three groups has been improved in different degree.The efficacy of external application of baidianling,Bozhi tablets orally combined with NB-UVB irradiation is superior to that of external application of Halometasone Cream,Bozhi tablets orally combined with NB-UVB irradiation and oral Bozhi tablets combined with NB-UVB irradiation.The combination of Chinese medicine and western medicine therapy has definite curative effect,obvious color effect and good clinical safety performance,and is worthy of further promotion.2.Baidianling group and compound kaliziran tincture group can induce hyperpigmentation of vitiligo model animals,increase TYR content,reduce MAO and MDA activity,promote melanocyte melanin synthesis,which may be the mechanism of baidianling in the treatment of vitiligo.The experimental results showed that 3% concentration of Baidianling had the greatest effect on model animals. |
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