| Objective: To evaluate the efficacy and safety of autologous blood therapy combined with 308 nm excimer laser in the treatment of localized vitiligo.Methods: According to the case selection criteria,90 patients with vitiligo were randomly divided into three groups: self-blood group(n = 30),fire needle group(n =30)and basic group(n = 30).The basic group was treated with 308 nm excimer laser,topical 1% tacrolimus ointment and oral paracetamol tablets.The fire needle group was combined with fire needle therapy on the treatment of the basic group.The self-blood group was treated with autologous blood injection in the basic group for a total of 12 weeks.The skin lesion area,leukoplakia pigment score and dermatosis quality of life score before and after treatment(4,8 and 12 weeks)were recorded respectively.Use SPSS26.0 to analyze the data and draw a conclusion.Results:1 A total of 4 patients fell off in this study,and 86 cases were actually completed(selfblood group(n = 29),fire needle group(n = 28)and basic group(n = 29).There were no significant differences in age,sex,leukoplakia area and pigment score before treatment and quality of life score of dermatosis among the three groups(P > 0.05).2 Comparison of clinical efficacy.The clinical efficacy was evaluated according to the changes of leukoplakia area.After4 weeks of treatment,the total effective rate of the self-blood group was 65.52%,the fire needle group was 42.86%,and the basic group was 34.48%.There was significant difference in the total effective rate between the self-blood group and the basic group(P < 0.05),but there was no significant difference between the self-blood group and the fire needle group(P > 0.05).There was no significant difference in the total effective rate between the fire needle group and the basic group(P > 0.05).After 8 weeks of treatment,the total effective rate was 79.31% in the self-blood group,64.29% in the fire needle group and 44.83% in the basic group.The difference between the self-blood group and the fire needle group and the basic group was statistically significant(P <0.05).There was no significant difference between the fire needle group and the basic group(P > 0.05).After 12 weeks of treatment,the total effective rates were 86.20% in the self-blood group,75.00% in the fire needle group and 62.07% in the basic group,respectively.The difference between the self-blood group and the fire needle group and the basic group was statistically significant(P < 0.05).Compared with the basic group,the fire needle group was not statistically significant(P > 0.05).The above results show that the clinical curative effect of the self-blood group is better.3 Comparison of leukoplakia area.The leukoplakia area before treatment in the self-blood group was(12.97 ±10.25)cm 2,and that in the fire needle group was(12.62 ±9.68)cm 2,and after 12 weeks treatment,(9.54 ±8.59)cm 2;in the basic group,the leukoplakia area before treatment was(11.33±10.66)cm 2,and after 12 weeks treatment,(8.21 ±8.74)2cm.After 12 weeks of treatment,the leukoplakia area and skin lesion area of the above three groups were compared before and after treatment(P < 0.01).Combined with the numerical changes of leukoplakia area,the three methods were all effective.There were significant differences between the self-blood group and the basic group(P < 0.05),and between the self-blood group and the fire needle group(P < 0.01).There was no significant difference in the area of skin lesions between the two groups(P > 0.05),which indicated that the leukoplakia area was improved better in the self-blood group.4 Comparison of leukoplakia pigment scores.After 12 weeks of treatment,the pigment scores of the patients were compared before and after treatment,all P < 0.01,and the pigment scores were significantly different,indicating that the treatment methods used in the self-blood group,the fire needle group and the basic group improved the leukoplakia pigment scores of the patients.After 12 weeks of treatment,the leukoplakia pigment scores of the three groups were compared,and the differences were statistically significant(P < 0.05),indicating that the improvement of leukoplakia pigment scores in the self-blood group > fire needle group > basic group.5(DLQI)comparison of quality of life scores in dermatosis.After 12 weeks of treatment,there were significant differences in DLQI scores among the self-blood group,fire needle group and basic group before and after treatment.There were significant differences among the three groups(P < 0.05).The results showed that the three groups had a certain effect on improving the quality of life of the patients,while the improvement degree of the self-blood group was more obvious than that of the other two groups.Conclusion.1.The clinical effect of autologous blood therapy combined with 308 nm excimer laser in the treatment of localized vitiligo is better than that of fire needle combined with308 nm excimer laser and basic therapy.The comparison between the self-blood group and the basic group shows that the self-blood injection therapy is effective,and compared with the fire needle group,it is proved that the self-blood injection therapy is better than the fire needle therapy.This provides a more effective combination therapy for clinical treatment of vitiligo.2.Autologous blood therapy combined with 308 nm excimer laser is superior to fire needle group and basic group in reducing leukoplakia area,improving pigment score and quality of life in patients with localized vitiligo. |
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