Yones Sami Sasi, Palmer Roy A, Garibaldinos Trish M, Hawk John L M
Dip Der, FCD, Photobiology Unit, Second Floor, St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Guys, King's and St Thomas' School of Medicine, King's College, London SE1 7EH, England.
Arch Dermatol. 2007 May;143(5):578-84. doi: 10.1001/archderm.143.5.578.
To compare the efficacy of oral psoralen-UV-A (PUVA) with that of narrowband-UV-B (NB-UVB) phototherapy in patients with nonsegmental vitiligo.
Double-blind randomized study.
Phototherapy unit in a university hospital.
Fifty-six patients with nonsegmental vitiligo. Interventions Twice-weekly therapy with PUVA or NB-UVB.
The change in body surface area affected by vitiligo and the color match of repigmented skin compared with unaffected skin were assessed after 48 sessions of therapy, at the end of the therapy course, and 12 months after the end of therapy.
The results in the 25 patients each in the PUVA and NB-UVB groups who began therapy were analyzed. The median number of treatments was 47 in the PUVA-treated group and 97 in the NB-UVB-treated group (P = .03); we suspect this difference was because of the differences in efficacy and adverse effects between the 2 modalities, such that patients in the NB-UVB group wanted a longer course of treatment. At the end of therapy, 16 (64%) of 25 patients in the NB-UVB group showed greater than 50% improvement in body surface area affected compared with 9 (36%) of 25 patients in the PUVA group. The color match of the repigmented skin was excellent in all patients in the NB-UVB group but in only 11 (44%) of those in the PUVA group (P<.001). In patients who completed 48 sessions, the improvement in body surface area affected by vitiligo was greater with NB-UVB therapy than with PUVA therapy (P = .007). Twelve months after the cessation of therapy, the superiority of NB-UVB tended to be maintained.
In the treatment of nonsegmental vitiligo, NB-UVB therapy is superior to oral PUVA therapy.
比较口服补骨脂素 - 紫外线A（PUVA）与窄谱中波紫外线（NB - UVB）光疗治疗非节段性白癜风患者的疗效。
双盲随机研究。
大学医院的光疗科。
56例非节段性白癜风患者。干预措施：每周两次接受PUVA或NB - UVB治疗。
在治疗48次后、疗程结束时以及治疗结束后12个月，评估白癜风累及的体表面积变化以及复色皮肤与未受累皮肤的颜色匹配情况。
对开始治疗的PUVA组和NB - UVB组各25例患者的结果进行分析。PUVA治疗组的中位治疗次数为47次，NB - UVB治疗组为97次（P = 0.03）；我们怀疑这种差异是由于两种治疗方式在疗效和不良反应方面存在差异，导致NB - UVB组的患者希望接受更长疗程的治疗。治疗结束时，NB - UVB组25例患者中有16例（64%）体表面积受累情况改善超过50%，而PUVA组25例患者中只有9例（36%）。NB - UVB组所有患者复色皮肤的颜色匹配情况均良好，而PUVA组只有11例（44%）（P<0.001）。在完成48次治疗的患者中，NB - UVB治疗对白癜风累及体表面积的改善大于PUVA治疗（P = 0.007）。治疗停止12个月后，NB - UVB的优势仍倾向于维持。
在治疗非节段性白癜风方面，NB - UVB治疗优于口服PUVA治疗。
