Whitton Maxine E, Ashcroft Darren M, González Urbà
Cochrane Skin Group, Nottingham, United Kingdom.
J Am Acad Dermatol. 2008 Oct;59(4):713-7. doi: 10.1016/j.jaad.2008.06.023.
Current treatments for vitiligo, a common pigmentary disorder affecting around 1% of the world's population, are largely unsatisfactory.
We sought to report a Cochrane review of all interventions for the treatment of vitiligo.
We systematically searched a range of databases for randomized controlled trials. At least two reviewers independently assessed study eligibility, methodological quality, and extracted data.
Nineteen trials were included. We found moderate evidence of the benefit of topical steroids. Our search uncovered limited to moderate evidence for various types and regimens of phototherapy (ultraviolet [UV] A and UVB) used alone or in combination with oral and topical treatments. Topical khellin combined with UVA should be questioned in view of the lack of available evidence of benefit. There is limited evidence of the benefit of topical tacrolimus and topical calcipotriol used in conjunction with UV light, and for oral ginkgo biloba, and thin split-thickness grafts.
Studies generally were poorly designed and reported.
Variations in study design and different outcome measures limit the evidence for the different therapeutic options. The best evidence from individual trials showed short-term benefit from topical steroids and various forms of UV light with topical preparations. Long-term follow-up and patient-centered outcomes should be incorporated in study design and psychologic interventions need more attention.
白癜风是一种常见的色素沉着紊乱疾病，影响着全球约1%的人口，目前的治疗方法大多不尽人意。
我们旨在报告一项关于白癜风治疗所有干预措施的Cochrane综述。
我们系统地检索了一系列数据库以查找随机对照试验。至少两名评审员独立评估研究的合格性、方法学质量并提取数据。
纳入了19项试验。我们发现局部用类固醇有益的证据中等。我们的检索发现单独使用或与口服及局部治疗联合使用的各种类型和方案的光疗（紫外线[A和B]）的证据有限至中等。鉴于缺乏有益的可用证据，局部用凯林与紫外线A联合使用应受到质疑。局部用他克莫司和局部用卡泊三醇与紫外线联合使用、口服银杏叶以及薄断层皮片移植有益的证据有限。
研究设计和报告普遍较差。
研究设计的差异和不同的结局测量方法限制了不同治疗选择的证据。个别试验的最佳证据显示局部用类固醇和各种形式的紫外线与局部制剂联合使用有短期益处。研究设计应纳入长期随访和以患者为中心的结局，心理干预需要更多关注。
