摘要
目的对比研究两种不同方法预处理皮损在光动力治疗中重度痤疮的疗效。方法将在我院就诊的中重度痤疮患者90例随机分为Ⅰ组(直接敷药组)、Ⅱ组(粉刺针清组)、Ⅲ组(点阵激光组),每组各30例。Ⅰ组不处理皮损,直接外敷5%盐酸氨基酮戊酸凝胶(ALA)后行光动力治疗;Ⅱ组洁面消毒后,用粉刺针处理囊肿、结节性皮损后外敷ALA凝胶后行光动力治疗;Ⅲ组洁面消毒后,采用点阵激光处理囊肿、结节性皮损后外敷ALA凝胶后行光动力治疗;每周1次,共3次。三组均口服克拉霉素胶囊和外用夫西地酸乳膏,共4周。三组均在治疗后第2、3、4周进行疗效判定,比较三组的疗效和不良反应,治疗结束后3月随访观察各组的复发率。结果治疗后2周,Ⅰ组、Ⅱ组、Ⅲ组总有效率分别为6.6%、13.3%、10%;治疗后3周,Ⅰ组、Ⅱ组、Ⅲ组总有效率分别为20%、40%、36.7%。2、3周三组比较差异无统计学意义(P>0.05)。治疗后4周Ⅰ组、Ⅱ组、Ⅲ组总有效率分别为43.3%、73.3%、76.7%,Ⅱ组、Ⅲ组与Ⅰ组比较差异有统计学意义(P=0.012,P<0.05)。Ⅱ组和Ⅲ组之间比较差异无统计学意义(P>0.05),疗效相当。三组均无严重的全身及局部不良反应。治疗结束3月后,Ⅰ组有3例复发,Ⅱ组、Ⅲ组未见复发,且还随时间延长后,部分皮损消退。结论使用粉刺针或点阵激光预处理结节、囊肿性皮损可以明显提高光动力疗法治疗中重度痤疮的疗效,但结节性皮损可能使用点阵激光更佳,值得临床的推广应用。
Objective To compare the effects of two different pretreatments for skin lesion in moderate to severe acne in photodynamic therapy.Methods 90 patients with moderate to severe acne treated in our hospital were randomly divided into groupⅠ(direct application group),groupⅡ(acne needle acupuncture group),and groupⅢ(lattice laser group),with 30 cases in each group.GroupⅠ:Directly applied 5%Aminolevulinic acid gel(ALA)on skin lesion externally before photodynamic therapy;GroupⅡ:After facial cleaning and disinfection,acne needle was used to treat the cyst and nodular skin lesions,and then the ALA gel was applied externally before photodynamic therapy;GroupⅢ:After facial cleansing and disinfection,lattice laser was performed to treat the cystic and nodular skin lesions,and then the ALA gel was applied externally before photodynamic therapy,once a week and total 3 times.All the three groups were given oral clarithromycin capsules and topical fusidic acid cream for 4 weeks.The efficacy in the three groups was evaluated at the 2 nd,3 rd,and 4 th week after treatment.The efficacy and adverse reactions in the three groups were compared.The recurrence rate of each group was observed at 3 months after the end of treatment.Results At 2 weeks after treatment,the total effective rates of groupⅠ,groupⅡ,and groupⅢwere 6.6%,13.3%,and 10%,respectively.At 3 weeks after treatment,the total effective rates of groupⅠ,groupⅡ,and groupⅢwere 20%,40%and 36.7%,respectively,without statistical difference among the three groups at 2 and 3 weeks.However,at 4 weeks after treatment,the total effective rates of groupⅠ,groupⅡ,and groupⅢwere 43.3%,73.3%,and 76.7%,respectively,with statistical difference between groupⅡ,groupⅢand groupⅠ(P=0.012,P<0.05).There was no statistical difference between groupⅡand groupⅢ,and the effect was approximate.There were no serious systemic or local adverse reactions in all three groups.After 3 months of treatment,there were 3 cases of recurrence in groupⅠ,no recurrence in group�
作者
赵菊花
庄化迪
李娜
杨羽
李达
王洁
Zhao Juhua;Zhuang Huadi;Li Na(Nanchong Central Hospital·The Second Affiliated Medical College of North Sichuan Medical College,Nanchong,Sichuan 631000,China.)
出处
《四川医学》
CAS
2019年第12期1200-1204,共5页
Sichuan Medical Journal
基金
四川省卫生和计划生育委员会科研课题(编号:18PJ421)
关键词
中重度痤疮
光动力疗法
粉刺针挤压
超脉冲CO2点阵激光
疗效
moderate to severe acne
photodynamic therapy
acne needle extrusion
ultra-pulsed CO2 lattice laser
efficacy