重復(fù)低能量強脈沖光治療痤瘡的臨床觀察

袁紹輝+張小敏+陳劍釗+孫志平+王柳均+鐘桂連+林歡兒+曾文軍

【摘要】 目的 評價重復(fù)低能量強脈沖光治療痤瘡的療效及安全性。方法 80例痤瘡患者， 隨機分為試驗組和對照組， 每組40例。試驗組采用重復(fù)低能量強脈沖光連續(xù)治療2次， 對照組采用正常能量強脈沖光治療1次。治療后評價兩組患者的臨床療效及不良反應(yīng)。結(jié)果 兩組患者治療后的皮疹均明顯改善。試驗組痊愈率為57.5%， 總有效率為85.0%；對照組痊愈率為32.5%， 總有效率為75.0%。試驗組痊愈率高于對照組， 差異有統(tǒng)計學(xué)意義（P<0.05）， 試驗組總有效率略高于對照組， 但差異無統(tǒng)計學(xué)意義（P>0.05）。試驗組疼痛評分低于對照組， 差異有統(tǒng)計學(xué)意義（P<0.05）。兩組紅斑、水皰、繼發(fā)性色素沉著等不良反應(yīng)發(fā)生率比較差異無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論 重復(fù)低能量強脈沖光治療痤瘡療效優(yōu)于單次高能量強脈沖光， 且不增加不良反應(yīng)。

【關(guān)鍵詞】 痤瘡；低能量；強脈沖光；臨床觀察

DOI：10.14163/j.cnki.11-5547/r.2018.01.012

【Abstract】 Objective To evaluate the efficacy and safety of repeated low-energy intense pulsed light in the treatment of acne. Methods A total of 80 acne patients were randomly divided into experimental group and control group， with 40 cases in each group. The experimental group received repeated low-energy intense pulsed light for 2 consecutive times， and the control group received normal energy intense pulsed light for 1 time. Evaluation were made on clinical efficacy and adverse reactions after treatment between two groups. Results The rash in the two groups was significantly improved after treatment. The experimental group had cure rate as 57.5% and total effective rate as 85.0%， while the control group had cure rate as 32.5% and total effective rate as 75.0%. The experimental group had higher cure rate than the control group， and the difference was statistically significant （P<0.05）. The experimental group had little higher total effective rate than the control group， but the difference was not statistically significant （P>0.05）. The experimental group had lower pain score than the control group， and the difference was statistically significant （P<0.05）. Both groups had no statistically significant difference in incidence of adverse reactions of erythema， blisters， secondary pigmentation （P>0.05）. Conclusion Repeated low-energy intense pulsed light provides better efficacy than single high-energy intense pulsed light without increasing adverse reactions.

【Key words】 Acne； Low-energy； Intense pulsed light； Clinical observation

強脈沖光（intense pulsed light， IPL）是近年發(fā)展起來治療痤瘡的新手段， 相較傳統(tǒng)的治療方法， 患者不需要系統(tǒng)用藥， 具有簡便、不良反應(yīng)少等優(yōu)勢。本科2016年初采用強脈沖光治療痤瘡， 取得滿意的療效， 尤其采用重復(fù)低能量強脈沖光治療痤瘡療效更好， 且不增加不良反應(yīng)， 現(xiàn)報告如下。

1 資料與方法

1. 1 一般資料 選取2016年1月～2017年5月本院門診就診80例尋常痤瘡患者， 其中男35例， 女45例， 年齡18～35歲， 病程3個月～5年。痤瘡診斷參考趙辨主編的《中國臨床皮膚病學(xué)》[1]， 其中Ⅰ級25例， Ⅱ級45例， Ⅲ級10例。患者治療前1個月均未口服抗生素或其他系統(tǒng)抗痤瘡藥物， 未口服光敏感藥物及其他可能對治療產(chǎn)生影響的藥物。排除妊娠或哺乳期婦女、職業(yè)性痤瘡、藥物或化學(xué)物品引起的痤瘡、合并紅斑狼瘡等自身免疫性疾病者、癲癇、瘢痕體質(zhì)、濕疹等變態(tài)反應(yīng)性疾病者、自身對光過敏者、糖尿病及有嚴重系統(tǒng)損害的患者、嚴重免疫功能低下、有精神病史及其他皮膚病史者。所有患者均簽署知情同意書。隨機將患者分為試驗組和對照組， 各40例。endprint