摘要
目的观察低能量调Q激光与氨甲环酸真皮内注射治疗痤疮后色素沉着的临床效果。方法选取2021年10月至2022年4月,痤疮后色素沉着患者133例,采用抽签法随机分为激光组(n=66)和氨甲环酸真皮内注射组(n=67)。激光组治疗光参数为脉宽4 ns,能量密度1.2~1.5 J/cm^(2),共治疗3次,每次治疗间隔时间1个月;氨甲环酸组使用真皮内注射氨甲环酸注射液,100mg/ml,5ml,1次/4周,共治疗3次。分析两组治疗前后色素沉着情况(post-acne hyperpigmentation index,PAHPI)、黑色素指数(melanin index,MI)、红斑指数(erythema index,EI)、不良反应情况等差异,并由患者采用整体评估量表(patient’s global assessment scale,PGAS)对自身痤疮和炎症后色素沉着情况进行评价。结果末次治疗后1个月,激光组和氨甲环酸组PAHPI分别为(8.42±1.7)分和(8.80±2.1)分,与治疗前比较,两组患者PAHPI情况均明显改善,差异具有显著意义(P<0.001)。激光组和氨甲环酸组活跃痤疮病变指数分别为6.61±1.5,6.48±1.6,与治疗前比较,两组患者活跃痤疮病变指数明显降低,差异具有显著意义(P<0.001)。两组EI分别为299.9±27.5,301.6±21.5;MI指数分别为241.0±29.0,251.3±29.6,与治疗前比较,两组患者黑色素指数和红斑指数明显降低,差异具有显著意义(P<0.001);治疗后,两组间MI比较,差异具有统计学意义(P<0.05)。治疗后激光组PGAS评分情况:0分10例、1分26例;氨甲环酸组PGAS评分情况:0分8例、1分25例,与治疗前比较,差异具有显著意义(P<0.001)。不良反应发生情况,95%患者治疗时有轻微疼痛感,皮肤出现红斑,不良反应在2周内消退。结论低能量点阵激光与氨甲环酸真皮内注射治疗均能改善痤疮后色素沉着,不良反应低。
Objective To investigate the clinical effect of low-power Q-switched laser and tranexamic acid intradermal injection in treating postinflammatory hyperpigmentation population.Methods One hundred and thirty-three participants with post-inflammatory hyperpigmentation(PIH)treated during the period from Oct.2021 to Apr.2022 were selected for the study,and randomly divided into a Q-switched group(n=66)and a tranexamic acid group(n=67)with the lottery method.The light treatment for the Q-switched group was given three times at an interval of 1 month and the light parameters were set as below:pulse width 4ns and energy density 1.2-1.5 J/cm^(2).For the tranexamic acid group,the patients were given intradermal injection of tranexamic acid of 5 ml(100 mg/ml)once four weeks,3 times in total.The differences in postinflammatory hyperpigmentation index(PAHPI),melanin index(MI),erythema index(EI)and adverse reactions before and after the treatment were analyzed for both groups,and the self-acne and post-inflammatory hyperpigmentation were evaluated by the patients with the Patient's Global Assessment Scale(PGAS).Results One month after the final treatment,the PAHPI of the fractional group and tranexamic acid group were 8.42±1.7 and 8.80±2.1 respectively,much higher than those before the treatment,and the difference was statistically significant(P<0.001).The active acne lesion index of the fractional group and tranexamic acid group were 6.61±1.5 and 6.48±1.6 respectively,much lower than those before the treatment,and the difference was statistically significant(P<0.001).The erythema index of the two groups were 299.9±27.5 and 301.6±21.5 respectively,and the melanin index of 241.0±29.0 and 251.3±29.6 respectively,all being much lower than those before the treatment,and the difference was statistically significant(P<0.001).The change of melanin index after the intervention was significant in both groups(P<0.05).There were 1 person with a PGAS score of 0 and 26 people with a score of 1 in the Q-switched group,and 8 people with a PGAS score of 0 and 25 people with a score of 1 in the tranexamic acid group.Compared with the pre-treatment period,the differences were statistically significant(P<0.001).More than 95%of the patients had mild pain and skin erythema during the treatment,and the adverse effects resolved within 2 weeks.Conclusions Both low-power Q-switched laser and tranexamic acid injection are rather effective in treating PIH while bringing in few adverse reactions.
作者
宋婷
刘艳
杨枫
程娴
宋璞
SONG Ting;LIU Yan;YANG Feng;CHENG Xian;SONG Pu(Department of Dermatology,Xijing Skin Hospital,the Fourth Military Medical University,Xi'an 710000,China)
出处
《中国激光医学杂志》
CAS
2023年第2期81-86,共6页
Chinese Journal of Laser Medicine & Surgery
