摘要
目的研究强脉冲光(IPL)与Q开关1064 nm激光在治疗热带地区老年黄褐斑中的安全性及两者联合应用的临床价值。方法前瞻性选择2020年1月至2022年1月间琼海市人民医院收治的133例老年黄褐斑患者作为研究对象,按照随机数字表法将其分为IPL组(单纯IPL治疗,n=44)、Q组(单纯Q开关1064 nm激光治疗,n=44)及联合组(IPL联合Q开关1064 nm激光治疗,n=45)。比较3组的治疗效果;于治疗前(T_(0)),治疗1(T_(1))、3(T_(3))、5(T_(5))、7(T_(7))及10次(T_(10))后,选择黄褐斑最严重的部位测量黑素指数(MCI);于T_(0)、T_(1)、T_(3)、T_(5)、T_(7)、T_(10)时,评估3组患者黄褐斑皮损面积及严重程度评分(MASI);统计治疗不良反应率和医师及患者对治疗的满意度。结果IPL组及Q组治疗总有效率比较,差异无统计学意义(P>0.05),联合组治疗总有效率为93.33%,均高于IPL组及Q组(77.27%、75.00%),差异均有统计学意义(P<0.05)。联合组T_(1)、T_(3)、T_(7)时皮损部位MCI值均低于IPL组及Q组,差异均有统计学意义(P<0.05)。IPL组及Q组T_(1)、T_(3)、T_(5)、T_(7)、T_(10)时MASI值比较,差异均无统计学意义(P>0.05);联合组T_(1)、T_(3)、T_(5)、T_(7)、T_(10)时MASI值均低于IPL组及Q组,差异均有统计学意义(P<0.05)。Q组中有7例患者表示治疗过程中有明显刺痛感,术后有9例面颊红肿,有3例患者出现色素沉着。IPL组及联合组中分别有8例及11例患者术后面颊红肿。IPL组及Q组医师对治疗的满意度及患者自身治疗满意度比较,差异均无统计学意义(P>0.05),联合组医师对治疗的满意度及患者自身治疗总满意度分别为95.56%、93.33%,均高于IPL组(79.55%、72.73%)及Q组(81.82%、77.27%),差异均有统计学意义(P<0.05)。结论IPL及Q开关1064 nm激光在治疗热带老年黄褐斑中各具优势及不足,两者单独应用在治疗黄褐斑中的疗效相似,而两者联合应用可优势互补,有效提高黄褐斑治疗效果。
Objective To study the safety of intense pulsed light(IPL)and Q-switched 1064 nm laser in the treatment of elderly melasma in tropical regions and the clinical value of combined application of the two.Methods A prospective study was conducted on 133 elderly patients with melasma admitted to Qionghai People's Hospital from January 2020 to January 2022.They were divided into IPL group(IPL alone,n=44),Q group(Q-switched 1064 nm laser alone,n=44)and combined group(IPL combined with Q-switched 1064 nm laser,n=45)according to the random number table method.The treatment effects of three groups were compared;the measurement of melanin index(MCI)at the most severe site of melasma in the three groups before treatment(T_(0)),after 1(T_(1)),3(T_(3)),5(T_(5)),7(T_(7)),and 10(T_(10))treatment were compared;the area and severity score(MASI)of melasma lesions in three groups of patients at T_(0),T_(1),T_(3),T_(5),T_(7),and T_(10)was compared;the rate of adverse reactions to treatment and the satisfaction of doctors and patients with treatment were counted.Results There was no statistically significant difference in the total effective rate between the IPL group and the Q group(P>0.05).The combined group had a total effective rate of 93.33%,which was higher than the IPL group and Q group(77.27%,75.00%),and the differences were statistically significant(P<0.05).The MCI values of T_(1),T_(3),T_(5),T_(7),and T_(10)lesions in the combined group were lower than those in the IPL group and Q group,the differences were statistically significant(P<0.05).There was no statistically significant difference in MASI values between IPL group and Q group at T_(1),T_(3),T_(5),T_(7),and T_(10)(P>0.05).The MASI values of the combination group at T_(1),T_(3),T_(5),T_(7),and T_(10)were lower than those of the IPL group and Q group,the differences were statistically significant(P<0.05).Seven patients in the Q group reported significant tingling during the treatment process,9 patients had swollen cheeks after surgery,and 3 patients had discoloration.There were 8 and 11 patients with postoperative cheek redness and swelling in the IPL group and the combination group,respectively.There was no statistically significant difference in the satisfaction of doctors with treatment and patients with self treatment between the IPL group and the Q group(P>0.05).The satisfaction of doctors with treatment and patients with self treatment in the combined group was 95.56%and 93.33%,respectively,which were higher than those in the IPL group(79.55%,72.73%)and Q group(81.82%,77.27%),the differences were statistically significant(P<0.05).Conclusion IPL and Q-switched 1064 nm laser have their own advantages and disadvantages in the treatment of elderly melasma in tropical regions.The efficacy of the two alone in the treatment of melasma is similar,but the combined application of the two can complement each other and effectively improve the therapeutic effect of melasma.
作者
冯菊蕊
李彩霞
辜东成
FENG Ju-rui;LI Cai-xia;GU Dong-cheng(Department of Dermatology,Qionghai People's Hospital,Qionghai Hainan 571400,China)
出处
《临床和实验医学杂志》
2023年第18期2002-2006,共5页
Journal of Clinical and Experimental Medicine
基金
海南省卫生健康行业科研项目(编号:21A200296)。
