果酸治疗黄褐斑的临床疗效观察  

Efficacy and safety of glycolic acid peeling in the treatment of melasma

作　　者：王娜[1] 项蕾红[2] 章伟[1] 郑志忠[2] 

机构地区：[1]上海皮肤病性病医院,上海200050 [2]复旦大学附属华山医院皮肤科,上海200040

出　　处：《临床皮肤科杂志》2011年第3期175-177,共3页Journal of Clinical Dermatology

摘　　要：目的:观察羟基乙酸(果酸)治疗黄褐斑的临床疗效和安全性,掌握果酸治疗的适应证及方法。方法:应用质量浓度分别为20%、35%、50%、70%的果酸对64例黄褐斑患者进行治疗,每2周1次,4次治疗为1个疗程。由两名资深皮肤科医生对患者进行黄褐斑皮损面积和严重程度指数(MASI)评分,采用自身前后对照进行疗效观察,记录患者出现的不良反应。结果:随着疗程的增加,患者的MASI评分逐渐下降。共有63例患者完成第1个疗程,表皮型黄褐斑有效率81.82%,混合型有效率40.00%,表皮型比混合型患者M.ASI下降更显著(P<0.05);Ⅲ型皮肤黄褐斑患者有效率39.13%,Ⅳ型有效率75.00%,Ⅳ型皮肤比Ⅲ型皮肤患者MASI下降更显著(P<0.05)。完成2个疗程的41例患者中,第1个疗程结束时有效率为41.46%,第2个疗程结束时有效率为78.05%,MASI值下降有统计学差异(P<0.05)。63例患者能耐受质量浓度为70%的果酸。刺痛、瘙痒等不良反应均在对症处理后消失。结论:果酸治疗黄褐斑,是一种安全有效且不良反应少的治疗方法;对于表皮型黄褐斑患者及Ⅳ型皮肤黄褐斑患者疗效尤佳。Objectives：To investigate the indications, procedures, therapeutic efficacy and safety of chemical peeling with glycolic acid in the treatment of melasma. Methods： Sixty-four patients with melasma were recruited in the study. The glycolic acids with four different concentrations （20%, 35%, 50%, and 70%） were applied to treat the patients twice a month. One course included four times of treatment. The severity of melasma was assessed by two dermatologists using the melasma area severity index （MASI）. At regular intervals the degree of improvement in pigmentation was reassessed with MASI scores. Side-effects, if any, were also recorded. Results： The MASI scores were decreased with the process of the treatment. Sixty-three patients completed one course. A higher response rate was found in the patients with epidermal-typed melasma than those with in mixed-type melasma （81.82% versus 40.00%, P 〈 0.05）. Again, a higher response rate was showed in the patients with skin-typed IV than those with skin-typed III （75.00% versus 39.13%, P〈 0.05）. Forty-one patients completed the two courses of treatment and obtained a final response rate of 78.05%, which was higher than that of first course treatment （41.46%） with a statistical difference（P 〈 0.05）. Sixty-three patients could tolerate the glycolic acid at the concentration of 70%. Slight irritation or burning was observed but disappeared at the end of the treatment. Conclusion： Glycolic acid peeling is proved to be an effective modality in the treatment of melasma with little adverse reactions, especially in the patients with epidermal-typed melasma or those with skin-typed IV.

关 键 词：果酸 黄褐斑 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]