重组人酸性成纤维细胞生长因子联合Q开关Nd:YAG激光治疗黄褐斑的多中心临床研究  

Muti-center clinical research on recombinant human acidic fibroblast growth factor with Q-switch Nd:YAG laser in treatment with chloasma

作　　者：李兵[1] 齐力攀 张轶[3] 

机构地区：[1]河北省人民医院整形烧伤科,河北石家庄050051 [2]石家庄市第一医院整形烧伤科 [3]白求恩国际和平医院整形烧伤科

出　　处：《中国美容医学》2014年第1期34-37,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的：评价重组人酸性成纤维细胞生长因子联合Q-开关Nd：YAG激光治疗黄褐斑的临床疗效及安全性。方法：入选3个研究中心，656例黄褐斑患者，随机分为2组，两组均应用Medlnec6Q一开关激光，以1064rim波长，6～8mm光斑照射面部，每周1次，10次为一个总疗程。治疗组术中同时给予重组人酸性成纤维细胞生长因子，溶于20ml生理盐水冲洗激光术后创面后持续多次喷雾治疗（3～4喷／cm。，6～8次／天），连续应用7～14天。对照组仅给予生理盐水冲洗及喷雾。采用MPA9（MultiProbeAdap—ter）型皮肤图像分析仪和SOFT5．5皮肤性质测试仪检测皮肤瘢痕状况、色素沉着，并评价创面愈合时间及创面红斑状况。结果：治疗组显效率（48％vs36％）及总有效率（88％vs74％）均高于对照组，并具有统计学差异（P〈O．05），采用rh—aFGF治疗后皮肤TEWL值（18．4±8．7vs25．8±11．4），黑色素指数（94．8±30．6VS104．2±27．9，P=0．014）相比于对照组下降更为明显。另外治疗组激光治疗后创面并发症明显少于对照组（10．3％vs38．7％）。远期随访显示，治疗组色素沉着面积2．4±1．6vs4．1±2．1，色素沉着评分1．2±0．3vsl．8±1．1明显低于对照纽，并具有统计学差异。结论：rh—aFGF术中应用联合术后序贯应用，可显著提高黄褐斑治疗疗效，减少激光术后并发症，远期可减少术后色素沉着的发生。Objective To evaluate the efficacy and safety of recombinant human acidic fibroblast growth factor with Q-switch Nd：YAG Laser in Treatment with Chloasma. Methods A multiple center, randomized controlled clinical study was conducted to compare the efficacy of the treatment group （n=330,treated with rh-aFGF washing during operation and atomizing after operation） and the control group （n=326,treated with 0.9%NS）. Both groups were treated by Medlite C6 Q-switch Nd：YAG laser with 1064nm wavelength,6-8mm spot, l.0-2.8J/cm2 energy.And the clinic efficacy and adverse effect were observed and recorded every days. Results The Significant efficiency between the treatment group and control group in the total effect rate （88%vs74%）, the efficiency rate （48%vs36%）,the TEWL （18.4±8.7vs25.8±11.4）,the melanin value （94. 8±30.6 vs 104. 2±27.9）.Besides,the wound complication of treatment group were lower than the control group.The scar area （2.4±l.6vs4.1±2.1,P〈0.05） and the pigmentation area （1.2 ±0.3vsl.8 ±1.1,P〈0.05） with a statistics difference after follow-up. Conclusion Our data indicate that the use of rh-aFGF with laser is an effective,low postoperative complications treatment for melasma patients.

关 键 词：重组人酸性成纤维细胞生长因子 黄褐斑 激光 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]