咪喹莫特乳膏联合艾拉-光动力疗法治疗尖锐湿疣的临床研究  

STUDY ON THE TREATMENT CASES OF CONDYLOMA ACUMINATA WITH IMIQUIMOD CREAM COMBINED WITH ELLA PHOTODYNAMIC THERAPY

作　　者：陈加媛[1] 贺勤[1] 宋鹏飞[1] 麦月好 孙立[2] CHEN Jia-yuan;HE Qin;SONG Peng-fei(Eighth hospital affiliated to zhongshan University,Shenzhen 518000 China)

机构地区：[1]中山大学附属第八医院皮肤科,广东深圳518000 [2]内蒙古医科大学附属医院

出　　处：《内蒙古医科大学学报》2018年第3期278-282,286,共6页Journal of Inner Mongolia Medical University

基　　金：内蒙古自治区卫生计生科研计划项目(201701061)

摘　　要：目的:探讨咪喹莫特乳膏联合艾拉-光动力治疗尖锐湿疣(CA)的临床疗效。方法:选取2014-01~2017-03期间我院103例CA病人,根据治疗方案分为观察组(n=52)与对照组(n=51)。对照组行单纯艾拉-光动力治疗,观察组行艾拉-光动力联合咪喹莫特乳膏治疗。对比两组临床疗效、治疗前后机体免疫功能[T淋巴细胞亚群(CD3^+、CD4^+、CD4^+/CD8^+)]、安全性,治疗结束后随访6mo,对比两组复发率、治疗前及治疗后6mo生活质量(SF-36评分)。结果:(1)临床疗效:观察组治疗总有效率94.23%(49/52)高于对照组80.39%(41/51)(P<0.05);(2)免疫功能:治疗前两组CD3^+、CD4^+、CD4^+/CD8^+比较无显著差异(均P>0.05),治疗后两组CD3^+、CD4^+、CD4^+/CD8^+较治疗前提高(均P<0.05),且观察组CD3^+、CD4^+、CD4^+/CD8^+高于对照组(均P<0.05);(3)安全性:艾拉-光动力治疗过程中,观察组出现2例局部轻度疼痛,对照组出现3例局部疼痛,照射治疗后对照组及观察组各出现1例轻度红肿;观察组涂抹咪喹莫特乳膏后部分病人有轻微烧灼(3例)、瘙痒(1例)、刺痛感(1例);(4)复发率:治疗后3mo观察组复发率1.92%(1/52)与对照组5.88%(3/51)比较无显著差异(P>0.05),治疗后6mo观察组复发率3.85%(2/52)低于对照组17.65%(9/51)(P<0.05);(5)生活质量:治疗前两组SF-36评分比较无显著差异(P>0.05),治疗后6mo两组SF-36评分较治疗前提高(均P<0.05),且观察组SF-36评分高于对照组(P<0.05)。结论:艾拉-光动力联合咪喹莫特乳膏治疗CA疗效显著,可有效改善病人免疫功能、降低复发率,且具有一定安全性,有利于提高病人生活质量。Objective：To investigate the clinical effect of imiquimod cream combined with Ellaphotodynamic therapy in the treatment of condyloma acuminata（CA）.Methods：A total of 103 cases ofCA patients in our hospital from 2014-01 to 2017-03 were selected and divided into the observationgroup（n = 52）and the control group（n = 51）according to the treatment plan.The control group was treated only with Ella - photodynamic therapy, and the observation group was treated with Ella -photodynamic combined with imiquimod cream.The clinical efficacy,the immune function Tlymphocytesubsets（ CD3^＋, CD4^＋, CD4^＋/ CD8^＋）,and the safety of the body before and after treatment of the two groups were compared.After 6months of follow-up,the recurrence rate,and the quality of life（ SF-36score）before and after 6months of the treatment of the two groups were compared.Results：（1）Clinicalefficacy：the total effective rate of treatment in the observation group[94.23%（49 / 52）]was higher thanthat of the control group[80.39%（41 / 51）] （P〈0.05）.（2） Immune function：there were insignificantdifferences in CD3^＋, CD4^＋and CD4^＋/ CD8^＋between the two groups before treatment（each P〉0.05）.After treatment, CD3^＋, CD4^＋and CD4^＋/ CD8^＋of two groups were improved compared with those beforetreatment（each P〈0.05）.And the CD3^＋, CD4^＋and CD4^＋/ CD8^＋in the observation group were higherthan those in the control group（each P〈0.05）.（3）Safety：during the Ella photodynamic therapy,therewere 2 cases of mild local pain in the observation group and 3 cases in the control group.After irradiation,1 case in the control group and 1 case in the observation group appeared mild redness and swelling. The patients in the observation group had mild cauterization （ 3 cases）, pruritus （ 1 cases） andprickle sensation（1 cases） after smearing Imiquimod Cream in the observation group. （4） Recurrencerate：there were insignificant differences in the recurrence rate betwee

关 键 词：尖锐湿疣 艾拉-光动力 咪喹莫特乳膏 免疫功能 生活质量 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]