低能量Q开关1064nm激光联合妥塞敏口服治疗黄褐斑疗效观察  

Clinical Effect of Low-energy Q-switch 1064nm Laser Combined with Oral Toxamine on Melasma

作　　者：范向华[1] 施伟伟[1] 黄红娟[1] 施健[1] 花志祥[1] FAN Xiang-hua;SHI Wei-wei;HUANG Hong-juan;SHI Jian;HUA Zhi-xiang(Department of Dermatology and Venereology,Nantong First People's Hospital,Nantong 226001,Jiangsu,China)

机构地区：[1]南通市第一人民医院皮肤性病科,江苏南通226001

出　　处：《中国美容医学》2021年第2期29-32,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:研究低能量Q开关1064nm激光联合妥塞敏治疗黄褐斑的疗效。方法:采用随机数字表法将笔者医院2016年1月-2019年1月收治的90例黄褐斑患者分为A组(低能量Q开关1064nm激光+妥塞敏,n=30)、B组(低能量Q开关1064nm激光,n=30)与C组(单独服用妥塞敏,n=30),三组均连续治疗10周,比较治疗后黄褐斑严重程度指数、皮损面积及皮损变化。结果:治疗前,三组mMASI评分比较无显著性差异(P>0.05),治疗后,三组mMASI得分均较同组治疗前显著下降(P<0.05),且A组治疗后mMASI下降值显著大于B组、C组(P<0.05),治疗后,B、C两组mMASI下降值无显著性差异(P>0.05);三组治疗有效率比较无显著性差异(P>0.05);三组患者治疗各时期皮损部位黑素指数值均显著高于其正常皮肤(P<0.05),治疗后,三组黑素指数均较同组治疗前显著下降(P<0.05),治疗前,三组患者皮损黑素指数无显著性差异(P>0.05),但A组治疗5周、10周后,黑素指数均显著低于B组及C组同时间段水平(P<0.05),B、C组治疗后各时间段内皮损黑素指数无显著性差异(P>0.05);三组治疗不良反应发生率比较无显著性差异(P>0.05);随访1年,三组复发率比较无显著性差异(χ2=2.917,P>0.05)。结论:单独应用妥塞敏与低能量Q开关1064nm激光治疗黄褐斑疗效相似,但两者联合能有效增强治疗效果,且药物安全性高。Objective To investigate the effect of low-energy Q-switch 1064nm laser combined with toxamine on melasma.Methods 90 patients with melasma in our hospital from January 2016 to January 2019 were enrolled,and equally divided into three groups,each with 30 cases.Group A received low-energy Q-switch 1064nm laser irradiation combined with transamin,group B received low-energy Q-switch 1064nm laser irradiation,and group C received transamin only.After 10 weeks of continuous treatment,the melasma severity index,melasma area and lesion size of the three groups were compared.Results There was a decrease in modified melasma area and severity index(mMASI)score in all three groups after treatment(P<0.05),and the decrease was more significant in group A than in other two groups(P<0.05),while the decrease showed no significant difference between group B and C(P>0.05).The clinical efficacy had no significant difference among three groups(P>0.05).The melanin index of lesion area was higher than that of normal area during treatment in all three groups(P<0.05),which was decreased in all groups after treatment(P<0.05).The melanin index had no significant difference among groups before treatment(P>0.05).The melanin index in group A at post-treatment 5w and 10w was lower than that of group B and C(P<0.05),while the melanin index showed no significant difference after treatment(P>0.05).The adverse reaction rate had no difference among three groups(P>0.05).The recurrence rate during the post-treatment 1-year follow-up had no significant difference among three groups(χ2=2.917,P>0.05).Conclusion Low-energy Q-switch 1064nm laser irradiation and transamin show similar treatment efficacy in the treatment of melasma,while the combination of the two can effectively and safely improve the treatment effect.

关 键 词：低能量Q开关1064nm激光 妥塞敏 黄褐斑严重程度指数 疗效 黑素指数 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]