瘢痕内注射曲安奈德和A型肉毒毒素治疗增生性瘢痕-一项随机对照试验  

Treating Hypertrophic Scars by Injecting Triamcinolone Acetonide and Botulinum Toxin A (BTX-A) into Focus,A Random Contrast Experiment

作　　者：张亦轩 卫家玉 俞舜 王丹 杨敏烈 吕国忠 ZHANG Yixuan;WEI Jiayu;YU Shun;WANG Dan;YANG Minlie;LV Guozhong(Graduate School,Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China;Wuxi Medical College,Jiangnan University,Wuxi 214122,Jiangsu,China;Department of Burns and Orthopedic Surgery,Affi liated Hospital of Jiangnan University,Wuxi 214041,Jiangsu,China)

机构地区：[1]南京中医药大学研究生院,江苏南京210023 [2]江南大学无锡医学院,江苏无锡214122 [3]江南大学附属医院烧伤整形科,江苏无锡214041

出　　处：《中国美容医学》2022年第2期77-81,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:比较瘢痕内注射A型肉毒毒素和曲安奈德的疗效及副作用。方法:选取2020年6月-2021年1月笔者医院整形美容科就诊的40例增生性瘢痕患者为研究对象,依据随机数字表法将患者分为两组,每组20例。对照组局部注射曲安奈德治疗,观察组局部注射A型肉毒毒素治疗,比较两组患者治疗后满意度和不良反应发生率,采用改良温哥华瘢痕量表(VSS)评估治疗前后增生性瘢痕的变化,采用视觉模拟评分表(VAS)评估治疗前后瘢痕处痛痒觉变化,采用CBS瘢痕检测仪评估治疗前后瘢痕处皮肤特性(瘢痕面积、色素含量、水分含量及油分含量)变化。结果:观察组患者总满意度为80.00%,显著高于对照组的45.00%,组间差异有统计学意义(P<0.05);对照组不良反应发生率为20.00%,显著高于观察组的0.00%,组间差异有统计学意义(χ^(2)=4.444,P<0.05)。治疗后,两组VSS分值及VAS均较治疗前降低,差异均有统计学意义(P<0.05)。治疗后两组VSS、VAS改善程度比较,差异无统计学意义(P>0.05)。结论:曲安奈德和A型肉毒毒素注射液治疗增生性瘢痕,其临床疗效未见明显差异,但肉毒毒素治疗不良反应发生率低,副作用少,患者满意度高,安全性更高,可临床推广应用。Objective To compare the efficacy and side effects of injecting BTX-A and triamcinolone acetonide into focus.Methods Patients with scar tissue who visited the outpatient department of plastic surgery in our hospital from June 2020 to January 2021 were selected.Forty patients were enrolled and randomly divided into two groups according to the random number table method.The 20 cases in the contrast group were treated with local injection of triamcinolone acetonide while the 20 cases in the observation group were treated with local injection of BTX-A.The satisfaction degrees and adverse reaction incidence rates of patients in the two groups after treatment were treated.The modified Vancouver Scar Scale (VSS) was used to evaluate the changes of hypertrophic scars before and after treatment.Visual Analogue Scale (VAS) was used to evaluate the changes of pain and itching sensations in the focus before and after treatment.CBS Scar Detector introduced from Taiwan was used to evaluate the changes of skin characteristics (scar area,pigment content,moisture content and oil content) before and after treatment.Results The total satisfaction degree of patients in the observation group is 80.00%,which is significantly higher than 45.00% of the contract group.The inter-group difference is of statistical significance (P<0.05).The adverse reaction incidence rate of the contrast group is 20.00%,which is significantly higher than 0.00% of the observation group.The inter-group difference is of statistical significance (χ^(2)=4.444,P<0.05).After the treatment,VSS scores and VAS scores of both hormone group and BTX group are both lowered those before the treatment,showing the difference of statistical significance (P<0.05).After the treatment,the VSS and VAS improvement degrees between both groups are insignificant,showing no statistical significance(P>0.05).It indicates that scars of both groups are improved after treatment,but with insignificant efficacy differences between two groups.CBS Scar Detector shows that the scar areas of p

关 键 词：增生性瘢痕 瘢痕治疗 曲安奈德 A型肉毒毒素 瘢痕量表 

分 类 号：R619.6[医药卫生—外科学]