新型1927 nm铥激光联合妥塞敏治疗黄褐斑疗效观察  

The Clinical Efficacy and Safety of a Novel 1927 nm Thulium Laser Combined with Transamin in the Treatment of Melasma

作　　者：刘晶[1] 朱瑜 胡蝶[1] 胡光蕾 何淑娟 焦立鑫 苟朋昊 曾维惠[1] LIU Jing;ZHU Yu;HU Die;HU Guanglei;HE Shujuan;JIAO Lixin;GOU Penghao;ZENG Weihui(Department of Dermatology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shaanxi,China;Department of Dermatology,Hanzhong Huamei Aolai Medical Plastic Surgery Hospital,Hanzhong 723000,Shaanxi,China;Department of Dermatology,Xunyi County Hospital,Xianyang 711300,Shaanxi,China)

机构地区：[1]西安交通大学第二附属医院皮肤病院,陕西西安710004 [2]汉中华美奥莱医学整形美容医院皮肤科,陕西汉中723000 [3]旬邑县医院皮肤科,陕西咸阳711300

出　　处：《中国美容医学》2022年第3期33-36,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:评估小能量、低密度新型1927 nm铥激光联合妥塞敏治疗黄褐斑的临床疗效及安全性。方法:选取30例黄褐斑患者(Fitzpatrick皮肤Ⅲ~Ⅳ型),随机分为1927 nm+妥塞敏组和妥塞敏组。1927 nm+妥塞敏组采用新型1927 nm铥激光联合妥塞敏治疗,1927 nm铥激光治疗重复次数1或2次,治疗间隔4~8周,接受3~5次治疗;妥塞敏口服250毫克/次,早晚各一次,口服3个月;妥塞敏组口服妥塞敏,用法同1927 nm+妥塞敏组。由两位研究者评估治疗前、治疗后1个月、3个月和6个月改良的黄褐斑面积及严重程度指数(mMASI)评分、医生整体评价法(Physician global assessment,PGA)、患者自评以及不良反应。结果:与治疗前相比,两组治疗后1个月、3个月及6个月mMASI评分下降,差异有统计学意义(P=0.000);1927 nm+妥塞敏组治疗后1个月、3个月的mMASI评分下降大于妥塞敏组,差异均有统计学意义(P=0.001,P=0.005);同时,1927 nm+妥塞敏组治疗后1个月、3个月的PGA评分优于妥塞敏组,差异有统计学意义(χ^(2)=5.932,P=0.035;χ^(2)=7.897,P=0.016);1927 nm+妥塞敏组治疗后无明显红斑、水肿、色素沉着以及疼痛等不良反应。结论:新型1927 nm铥激光联合妥塞敏治疗黄褐斑安全有效,值得临床推广应用。Objective To evaluate the clinical efficacy and safety of a novel 1927 nm thulium laser combined with Transamin in the treatment of Melasma.Methods A total of 30 subjects(FitzpatrickⅢskin-Ⅳtype)were randomly divided into 1927 nm+Transamin group and Transamin group.The experimental group was treated with a novel 1927 nm thulium laser combined with Transamin.The number of 1927 thulium laser repeats was 1 or 2.Treatment interval was 3 to 5 sessions,and 4 to 8 weeks.Transamin was taken orally 250 mg/time,once in the morning and once in the evening,for 3 months.The control group was given Transamin orally,the same as the experimental group.Modified melasma area and severity index(mMASI)score,Physician Global Assessment(PGA),patient self-assessment,and adverse events were assessed by two investigators before treatment,1,3,and 6 months after treatment.Results Compared with previous treatment,the mMASI scores in both groups improved to varying degrees 1,3 and 6 months after treatment,with statistical significance(P=0.000).In the experimental group,mMASI scores descends greater than the control group to varying degrees 1 and 6 months after treatment,with statistical significance(P=0.001,P=0.001).Meawhile,the PGA scores in 1 and 3 months after treatment were better than the control group,with statistical significance(χ^(2)=5.932,P=0.035,χ^(2)=7.897,P=0.016).There were no adverse reactions of erythema,edema,chromatism and pain in the treatment group.Conclusion The new 1927 nm thulium laser combined with Transamin is safe and effective in the treatment of melasma,which is worthy of clinical application.

关 键 词：黄褐斑 1927 nm铥激光 妥塞敏 非剥脱点阵激光 联合治疗 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]