A型肉毒毒素皮内注射治疗红斑毛细血管扩张型玫瑰痤疮的效果  

Clinical effects of botulinum toxin A intradermal injection in treatment of erythematotelangiectatic rosacea

作　　者：田阳子[1] 张荣利[1] 张倩[1] 景焕 高琳[1] 李凯[1] Tian Yangzi;Zhang Rongli;Zhang Qian;Jing Huan;Gao Lin;Li Kai(Department of Dermatology,Xijing Hospital,Fourth Military Medical University,Xi′an 710032,China)

机构地区：[1]第四军医大学西京皮肤医院皮肤科,西安710032

出　　处：《中华医学美学美容杂志》2022年第4期296-299,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的评估A型肉毒毒素(BTX-A)皮内注射治疗红斑毛细血管扩张型玫瑰痤疮的有效性及安全性。方法2019年1月至2020年12月,第四军医大学西京皮肤医院接受治疗红斑毛细血管扩张型玫瑰痤疮患者30例,男4例,女26例,年龄23~42(31±6)岁。将患者分为两组,均给予BTX-A皮内微滴注射,其中BTX-A低浓度组患者每个点注射约0.25 U,BTX-A高浓度组每个点注射约0.5 U。于治疗前及治疗后2、4、8、12周进行医师红斑评估量表(CEA)评分,于治疗前和治疗后12周进行玫瑰痤疮标准分级系统评分。结果两组治疗均可显著降低CEA评分,但BTX-A高浓度组患者CEA评分下降更显著(P<0.05),起效时间更短,且疗效持续时间更长。治疗后,两组患者阵发性潮红、持久性红斑、烧灼感、刺痛感评分以及玫瑰痤疮标准分级系统总积分均显著低于治疗前(高浓度组t=5.00、5.93、4.10、2.74、12.37;低浓度组t=6.17、4.12、2.87、2.81、7.88;均P<0.05),高浓度组较低浓度组改善更显著(t=2.02、2.31、2.15、2.56,P<0.05)。两种治疗方式总有效率差异无统计学意义(P>0.05)。结论BTX-A皮内注射治疗玫瑰痤疮安全有效,高浓度组疗效更好、起效更快、维持时间更长,值得临床应用。Objective To evaluate the efficacy and safety of intradermal injection of botulinum toxin A(BTX-A)in the treatment of erythematotelangiectatic rosacea.Methods From January 2019 to December 2020,30 patients with erythematotelangiectatic rosacea were treated in the Department of Dermatology at Xijing Hospital,Fourth Military Medical University.There were 26 females and 4 males,the age range from 23 to 42 years,with the average(30.9±5.7)years.Patients were randomly divided into two groups and given intradermal injection of botulinum toxin A.In detail,0.25 U and 0.5 U was injected at each point in the low and high concentration group of BTX-A.The clinician erythema assessment(CEA)scores were recorded before treatment and at 2,4,8 and 12 weeks after treatment.The standard grading system scores for rosacea were recorded before treatment and at 12 weeks after treatment.Results Both treatments could significantly reduce CEA scores,but the declined degree was more significant(P<0.05),the onset time was shorter and the duration of efficacy was longer in the high concentration group.The scores of flushing,persistent erythema,burning sensation,stinging sensation and the total score of the standard grading system for rosacea after treatment in both two groups were significantly lower than those before treatment(high concentration group:t=5.00,5.93,4.10,2.74,12.37;low concentration group:t=6.17,4.12,2.87,2.81,7.88;P<0.05),and the improvement in high concentration group was significantly more than that in low concentration group(t=2.02,2.31,2.15,2.56,P<0.05).There was no significant difference in the overall effective rate between the two treatments(P>0.05).Conclusions Intradermal injection of BTX-A is safe and effective in the treatment of rosacea.Compared with the low concentration group,the efficacy is better,the onset time is shorter and the duration of efficacy is longer in the high concentration group.

关 键 词：玫瑰痤疮 肉毒杆菌毒素类 A型 疗效比较研究 皮内注射 浓度 

分 类 号：R758.734[医药卫生—皮肤病学与性病学]