曲尼司特联合硅酮凝胶超声导入治疗增生性瘢痕疗效探讨  

Therapeutic Effect of Tranilast Combined with Silicone Gel Ultrasound Import in the Treatment of Hypertrophic Scar

作　　者：历虎 张明珠 齐长春 LI Hu;ZHANG Mingzhu;QI Changchun(Department of Burn and Plastic Surgery,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,Hebei,China)

机构地区：[1]华北理工大学附属医院烧伤整形科,河北唐山063000

出　　处：《中国美容医学》2022年第10期35-38,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察曲尼司特联合硅酮凝胶超声导入治疗增生性瘢痕的疗效。方法:选取2018年11月-2020年10月治疗的烧伤及外伤所致增生性瘢痕患者136例,遵照知情同意原则并按照随机数字表法均分为两组,对照组68例采用医用硅酮凝胶超声导入治疗,观察组68例采用曲尼司特联合医用硅酮凝胶超声导入治疗,比较两组临床疗效、美学效果、胶原纤维指标、基质金属蛋白酶(Matrix metalloproteinases,MMPs)及不良反应情况。结果:观察组总有效率为95.6%,略高于对照组的86.8%,但组间比较差异无统计学意义(P>0.05)。治疗前两组温哥华瘢痕量表(Vancouver scar scale,VSS)评分比较差异无统计学意义(P>0.05);治疗后3个月两组VSS评分均显著降低,且观察组VSS评分显著低于对照组,差异有统计学意义(P<0.05)。治疗前两组Ⅰ、Ⅲ型胶原纤维含量及Ⅰ/Ⅲ型胶原纤维含量比值比较差异无统计学意义(P>0.05);治疗后3个月两组以上各项均显著改善,且观察组Ⅰ型胶原纤维含量及Ⅰ/Ⅲ型胶原纤维含量比值显著低于对照组,Ⅲ型胶原纤维含量显著高于对照组,差异有统计学意义(P<0.05)。治疗前两组MMP-2、MMP-9水平比较差异无统计学意义(P>0.05);治疗后3个月两组血清MMP-2、MMP-9水平均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.05)。两组均无严重不良反应发生。结论:曲尼司特联合医用硅酮凝胶超声导入治疗烧伤及外伤所致增生性瘢痕疗效满意,可显著改善患者瘢痕情况,具有更佳的美学效果,能够更好地改善患者的胶原纤维指标,具有良好的MMPs调节效应,并且安全可靠。Objective To observe the effect of tranilast combined with silicone gel ultrasound import in the treatment of hypertrophic scar.Methods 136 patients with trauma and burn hypertrophic scar treated from November 2018 to October 2020 were selected as subjects,and they were divided into two groups according to the principle of informed consent and the random number table method.68 patients in the control group were treated with ultrasound import of medical silicone gel,and 68 patients in the observation group were treated with tranilast combined with ultrasound import of medical silicone gel.The clinical efficacy,cosmetic effect,collagen fiber index,MMPs and adverse reaction of two groups were compared.Results The total effective rate of the observation group was 95.6%,it was slightly higher than that of the control group(86.8%),but there was no significant difference between the groups(P>0.05).There was no significant difference in VSS score between two groups before treatment(P>0.05).After 3 months of treatment,the VSS scores of two groups were significantly decreased,and the VSS score of the observation group was significantly lower than that of the control group(P<0.05).There were no significant difference in the content of typeⅠandⅢcollagen fibers and the ratio of typeⅠ/Ⅲcollagen fibers between two groups before treatment(P>0.05).After 3 months of treatment,the above items in two groups were significantly improved,and the content of typeⅠcollagen fibers and the ratio of typeⅠ/Ⅲcollagen fibers in the observation group were significantly lower than those in the control group,and the content of typeⅢcollagen fibers was significantly higher than that in the control group(P<0.05).There was no significant difference in serum MMP-2 and MMP-9 levels between two groups before treatment(P>0.05).After 3 months of treatment,the serum MMP-2 and MMP-9 levels in two groups were significantly decreased,and those in the observation group were significantly lower than those the control group(P<0.05).No serious adv

关 键 词：增生性瘢痕 外伤 烧伤 曲尼司特 医用硅酮凝胶 超声导入 胶原纤维 基质金属蛋白酶 

分 类 号：R619.6[医药卫生—外科学]