氨甲环酸不同给药途径联合Q开关Nd:YAG激光治疗黄褐斑  

Treatment of Melasma by Different Administration Routes of Tranexamic Acid Combined with Q-switched Nd:YAG Laser

作　　者：吴磊[1] 蔡美红[1] 陈小建[1] WU Lei;CAI Meihong;CHEN Xiaojian(Department of Dermatology and Venereology,Suzhou Hospital Affi liated to Nanjing Medical University,Suzhou 215006,Jiangsu,China)

机构地区：[1]南京医科大学附属苏州医院皮肤性病科,江苏苏州215006

出　　处：《中国美容医学》2022年第12期81-84,共4页Chinese Journal of Aesthetic Medicine

基　　金：苏州市民生科技基金(编号:SYSD2019124)。

摘　　要：目的:探究氨甲环酸不同给药途径联合大光斑低能量Q开关Nd:YAG激光治疗黄褐斑的治疗效果。方法:随机选取笔者科室2019年9月-2020年9月收治的81例黄褐斑患者为研究对象,按照随机数字表法分为两组。对照组(n=40)给予口服氨甲环酸片联合大光斑低能量Q开关Nd:YAG激光治疗;观察组(n=41)给予氨甲环酸巴布剂贴敷联合大光斑低能量Q开关Nd:YAG激光治疗,比较两组临床疗效、临床症状[黄褐斑皮损面积和严重指数评分表(Melasma area severity index,MASI)],生活质量[皮肤病生活质量指数(Dermatology life quality index,DLQI)、黄褐斑生活质量评分量表(Melasma quality of life scale,MELASQOL)]及不良反应。结果:观察组总有效率为87.80%,对照组为65.85%,两组比较差异有统计学意义(P<0.05);治疗4个月后,两组MASI、DLQI、MELASQOL评分均显著降低(P<0.05),且治疗后组间比较差异有统计学意义(P<0.05);观察组不良反应总发生率为7.32%,对照组为17.50%,两组比较差异无统计学意义(P>0.05);治疗后随访6个月,观察组复发率为2.44%,对照组为7.50%,两组比较差异无统计学意义(χ^(2)=0.475,P>0.05)。结论:氨甲环酸巴布剂贴敷联合大光斑低能量Q开关Nd:YAG激光治疗黄褐斑疗效更佳,治疗后患者面部皮损改善效果更为显著,不良反应发生率及复发率均较低,值得临床推广应用。Objective To explore the cosmetic effect of different administration routes of tranexamic acid combined with largespot and low-energy Q switched Nd:YAG laser in the treatment of chloasma.Methods A total of 81 patients with melasma admitted to the author’s department from September 2019 to September 2020 were randomly selected as research objects and divided into two groups according to random number table method.The control group(n=40)was given oral tranexamic acid tablets combined with large-spot and low-energy Q switched Nd:YAG laser,and the observation group(n=41)was given tranexamic acid cataplasm application combined with large-spot and low-energy Q switched Nd:YAG laser.The clinical efficacy,clinical symptoms[Melasma area severity index(MASI)],quality of life[Dermatology Life Quality Index(DLQI),Melasma Quality of Life Scale(MELASQOL)]and adverse reactions were compared between the two groups.Results The total effective rate was 87.80%in observation group and was 65.85%in control group(P<0.05).After 4 months of treatment,the scores of MASI,DLQI and MELASQOL were significantly reduced in the two groups(P<0.05),and the differences between the groups after treatment were significant(P<0.05).The total incidence rate of adverse reactions was 7.32%in observation group and was 17.50%in control group(P>0.05).At 6 months of follow-up after treatment,the recurrence rate was 2.44%in observation group and was 7.50%in control group,with statistically significant difference(χ^(2)=0.475,P>0.05).Conclusion Tranexamic acid cataplasm application combined with large-spot and low-energy Q switched Nd:YAG laser has a better efficacy on chloasma,and it has a more significant facial cosmetic effect after treatment and lower adverse reactions and recurrence rate,thus it is worth recommending.

关 键 词：氨甲环酸 Q开关ND:YAG激光 黄褐斑 临床疗效 生活质量 

分 类 号：R758.4[医药卫生—皮肤病学与性病学]