Q开关755 nm紫翠宝石激光联合氨甲环酸外用治疗面部黄褐斑25例疗效观察  

Efficacy of Q-switched-755nm Alexandrite Laser and Tranexamic Acid Externally in the Treatment of 25 Cases of Facial Chloasma

作　　者：张玲玲 钱晓莺 金艺[2] 刘楠楠 Zhang Lingling;Qian Xiaoying;Jin Yi;Liu Nannan(Zhejiang Rongjun hospital,Jiaxing 314000,China;Zhejiang Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]浙江省荣军医院,浙江嘉兴314000 [2]浙江省嘉兴市妇幼保健院,浙江嘉兴314000

出　　处：《中国中西医结合皮肤性病学杂志》2022年第6期498-501,共4页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

基　　金：嘉兴市级科技计划项目(编号:2019AD32152)。

摘　　要：目的研究Q755紫翠宝石激光联合外用氨甲环酸治疗面部黄褐斑的临床疗效。方法选取浙江省荣军医院皮肤科2020年3—5月就诊的黄褐斑患者50例,随机分为治疗组及对照组,每组25例。治疗组采用调Q755紫翠宝石激光5 mm光斑,1.6 J/cm2能量,70 ns脉宽的模式对皮损进行照射,2周1次,治疗6次,同时外涂氨甲环酸精华液,早晚各1次,连续6个月;对照组局部使用氨甲环酸精华液,早晚1次,连续使用6个月。2组同时保湿防晒。疗程结束后观察黄褐斑面积及严重指数(MASI)以及医患双方主观评价。统计学分析,计量资料采用独立样本t检验,计数资料采用χ2检验。结果治疗前MASI评分治疗组(19.66±10.11),对照组(20.29±9.90),2组患者MASI评分比较差异无统计学意义(P=0.824),治疗后MASI评分治疗组(9.54±5.04)明显低于对照组(13.79±4.51),差异有统计学意义(P=0.003)。治疗前后治疗组患者MASI评分明显低于治疗前,差异有统计学意义(P=0.000),治疗前后对照组患者MASI评分差异有统计学意义(P=0.004)。治疗后医患主观评价,医生整体评估(PGA),治疗组(2.16±0.27)分,色斑清除率75%~90%,对照组(3.88±0.25)分,色斑清除率25%~49%,2组比较差异有统计学意义(P<0.05)。疗程结束后患者自我满意度评价,治疗组满意率(88%)高于对照组(56%),差异有统计学意义(P<0.05)。结论Q开关755 nm紫翠宝石激光5 mm光斑,1.6 J/cm2能量,70 ns脉宽,联合氨甲环酸外用,可以改善面部黄褐斑,供临床借鉴。Objective In order to evaluate the clinical efficacy of Q-switched-755 alexandrite laser combined with tranexamic acid in the treatment of facial chloasma.Methods From March 2020 to May 2020,50 patients with chloasma from the department of dermatology of Zhejiang Rongjun hospital were enrolled and randomized divided into treatment group and control group.In the treatment group,the skin lesions were irradiated by Q-switched-755 alexandrite laser for six sessions with the mode of 5 mm spot,1.6 J/cm2 energy,70 ns pulse width for every two weeks.At the same time,tranexamic acid serum was applied topically on the lesions twice a day for six months.In the control group,tranexamic acid serum was used in the same way as patients in the treatment group,without laser therapy.Melasma area and severity index(MASI)of chloasma as well as subjective evaluation of both doctors and patients were carried out before treatment and at the end of six months treatment.Independent sample t-test and chi-square test were used for statistical analysis.Results Before treatment,MASI score of the treatment group was(19.66±10.11),and that of the control group was(20.29±9.90),with no significant differences(P=0.824).At the end of the treatment,MASI score of the treatment group(9.54±5.04)was significantly lower than that of the control group(13.79±4.51,P=0.003).In both groups,MASI score at the end of treatment was significantly lower than that before treatment(P=0.000).Subjective evaluation of doctors showed that physician global assessment(PGA)decreased from 3.88±0.25 to 2.16±0.27 after treatment.Pigmentation removal rate was 75%~90%in the treatment group,and 25%~49%in the control group,showing a significant difference(P<0.05).Self satisfaction in the treatment group(88%)was significantly higher than that in the control group(56%,P<0.05).Conclusion Q-switched-755 nm alexandrite laser therapy with a mode of 5 mm spot,1.6 J/cm2 energy,70 ns pulse width,combined with topical use of tranexamic acid serum,can effectively improve facial chloasm

关 键 词：Q开关755 nm紫翠宝石激光 氨甲环酸 黄褐斑 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]