无针水光联合强脉冲光治疗黄褐斑的疗效  

Efficacy of Joint Treatment of Melasma with Needleless Water-Light and Strong Pulsed Light & Its Effects

作　　者：苏萍 杨今言[2] 丁赢 詹明峰[4] SU Ping;YANG Jinyan;DING Ying;ZHAN Mingfeng(Department of Dermatology,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,China;Department of Dermatology,the Second Affiliated Hospital of Xinjiang Medical University;Comay Medical Plastic SurgeryInstitute;Department of Dermatology,the Fifth Afiliated Hospital of Xinjiang Medical University)

机构地区：[1]新疆医科大学第六附属医院皮肤科,乌鲁木齐市830002 [2]新疆医科大学第二附属医院皮肤科 [3]科美医疗整形机构 [4]新疆医科大学第五附属医院皮肤科

出　　处：《中国激光医学杂志》2023年第1期24-30,共7页Chinese Journal of Laser Medicine & Surgery

基　　金：新疆维吾尔自治区自然科学基金(2020D01C226)。

摘　　要：目的 观察无针水光联合强脉冲光治疗黄褐斑的临床疗效。方法 选取2020年4月至2021年3月,黄褐斑患者106例,采用随机数字法分为观察组和对照组,每组患者53例。两组均进行常规干预,对照组在常规干预基础上实施强脉冲光治疗,观察组在对照组基础上联合无针水光治疗。治疗前、治疗7周、治疗13周记录黄褐斑面积和严重指数(melasma area and severity index,MASI)评分,皮肤水分流失测试仪检测表皮油脂量、含水量,改良硫代巴比妥酸法检测血清丙二醛(malondialdehyde,MDA)水平,黄嘌呤氧化酶法检测超氧化物歧化酶(superoxide dismutase,SOD)水平,以皮肤检测仪检测色素沉着情况,观察不良反应发生情况;末次治疗后6个月随访,比较两组临床疗效和复发率。结果 末次治疗后6个月,观察组总有效率92.5%(49/53)高于对照组77.4%(41/53)(P<0.05);治疗后7周、13周两组MASI评分、血清MDA水平均低于治疗前,且治疗后13周低于治疗后7周,治疗后7周、13周观察组MASI评分、血清MDA水平低于对照组(P<0.05);治疗后7周、13周两组表皮油脂量、含水量、血清SOD水平均高于治疗前,且治疗后13周高于治疗后7周;治疗后7周、13周观察组表皮油脂量、含水量、血清SOD水平高于对照组(P<0.05);治疗后7周、13周观察组色素沉着严重程度较对照组轻微(P<0.05);观察组不良反应发生率5.66%(3/53)低于对照组18.9%(10/53)(P<0.05);观察组复发率4.08%(2/53)低于对照组19.5%(8/53)(P<0.05)。结论 无针水光联合强脉冲光治疗黄褐斑,可提高治疗效果,通过抗氧化作用淡化色斑、减少色素沉着,且保湿效果较好,复发率低,安全可靠。Objective To analyze the clinical efficacy to treat melasma jointly with needle-free water light and strong pulsed light.Methods A total of 106 patients of chloasma treated from Apr. 2020 to Mar. 2021 were selected and randomly divided into the observation group(n=53) and control group(n=53). The patients in both groups were given routine intervention, then the patients in the control group were given intense pulsed light therapy and those in the observation group needle-free water-light therapy in addition.For both groups, the melasma area and severity index(MASI) scores were recorded before the treatment and after 7 and 13 weeks’ treatment respectively, the epidermal oil and fat and water content were measured with skin moisture loss testers, the serum malondialdehyde(MDA) level, superoxide dismutase(SOD) level and pigmentation situation were detected with modified thiobarbituric acid method, xanthine oxidase method and skin detectors respectively, and the occurrence of adverse reactions were observed. Moreover, the clinical efficacy and recurrence rates were compared between the two groups 6 months after the treatment.Results Six months after the last treatment, the total effective rate [92. 5%(49/53)] of the observation group was higher than that(77. 4% [41/53]) of the control group(P<0. 05). Upon 7 and 13 weeks’ treatment, the MASI score and serum MDA level in both groups dropped, the decreases were much greater in the observation group than in the control group(P<0. 05), and the amount of epidermal oil and serum MDA were lower in the observation group than in the control group. The serum SOD level of water content was higher than that before the treatment, and the epidermal oil content, water content and serum SOD level in the observation group were higher than those in the control group(P<0. 05). The pigmentation was less severe in the observation group than in the control group(P<0. 05). The incidence [5. 66%(3/53)] of adverse reactions in the observation group was lower than that [18. 9%(10/53)] in t

关 键 词：黄褐斑 强脉冲光 无针水光 皮肤生理参数 色素沉着 抗氧化 

分 类 号：R454.2[医药卫生—治疗学] R758.42[医药卫生—临床医学]