4种方法治疗黄褐斑的临床疗效和安全性比较  

Comparison of Clinical Efficacy and Safety of Four Methods in the Treatment of Chloasma

作　　者：吴栋杰 杨美红 WU Dong-jie;YANG Mei-hong(Department of Dermatology,Liuzhou Traditional Chinese Medicine Hospital,Guangxi Zhuang Autonomous Region 545001,China;Department of Dermatology,Liuzhou People's Hospital,Guangxi Medical University,Guangxi Zhuang Autonomous Region,545001,China)

机构地区：[1]柳州市中医医院皮肤科,广西柳州545001 [2]广西医科大学附属柳州市人民医院皮肤科,广西柳州545001

出　　处：《中国医疗美容》2023年第7期26-30,共5页China Medical Cosmetology

摘　　要：目的评价分别使用外用氢醌乳膏、果酸换肤、强脉冲光(IPL)、1064nm调Q激光治疗黄褐斑的临床疗效和安全性。方法选取128例黄褐斑患者作为研究对象,根据患者选择的治疗方案随机分为外用氢醌乳膏组(A组),果酸换肤组(B组),强脉冲光组(C组)和1064nm调Q激光组(D组),每组各32例。各组均严格按照用药方法、规范操作仪器治疗、精细护理及健康教育等进行治疗3个月,于入组6个月、12个月后分别进行1次疗效判定及不良反应评估。结果各组入组前和入组6个月后(MASI)评分比较差异有统计学意义(P均<0.05),且入组6个月后D组1064nm调Q激光在黄褐斑面积和严重指数(MASI)评分、医生整体评价(PGA)、患者满意度评价明显优于A组(t=4.138,χ^(2)=10.604,χ^(2)=6.349)、B组(t=3.146,χ^(2)=6.256,χ^(2)=5.107)和C组(t=2.867,χ^(2)=4.063,χ^(2)=4.015),差异有统计学意义(P均<0.05)。治疗期间不良反应发生率分别为25.00%、21.86%、12.50%、18.75%,两两比较差异无统计学意义(P均>0.05);入组6个月后不良反应发生率分别为12.50%、9.38%、3.13%、6.25%,两两比较差异无统计学意义(P均>0.05)。入组12个月后各组复发率分别为37.50%、36.37%、42.86%和40.91%,两两比较差异无统计学意义(P均>0.05)。结论4种方法治疗黄褐斑,1064nm调Q激光有效率更高,其次是强脉冲光(IPL)、果酸换肤、外用氢醌乳膏,4种治疗方法的不良反应和复发率无明显差异。Objective To evaluate the clinical efficacy and safety of hydroquinone cream for topical application,glycolic peeling,intense pulsed light(IPL),1064nm Q-switched laser in the treatment of chloasma.Methods A total of 128 patients with chloasma were selected as research objects,and were randomly divided into group A(hydroquinone cream for topical application),group B(glycolic peeling),group C(intense pulsed light(IPL))and group D(1064nm Q-switched laser)pursuant to the treatment plan selected by patients,with 32 cases in each group.Patients in each group were treated in strict conformity with the methods of medication,standardized instrument treatment,fine nursing and health education for full course of treatment,with the efficacy determination and adverse reactions evaluation once 6 months and 12 months respectively after joining the group.Results There were significant differences in melasma area and severity index(MASI)scores between all groups 6 months before and after joining the groups(P<0.05).After 6 months of joining the groups,the results of group D(1064nm Q-switched laser)were significantly superior to those in group A(t=4.138,χ^(2)=10.604,χ^(2)=6.349),group B(t=3.146,χ^(2)=6.256,χ^(2)=5.107)and C group(t=2.867,χ^(2)=4.063,χ^(2)=4.015),giving statistically significant difference(all P<0.05).The incidence of adverse reactions during treatment was 25%,21.8%,12.5%and 18.7%respectively,giving no significant difference according to pairwise comparisons(P mean>0.05);The incidence of adverse reactions after 6 months of joining the groups was 12.5%,9.38%,3.13%and 6.25%respectively,giving no significant difference according to pairwise comparisons(P mean>0.05).The recurrence rates after 12 months of joining the groups were 37.5%,36.4%,42.8%and 40.9%respectively,giving no significant difference according to pairwise comparisons(P mean>0.05).Conclusion In terms of efficiency of the four methods,1064nm Q-switched laser shows a higher efficiency in single-method treatment of chloasma,followed by intense pulsed l

关 键 词：黄褐斑 1064nm调Q激光 氢醌乳膏 果酸换肤 强脉冲光 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]