CO_(2)激光联合光动力疗法治疗鲍温样丘疹病的疗效  

Joint Effect of CO_(2) Laser Photodynamic Therapy on Bowen-Like Papules

作　　者：王丽兵 杨惠君[1] 杨正生[1] 林宁宁[1] 李响 高鸿炜 王心妹[1] WANG Libing;YANG Huijun;YANG Zhengsheng;LIN Ningning;LI Xiang;GAO Hongwei;WANG Xinmei(Department of Dermatology,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院皮肤科,秦皇岛市066000

出　　处：《中国激光医学杂志》2023年第4期194-197,239,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：秦皇岛市科学技术研究与发展计划课题(201902A173)。

摘　　要：目的观察CO_(2)激光联合光动力治疗(photodynamic therapy,PDT)鲍温样丘疹病的临床效果,分析患者血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)的改变。方法选择2020年1月至2022年1月,鲍温样丘疹病患者90例,按随机数字表法分成对照组与观察组,两组患者均行CO_(2)激光治疗,治疗功率20 W。观察组在CO_(2)激光治疗后即刻行PDT治疗,治疗功率密度为100 mW/cm^(2)、波长633 nm,照射时间30 min和能量密度90 J/cm^(2)。对照组仅采用CO_(2)激光治疗。治疗前和治疗后3个月观察两组患者的治疗效果,IL-6、TNF-α改变,不良反应及复发情况。结果治疗后3个月,观察组治疗后总有效率为80.0%,高于对照组的60.0%,差异具有统计学意义(P<0.05)。治疗后3个月,观察组治疗后IL-6、TNF-α水平均低于对照组,差异具有统计学意义(P<0.05);治疗期间观察组和对照组不良反应发生率分别为4.44%和20.0%,两组比较差异具有统计学意义(P<0.05)。治疗后6个月观察组复发率为4.44%,显著低于对照组的17.8%(P<0.05)。结论采取CO_(2)激光与PDT相结合治疗鲍温样丘疹病,效果明显,且能改善患者的炎症因子,减少不良反应的发生,降低复发率,值得推广。Objective To observe the joint clinical effect of CO_(2) laser and photodynamic therapy(PDT) on Bowenoid papulosis and analyze the changes of serum interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α).Methods Totally 90 patients with Bowenoid papule treated over the period from Jan.2020 to Jan.2022 were selected and divided randomly into a control group and observation group.The patients in the control group were treated with CO_(2) laser,and those in the observation group were given both CO_(2) laser treatment and photodynamic therapy.The therapeutic effect,IL-6 and TNF-α value,adverse reactions and recurrence were observed before and three months after treatment respectively for both groups.Results Three months after the treatment,the total effective rate of the observation group was 80.0%,higher than that(60.0%) of the control group,and the difference was statistically significant(P<0.05).The levels of IL-6 and TNF-α in the observation group were lower than those in the control group,and the difference were remarkable(P<0.05).The incidence of adverse reactions during treatment was 4.44% in the observation group and 20.0% in the control group,and the recurrence rate was 4.44% in the observation group and 17.8% in the control group.The differences were also statistically significant(P<0.05).Conclusions The combination of CO_(2) laser and photodynamic therapy is rather effective on Bowenoid papular diseases.Moreover,it will improve the inflammatory factors of patients,reduce the occurrence of adverse reactions and reduce the recurrence rate,for which it is worthy of a wide promotion.

关 键 词：鲍温样丘疹病 激光 光动力疗法 IL-6 TNF-Α 

分 类 号：R454.2[医药卫生—治疗学] R739.5[医药卫生—临床医学]