强脉冲光/Q开关Nd∶YAG激光联合左旋维C治疗黄褐斑的疗效评价  

Effects of Intense Pulsed Light/Q-switched Nd:YAG Laser Combined with L-vitamin C Therapy on Melanin Deposition,Skin Lesions and Serum Oxidative Stress Indicators in Patients with Melasma

作　　者：许晓春[1] 车洪[1] 康萍 XU Xiaochun;CHE Hong;KANG Ping(Department of Dermatology,Ordos Central Hospital,Ordos 017010,Inner Mongolia,China)

机构地区：[1]内蒙古鄂尔多斯市中心医院皮肤科,内蒙古鄂尔多斯017010

出　　处：《中国美容医学》2024年第1期86-90,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察强脉冲光(Intense pulsed light,IPL)和Q开关Nd∶YAG1064 nm激光分别联合左旋维C治疗对黄褐斑患者黑色素沉积、皮损情况及血清氧化应激指标的影响。方法:选取2018年1月-2020年10月笔者医院收治的150例黄褐斑患者,随机分组为IPL组和Q开关Nd∶YAG激光组各75例,IPL组采用IPL联合左旋维C治疗,Q开关Nd∶YAG激光组采用激光联合左旋维C治疗。比较两组疗效、黑色素沉积[黄褐斑面积及严重程度评分(Melanin area and severity index,MASI)]、皮损情况及血清氧化应激指标[丙二醛(Malondialdehyde,MDA)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-px)、超氧化物歧化酶(Superoxide dismutase,SOD)]变化、不良反应发生情况、复发率、满意度。结果:治疗后,IPL组总有效率为78.67%,Q开关Nd∶YAG激光组总有效率82.67%。两组MASI评分和皮损积分均显著低于治疗前(P<0.05)。治疗后,两组MDA显著低于同组治疗前,GSH-px、SOD高于治疗前(P<0.05)。两组不良反应发生率、随访1年的复发率、满意度比较差异无统计学意义(P>0.05);IPL组皮损评分小于Q开关Nd∶YAG激光组(P<0.05)。结论:IPL及Q开关Nd∶YAG1064 nm激光联合左旋维C治疗均可获得较好去除黄褐斑的效果,对黑色素沉积、皮损情况及血清氧化应激指标均有改善。Objective To observe the effects of intense pulsed light(IPL)or Q-switched Nd∶YAG 1064 nm laser combined with L-vitamin C therapy on melanin deposition,skin lesions and serum oxidative stress indicators in patients with melasma.Methods 150 patients with melasma who were treated in the hospital were recruited between January 2018 and October 2020,and they were randomly divided into the IPL group and the Q-switched Nd:YAG group,with 75 cases in each group.The IPL group was treated with IPL combined with L-vitamin C,while the Q-switched Nd:YAG group was given laser combined with L-vitamin C.The efficacy,melanin deposition[Melanin Area and Severity Index(MASI)],skin lesions and serum oxidative stress indicators[malondialdehyde(MDA),glutathione peroxidase(GSH-px),superoxide dismutase(SOD)],occurrence of adverse reactions,recurrence rate and satisfaction were compared between the two groups.Results After treatment,the total effective rate was 78.67%in the IPL group and 82.67%in the Q-switched Nd:YAG group.The MASI score and skin lesion score in the two groups were significantly lower than those before treatment(P<0.05).The MDA in the two groups was significantly lower while the GSH-px and SOD were higher than those before treatment(P<0.05).There were no statistical differences in incidence rates of adverse reactions,recurrence rate at 1-year follow-up and satisfaction between the two groups(P>0.05).The skin lesion score in the IPL group was lower than that in the Q-switched Nd:YAG group(P<0.05).Conclusion IPL and Q-switched Nd:YAG laser combined with L-vitamin C both can achieve good effects on removing melasma,and can improve melanin deposition,skin lesions and serum oxidative stress indicators.

关 键 词：强脉冲光 激光 左旋维C 黄褐斑 黑色素沉积 皮损 氧化应激 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]