CO_(2)点阵激光联合红蓝光治疗中重度痤疮的临床疗效  

Clinical Efficacy:Joint Treatment of Moderate to Severe Acnes with CO_(2) Dot Matrix Laser and Red and Blue Light Therapy Instrument

作　　者：宋婷 王媛丽 王莉 杨娟 程娴 宋璞 SONG Ting;WANG Yuanli;WANG Li;YANG Juan;CHENG Xian;SONG Pu(Department of Dermatology,Xijing Hospital,the Fourth Military Medical University,Xi’an 710000,China)

机构地区：[1]空军军医大学西京皮肤科,西安市710000

出　　处：《中国激光医学杂志》2024年第1期29-34,60,共7页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的本研究旨在分析CO_(2)点阵激光联合红蓝光治疗中重度痤疮的有效性和安全性。方法回顾性分析2017年1月至2021年12月,中重度痤疮患者78例,根据治疗方式不同,分为对照组(n=38)和观察组(n=40)。对照组仅应用红蓝光治疗,蓝光波长415 nm,功率密度45 mW/cm^(2),照射时间17 min;红光波长633 nm,功率密度105 mW/cm^(2),能量密度126 J/cm^(2),照射时间20 min。在前4周,每周红、蓝光联合治疗1次,共4次;后4周,红、蓝光交替治疗各2次,共4次,共治疗8周为一个疗程。观察组在红蓝光治疗前应用点阵激光治疗,点阵激光能量参数,采用Deep模式:能量密度20 J/cm^(2);Superficial模式:能量密度90~120 mJ/cm^(2),Density:覆盖率40%~60%,重复1~2次。点阵激光完成后,清除皮肤渗液,用预冷生理盐水敷患处30 min后,进行红蓝光治疗。在治疗第8周末,痤疮综合分级系统量表(global acne grading system,GAGS)两组临床疗效、痤疮分级、皮肤屏障功能、生活质量。同时,记录两组每次治疗后1周内脱屑、瘙痒、红斑、鳞屑、水疱、色素等不良反应发生情况。治疗后3个月,观察痤疮复发情况。结果在治疗第8周末,观察组总有效率为90.0%(36/40),高于对照组60.5%(23/38),差异具有统计学意义(P<0.05);两组GAGS评分均降低,且观察组GAGS降低幅度大于对照组(P<0.05);两组皮肤屏障功能均改善,且观察组角质层含水量高于对照组,经表皮水分流失量、面部脂溢量低于对照组(均P<0.05);两组生活质量升高,且观察组升高幅度大于对照组(均P<0.05)。在治疗1周内,观察组不良反应发生率低于对照组,但两组比较差异无统计学意义(P>0.05)。治疗后3个月,观察组复发率低于对照组,差异具有统计学意义(P<0.05)。结论CO_(2)点阵激光联合红蓝光治疗中、重度痤疮临床疗效明显,能早期改善痤疮症状,提升生活质量,且安全、低复发。Objective To analyze the effectiveness and safety to treat moderate to severe acnes jointly with CO 2 lattice laser and red and blue light therapy equipment.Methods Totally 78 patients with moderate and severe acnes diagnosed over the period from Jan.2017 to Dec.2021 were selected and divided into two groups by treating modality:the control group(n=38)and observation group(n=40).The patients in the control group were treated with red and blue light therapy instrument,and those in the observation group were given the treatment of CO_(2) point array laser in addition.The clinical efficacy,acne grading,skin barrier function,life quality,adverse effects and recurrence were compared between the two groups.Results After 8 weeks,the total effective rate of the observation group and control group was 90.00%(36/40)and 60.53%(23/38)respectively,and the difference was statistically significant(P<0.05).Gags scores were reduced in both groups,and the reduction was greater in the observation group than in the control group(P<0.05).Skin barrier functions of both groups were improved.In addition,the water content of stratum corneum was higher,and the transepidermal water loss and facial seborrhea were lower in the observation group than in the control group(P<0.05).The life quality was also improved in both groups,and the improvement was greater in the observation group than in the control group(P<0.05).Within one week of the treatment,the incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not remarkable(P>0.05).The results of 3 months’follow-up showed that the recurrence rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusions Treating moderate to severe acnes jointly with CO_(2) lattice laser and red and blue light therapy equipment is rather effective and safe with a low recurrence rate,which will improve acne symptoms at an early stage as well as promote the recovery of ski

关 键 词：痤疮 皮肤 点阵激光 红蓝光治疗仪 联合治疗 

分 类 号：R454.2[医药卫生—治疗学] R758.733[医药卫生—临床医学]