A型肉毒毒素微滴注射联合超脉冲点阵CO_(2)激光治疗增生性瘢痕的疗效及对血清炎性因子的影响  

Curative Effect of Botulinum Toxin Type A Microdrop Injection Combined with Ultrapulse CO_(2) Fractional Laser on Hypertrophic Scar and Its Infl uences on Serum Inflammatory Factors

作　　者：曾占权 文洋 ZENG Zhanquan;WEN Yang(Department of Dermatology,Xichan Guanghua Medical Cosmetics Clinic,Chengdu 610000,Sichuan,China;Department of Cosmetic Dermatology,Affiliated Hospital of Zunyi Medical University,Zunyi 563099,Guizhou,China)

机构地区：[1]青羊西婵光华医疗美容门诊部皮肤科,四川成都610000 [2]遵义医科大学附属医院美容皮肤科,贵州遵义563099

出　　处：《中国美容医学》2024年第7期31-34,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察A型肉毒毒素微滴注射联合超脉冲点阵CO_(2)激光对增生性瘢痕(Hypertrophic scar,HS)的疗效及对TNF-α、IL-1β、IL-10的影响。方法:选取2019年4月-2023年1月在笔者医院收治的120例存在HS患者,随机数字表法分为观察组(n=60,采用A型肉毒毒素微滴注射联合超脉冲点阵CO_(2)激光治疗)和对照组(n=60,采用超脉冲点阵CO_(2)激光治疗)。均完成3个周期的治疗,比较两组患者治疗前(T0)、治疗1周期后1个月(T1)、3周期后1个月(T2)温哥华瘢痕量表(Vancouver scar scale,VSS)评分、视觉疼痛模拟评分(Visual analogue scale,VAS)、瘙痒峰值数字评定量表(Numeric rating scale,NRS)、血清TNF-α、IL-1β、IL-10、转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、表皮生长因子(Epidermal growth factor,GF)水平。记录满意度及不良反应。结果:治疗后,观察组T2时间点的VSS、VAS及NRS评分均低于对照组(P<0.05);观察组TNF-α、IL-1β、水平均低于对照组,IL-10水平高于对照组(P<0.05);观察组TGF-β1、EGF水平均低于对照组(P<0.05)。观察组总满意度为80.00%,高于对照组的63.33%(P<0.05)。两组患者均未发现明显不良反应。结论:HS患者应用A型肉毒毒素微滴注射联合超脉冲点阵CO_(2)激光治疗可进一步有效淡化瘢痕,降低炎性因子表达水平,缓解瘢痕症状,且具有安全性。Objective To observe the curative effect of botulinum toxin type A microdrop injection combined with ultrapulse CO_(2) fractional laser on hypertrophic scar(HS)and its influences on serum tumor necrosis factor(TNF)-α,interleukin(IL)-1β,and IL-10.Methods A total of 120 patients with HS admitted to the hospital were enrolled between April 2019 and January 2023.According to the random number table method,they were divided into observation group(n=60,botulinum toxin type A microdrop injection combined with ultrapulse CO_(2) fractional laser)and control group(n=60,ultrapulse CO_(2) fractional laser).All were treated for 3 cycles.The scores of Vancouver Scar Scale(VSS),visual analogue scale(VAS)and Numerical Rating Scale(NRS),levels of serum TNF-α,IL-1β,IL-10,transforming growth factor-β1(TGF-β1)and epidermal growth factor(EGF)were compared between the two groups before treatment(T0),at 1 month after 1 cycle of treatment(T1)and 3 cycles of treatment(T2).The satisfaction and adverse reactions were recorded.Results At T2,scores of VSS,VAS and NRS in observation group were lower than those in control group(P<0.05).The levels of TNF-αand IL-1βin observation group were lower than those in control group,while IL-10 level was higher than that in control group(P<0.05).The levels of TGF-β1 and EGF in observation group were lower than those in control group(P<0.05).The total satisfaction in observation group was higher than that in control group(80.00%vs 63.33%,P<0.05).There were no significant adverse reactions in either group.Conclusion Botulinum toxin type A microdrop injection combined with ultrapulse CO_(2) fractional laser can effectively and further fade scars,reduce inflammatory factors and relieve scar symptoms in HS patients,with certain safety.

关 键 词：A型肉毒毒素 微滴注射 超脉冲点阵CO_(2)激光 增生性瘢痕 炎性因子 

分 类 号：R619.6[医药卫生—外科学]