A型肉毒毒素联合剥脱性点阵激光对面部痤疮瘢痕的疗效观察  

The efficacy of botulinum toxin type A combined with exfoliative fractional laser on facial acne scarring

作　　者：范白露 徐静 田丽 韩志强 贾梦娜 赵书含 袁梅 FAN Bailu;XU Jing;TIAN Li;HAN Zhiqiang;JIA Mengna;ZHAO Shuhan;YUAN Mei(Department of Plastic and Burn,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院整形烧伤科,安徽蚌埠233004

出　　处：《中华全科医学》2024年第8期1332-1335,共4页Chinese Journal of General Practice

基　　金：安徽省高等学校自然科学研究重点项目(KJ2020A0576)。

摘　　要：目的探讨A型肉毒毒素联合激光对面部萎缩性痤疮瘢痕的临床疗效。方法选取2021年10月—2022年10月在蚌埠医科大学第一附属医院整形烧伤科就诊的50例面部萎缩性痤疮瘢痕患者,并采用随机数字法将患者分为对照组和观察组,每组25例。所有患者分别给予3次激光,激光治疗中均选择双模式覆盖,每次激光治疗间隔8~10周。其中观察组在第1次激光治疗后的7~14 d内在瘢痕下注射1次A型肉毒毒素。治疗前、治疗结束3个月后,分别采用痤疮瘢痕临床评分量表和调查人员视觉评分(IVS)对患者面部痤疮瘢痕的疗效进行评价,并记录患者的满意度及不良反应发生情况。结果观察组治疗后痤疮瘢痕临床评分为60.0(45.0,60.0)分,其中平均秩次为21.96,对照组治疗后痤疮瘢痕临床评分为60.0(60.0,60.0)分,其中平均秩次为29.04,观察组治疗后的痤疮瘢痕临床评分低于对照组,差异有统计学意义(Z=-2.014,P=0.044)。观察组治疗前后痤疮瘢痕临床评分差值为15.0(0.0,15.0)分,对照组为0.0(0.0,7.5)分,观察组治疗前后痤疮瘢痕临床评分差值明显高于对照组,差异有统计学意义(Z=-2.076,P=0.038)。观察组IVS评分[3.0(2.0,3.0)分]高于对照组[2.0(1.0,2.0)分],观察组的满意度评分[3.0(3.0,4.0)分]高于对照组[2.0(2.0,3.0)分],差异均有统计学意义(P<0.05)。结论A型肉毒毒素联合剥脱性点阵激光治疗面部萎缩性痤疮瘢痕疗效较好,并能在一定程度上抑制皮肤油脂分泌,干预痤疮及其瘢痕发展,具有临床参考意义。Objective To investigate the clinical efficacy of botulinum toxin type A in combination with laser on facial atrophic acne scars.Methods Fifty patients with facial atrophic acne scars who visited the Department of Plastic and Burn,the First Affiliated Hospital of Bengbu Medical University from October 2021 to October 2022 were selected.Patients were randomly divided into control group and observation group by random number method with 25 cases in each group.All patients received three laser treatments each,and dual-mode coverage was selected for laser treatment,with an interval of 8-10 weeks between each laser treatment.In observation group,an injection of botulinum toxin type A was given under the scar within 7-14 days after the first laser treatment.Before the treatment and three months after the end of the treatment,the efficacy of the patients'facial acne scars was comparatively analyzed using the echelle d'evaluation clinique des cicatrices d'acne(ECCA)weighting scale and the integrated visualization system(IVS),respectively,and the patients'satisfaction and adverse reactions were recorded.Results The ECCA score of observation group after treatment was 60.0(45.0,60.0)points,of which the mean rank was 21.96,and the ECCA score of control group after treatment was 60.0(60.0,60.0)points,of which the mean rank was 29.04,and the analysis of the data showed that the overall ECCA score of observation group after treatment was lower than that in control group,and the difference was statistically significant(Z=-2.014,P=0.044).The difference between the ECCA before and after treatment for the observation group was 15.0(0.0,15.0),compared to 0.0(0.0,7.5)for the control group.The change in ECCA for the observation group was significantly higher than that of the control group,with statistical significance(Z=-2.076,P=0.038).The IVS score in observation group[3.0(2.0,3.0)points]was higher than that in control group[2.0(1.0,2.0)points],and the satisfaction score of the observation group[3.0(3.0,4.0)points]was higher than tha

关 键 词：A型肉毒杆菌毒素 剥脱性点阵激光 痤疮瘢痕 

分 类 号：R758.733[医药卫生—皮肤病学与性病学] R619.6[医药卫生—临床医学]