694 nm调Q红宝石点阵激光联合氨甲环酸注射液外敷治疗黄褐斑的临床疗效  

Clinical efficacy of 694 nm Q-switched ruby fractional laser combined with topical tranexamic acid injection for the treatment of melasma

作　　者：李林丽 刘平[2] 苏慧[2] 王雨婷 袁仪珮 Li Linli;Liu Ping;Su Hui;Wang Yuting;Yuan Yipei(Department of Dermatology,XD Group Hospital,Xi'an 710077,China;Department of Dermatology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西电集团医院皮肤科,西安710077 [2]西安交通大学第二附属医院皮肤科,西安710004

出　　处：《保健医学研究与实践》2024年第5期85-89,共5页Health Medicine Research and Practice

基　　金：陕西省社会发展科技攻关项目(2023SF-124)。

摘　　要：目的探讨694 nm调Q红宝石点阵激光联合氨甲环酸注射液外敷治疗黄褐斑的临床疗效,以期为临床治疗黄褐斑提供参考。方法选取2019年7月-2023年3月西电集团医院收治的106例黄褐斑患者为研究对象,根据治疗方案不同分为对照组(52例)和观察组(54例)。对照组患者采用694 nm调Q红宝石点阵激光治疗,观察组患者采用694 nm调Q红宝石点阵激光联合氨甲环酸注射液外敷治疗。比较2组患者的临床疗效,治疗前后黄褐斑面积和严重程度指数(MASI)评分、皮肤状态、复发率及不良反应发生情况。结果观察组患者的治疗总有效率为83.33%(45/54),高于对照组的63.46%(33/52),差异有统计学意义(χ^(2)=5.382,P=0.020)。2组患者治疗前MASI评分比较,差异无统计学意义(P>0.05);2组患者治疗后MASI评分均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者治疗前皮肤毛孔、纹理、皱纹、色素斑4项皮肤状态评分比较,差异均无统计学意义(P>0.05);2组患者治疗后皮肤毛孔、皱纹、纹理、色素斑4项皮肤状态评分均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组患者黄褐斑复发率为5.56%(3/54),低于对照组的19.23%(10/52),差异有统计学意义(χ^(2)=4.604,P=0.032)。对照组和观察组患者不良反应发生率分别为9.62%(5/52)和7.41%(4/54),差异无统计学意义(χ^(2)=0.004,P=0.953)。结论黄褐斑患者采用694 nm调Q红宝石点阵激光联合氨甲环酸注射液外敷治疗效果较好,可有效改善患者皮肤色素沉着症状,且不良反应发生风险及复发风险均较低。Objective To explore the clinical efficacy of 694 nm Q-switched ruby fractional laser combined with topical tranexamic acid injection for the treatment of melasma,providing a reference for its clinical treatment.Methods A total of 106 melasma patients treated at XD Group Hospital from July 2019 to March 2023 were selected as research participants and divided into a control group(52 cases)and an observation group(54 cases)based on different treatment plans.The control group patients were treated with 694 nm Q-switched ruby fractional laser,while the observation group patients with 694 nm Q-switched ruby fractional laser combined with topical tranexamic acid injection.The clinical efficacy,melasma area and severity index(MASI)scores,skin conditions,recurrence rates,and adverse reaction occurrence between the two groups were compared before and after treatment.Results The overall response rate of treatment in the observation group was 83.33%(45/54),which was higher than that in the control group at 63.46%(33/52),with a statistically difference(χ^(2)=5.382,P=0.020).No statistically significant difference was observed in MASI scores between the two groups before treatment(P>0.05);after treatment,the MASI scores in both groups were significant lower than before treatment,and the observation group had significant lower scores than the control group(P<0.05).No statistically significant differences were noted in the skin condition scores of skin pores,texture,wrinkles,and pigmented spots between the two groups before treatment(P>0.05).The skin condition scores in all four categories in both groups were significantly decreased after treatment,and the observation group had significantly lower scores than the control group(P<0.05).The recurrence rate of melasma in the observation group was 5.56%(3/54),which was lower than that in the control group at 19.23%(10/52),with a statistically significant difference(χ^(2)=4.604,P=0.032).The incidence of adverse reactions in the control and observation groups was 9.62%(5/52)and 7.41

关 键 词：694 nm调Q红宝石点阵激光 氨甲环酸注射液 黄褐斑 临床疗效 皮肤状态 复发风险 

分 类 号：R751[医药卫生—皮肤病学与性病学]