光动力联合疗法治疗玫瑰痤疮临床效果分析  

Analysis of the Clinical Effect of Photodynamic Combination Therapy in the Treatment of Rosacea

作　　者：宋红娟 马国安 闫婷 刘丽丽 丁红炜 SONG Hongjuan;MA Guo'an;YAN Ting;LIU Lili;DING Hongwei(Department of Dermatology,Hengshui People's Hospital,Hengshui 053000,Hebei,China;Department of chest surger,Hengshui People's Hospital,Hengshui 053000,Hebei,China;Department of Otolaryngology,the Fourth People's Hospital of Hengshui,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院皮肤科,河北衡水053000 [2]衡水市人民医院胸外科,河北衡水053000 [3]衡水市第四人民医院耳鼻喉科,河北衡水053000

出　　处：《中国美容医学》2024年第10期45-49,共5页Chinese Journal of Aesthetic Medicine

基　　金：衡水市科技计划项目(编号:2021014078Z)。

摘　　要：目的:观察光动力联合疗法治疗玫瑰痤疮的临床疗效。方法:选取2022年1月-2023年1月笔者医院就诊的200例玫瑰痤疮患者。采用随机数字表法分为研究组、对照组,各100例,并根据分型分为红斑毛细血管扩张型、丘疹脓疱型两个亚组。对照组给予外用克林霉素甲硝唑搽剂及医用愈肤生物膜治疗,研究组在对照组基础上给予5-氨基酮戊酸光动力疗法。比较两组治疗前、治疗4周后临床症状评分、皮损部位角质层含水量、经皮水丢失量(Trans epidermal water loss,TEWL)、血清白介素-17(IL-17)、干扰素-γ(IFN-γ)水平,记录两组疗效、蠕形螨转阴率、不良反应。结果:两种亚型研究组总有效率、蠕形螨转阴率均高于对照组(P<0.05);治疗4周后,两种亚型研究组临床症状评分均低于对照组(P<0.05);治疗4周后,两种亚型研究组角质层含水量均高于对照组,TEWL均低于对照组(P<0.05);治疗4周后,两种亚型研究组血清IL-17、IFN-γ水平均低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:光动力联合疗法治疗红斑毛细血管扩张型、丘疹脓疱型玫瑰痤疮,可减轻临床症状,降低炎症因子表达,改善皮肤屏障功能,有效驱除蠕形螨,效果显著。Objective To observe the clinical effect of photodynamic combination therapy on rosacea.Methods A total of 200 patients with rosacea treated at the author's hospital from January 2022 to January 2023 were selected for the study.They were randomly divided into two groups,the study group and the control group,with 100 patients in each group.Both groups were further subdivided into erythema telangiectatic type and papulopustular type.The control group was treated with topical clindamycin metronidazole liniment and a medical skin healing biofilm.The study group received 5-aminolevulinic acid photodynamic therapy in addition to the treatment given to the control group.Clinical symptom scores,stratum corneum hydration,transepidermal water loss(TEWL),and serum levels of interleukin-17(IL-17)and interferon-gamma(IFN-γ)were compared between the two groups before treatment and 4 weeks after treatment.The treatment efficacy,Demodex negative conversion rate,and incidence of adverse reactions were recorded in both groups.Results The total effective rate and Demodex negative conversion rate in both subtypes of the study group were higher than those in the control group(P<0.05).After 4 weeks of treatment,clinical symptom scores in both subtypes of the study group were lower than those in the control group(P<0.05).The stratum corneum hydration in both subtypes of the study group was higher,and TEWL was lower,compared to the control group(P<0.05).Serum levels of IL-17 and IFN-γin both subtypes of the study group were lower than those in the control group after 4 weeks of treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Photodynamic combination therapy for erythema telangiectatic and papulopustular rosacea effectively reduces clinical symptoms,decreases inflammatory factor expression,improves skin barrier function,and successfully eliminates Demodex,with significant therapeutic benefits.

关 键 词：玫瑰痤疮 5-氨基酮戊酸光动力 克林霉素甲硝唑搽剂 皮肤屏障功能 干扰素-γ 白介素-17 联合疗法 

分 类 号：R758.734[医药卫生—皮肤病学与性病学]