强脉冲光联合水光注射肉毒素治疗玫瑰痤疮的自身对照临床观察  

A Self-Control Clinical Observation of Intense Pulsed Light Combined with Intradermal Injection Botulinum Toxin in Rosacea Treatment

作　　者：齐鑫 王一冲 姚树兰[1,2] 祝琳琳[1,3] 吴严[1] QI Xin;WANG Yichong;YAO Shulan;ZHU Linlin;WU Yan(Department of Dermatology,The First Hospital of China Medical University,Shenyang 110000,China;Department of Dermatology,Affiliated Hospital of Jining Medical Vniversity,Jining 272029,China;Department of Dermatology,The Seventh People′s Hospital of Shenyang,Shenyang 110000,China)

机构地区：[1]中国医科大学附属第一医院皮肤科,辽宁沈阳110000 [2]济宁医学院附属医院皮肤科,山东济宁272029 [3]沈阳市第七人民医院皮肤科,辽宁沈阳110000

出　　处：《皮肤科学通报》2024年第4期415-423,共9页Dermatology Bulletin

摘　　要：目的评价强脉冲光(intense pulsed light,IPL)联合水光注射肉毒素(intradermal injection botulinum toxin,IIBT)治疗玫瑰痤疮的临床疗效及安全性。方法按照纳入排除标准招募以红斑或毛细血管扩张为主要临床表现的玫瑰痤疮受试者,按照随机数字表法,将受试者双侧面部按照不同治疗方案分为试验侧(T侧)和对照侧(C侧),T侧采用IPL联合IIBT治疗,C侧采用IPL治疗,每侧分别治疗3次,间隔4~5周,分别于首次治疗前(T0)、每次治疗后(T1-T3)、随访期(Tfu)进行临床评估,包括症状评分、潮红严重程度评分(global flushing symptom score,GFSS)、临床医师红斑评估量表(clinician′s erythema assessment,CEA)、VISIA红色区分值、红斑指数(erythema index,EI)、角质层含水量、患者生活质量改善程度及满意度,随时记录不良反应。结果无论试验侧还是对照侧,治疗后症状评分、GFSS、CEA、EI分别较T0不同程度下降,角质层含水量较T0不同程度升高,以上差异均有统计学意义(P<0.05);不良反应轻微,包括短暂红斑、治疗后一周内皮肤干燥。两侧组间比较示,与C侧相比,T侧的症状评分从T1开始下降(T=6.44 vs.C=7.11),GFSS(T=3.61 vs.C=4.89)、CEA(T=2.53 vs.C=2.89)、EI(T=287.17 vs.C=325.72)从T2开始下降,角质层含水量在Tfu升高(T=48.93 vs.C=46.05),治疗结束后满意度更高(T=88.23%vs.C=52.94%),以上差异均有统计学意义(P<0.05),双侧不良反应发生率差异无显著统计学意义(P>0.05)。结论IPL联合IIBT治疗玫瑰痤疮疗效优于单独IPL,安全性可,患者满意度高。Objective To evaluate the efficacy and safety of intense pulsed light combined with intradermal injection botulinum toxin for the treatment of rosacea.Methods Rosacea subjects with erythema or telangiectasia as the main clinical manifestations were recruited according to the inclusion criteria.According to the random number table methods,both sides of the subjects were divided into the treatment side(T side)and the control side(C side)with different treatment plans.The T side was treated with IPL combined with IIBT,and the C side was treated with IPL,each side was treated 3 times,at an interval of 4-5 weeks.Clinical assessments were performed before the first treatment(T0),after each treatment(T1-T3),and during the follow-up period(Tfu),including symptom score,global flushing symptom score(GFSS),clinician′s erythema assessment(CEA),VISIA red value,erythema index(EI),water content of stratum corneum,improvement degree of patients′quality of life,satisfaction evaluation and adverse reactions recorded at any time.Results After treatment,symptom score,GFSS,CEA and EI were decreased in different degrees compared with T0,and water content of stratum corneum was increased in different degrees compared with T0,with statistical significance(P<0.05).Adverse reactions were mild,including transient erythema and dry skin within a week after treatment.Comparison between the two groups showed that symptom scores on the T side decreased from T1 compared with the C side(T=6.44 vs.C=7.11).GFSS(T=3.61 vs.C=4.89),CEA(T=2.53 vs.C=2.89),EI(T=287.17 vs.C=325.72)decreased from T2,and water content of stratum corneum increased at Tfu(T=48.93 vs.C=46.05).After treatment,the satisfaction rate was higher(T=88.23%vs.C=52.94%),and the above differences were statistically significant(P<0.05).There was no significant difference in the incidence of bilateral adverse reactions(P>0.05).Conclusion The rosacea treatment with intense pulsed light combined with intradermal injection botulinum toxin is significantly more effective than the use of i

关 键 词：玫瑰痤疮 强脉冲光 肉毒素 水光注射 

分 类 号：R758.73[医药卫生—皮肤病学与性病学]