积雪苷霜软膏联合调Q1064nm激光治疗黄褐斑效果分析  

Analysis of Cosmetic Effect of Asiaticoside Ointment Combined with Q-switched 1064 nm Laser in Treating Chloasma

作　　者：杨皓月 普雄明[2] 杨丽娟 YANG Haoyue;PU Xiongming;YANG Lijuan(Chengdu Wuhou Bofu Medical Beauty Clinic,Chengdu 610000,Sichuan,China;Department of Dermatology,Xinjiang Uygur Municipal People's Hospital,Urumqi 830001,Xinjiang,China)

机构地区：[1]成都武侯博肤医学美容门诊部,四川成都610000 [2]新疆维吾尔自治区人民医院皮肤科,新疆乌鲁木齐830001

出　　处：《中国美容医学》2025年第2期131-136,共6页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究积雪苷霜软膏联合调Q1064 nm激光治疗黄褐斑患者的疗效。方法:选取2021年1月-2022年1月笔者医院皮肤科收治的黄褐斑患者为研究对象,采用简单抽样法随机分为软膏组、激光组、联合组,各42例,其中软膏组采用积雪苷霜软膏单独治疗,激光组采用调Q1064 nm激光单独治疗,联合组采用调Q1064 nm激光联合积雪苷霜软膏治疗,比较三组患者不良反应发生情况,并对比三组患者治疗前及治疗6个月后的疗效[黄褐斑面积严重指数(MASI)、黑素指数、黄褐斑颜色、毛细血管扩张评分]、皮肤菌群(微球菌、需氧革兰阴性杆菌、痤疮丙酸杆菌)水平、疾病相关激素水平[血清卵泡刺激素(FSH)、雌二醇(E2)、促黑激素(MSH)、超氧化物歧化酶(SOD)、过氧化脂质(LPO)]、皮肤生理参数[经皮水分丢失(TEWL)、表皮油脂含量、角质层含水量]水平变化。结果:联合组治疗6个月后疗效相关指标、皮肤菌群(微球菌、痤疮丙酸杆菌)、疾病相关激素水平(FSH、E2、MSH、LPO)均显著低于软膏组及激光组(P<0.05);SOD水平显著高于软膏组及激光组(P<0.05)。治疗6个月后,三组患者需氧革兰阴性杆菌数量、皮肤生理参数均差异无统计学意义(P>0.05)。治疗后1年进行随访时发现,联合组复发率为33.22%(13/39)低于软膏组复发率42.11%(16/38)、激光组复发率为47.37%(18/38),但三组差异均无统计学意义(P>0.05)。结论:积雪苷霜软膏联合调Q1064 nm激光对黄褐斑患者皮肤具有良好疗效,能够明显改善机体相关激素水平,调节皮肤微环境,维持皮肤屏障正常功能,具有较高安全性。Objective To explore the skin cosmetic effect of asiaticoside ointment combined with Q-switched 1064nm laser on patients with chloasma.Methods Patients with chloasma in department of dermatology of the author's hospital were selected from January 2021 to January 2022 as the study subjects,and were randomly divided into ointment group,laser group and combined group with 42 cases in each group by simple sampling method.The ointment group was treated with asiaticoside ointment alone,and the laser group received Q-switched 1064 nm laser alone,and the observation group was given Q-switched 1064nm laser combined with asiaticoside ointment.The occurrence of adverse reactions,and cosmetic effect[melasma area severity index(MASI),melanin index,melasma color,telangiectasia score],skin flora(Micrococcus,aerobic Gramnegative bacilli,Propionibacterium acnes),disease-related hormones[serum follicle stimulating hormone(FSH),estradiol(E2),melanocyte stimulating hormone(MSH),superoxide dismutase(SOD),lipid peroxide(LPO)]and skin physiological parameters[transepidermal water loss(TEWL),epidermal oil content,stratum corneum water content]before treatment and after 6 months of treatment were compared among the three groups.Results After 6 months of treatment,the related indicators of cosmetic effect,skin flora(Micrococcus,Propionibacterium acnes)and disease-related hormones(FSH,E2,MSH,LPO)in combined group were significantly lower than those in ointment group and laser group(P<0.05)while the level of SOD was significantly higher than that in ointment group and laser group(P<0.05).There were no obvious differences in the aerobic Gram-negative bacilli count and skin physiological parameters among the three groups after 6 months of treatment(P>0.05).Follow-up at 1 year after treatment found that the recurrence rate in combined group[33.22%(13/39)]was lower than that in ointment group[42.11%(16/38)]and laser group[47.37%(18/38)](P>0.05).Conclusion Asiaticoside ointment combined with Q-switched 1064nm laser has a good cosmetic effect on

关 键 词：积雪苷霜软膏 调Q1064 nm激光 黄褐斑 皮肤菌群 皮肤生理参数 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]