IPL联合果酸治疗中重度痤疮的临床研究
发布时间：2018-07-15 08:03
【摘要】：目的探讨IPL(Intense Pulsed Laser,强脉冲光)联合果酸治疗中重度痤疮的临床疗效与安全性。方法根据痤疮诊断标准和严重程度分级选取门诊中重度痤疮患者61例,所有患者均完成试验,年龄在18岁-35岁之间,随机分为三组:A组16例,B组23例,C组22例。治疗前详细了解患者基本情况并向患者仔细交代注意事项。每次治疗前彻底清洁患者面部皮肤,由同一位观察者确定皮损程度及类型,记录皮损的改善情况,并进行疗效与安全性评价。A组:IPL联合果酸治疗;B组:单纯果酸治疗;C组:单纯IPL治疗。分别在治疗结束后第4、8周末评估最终疗效。结果三组患者性别、年龄、病程和痤疮严重程度均无统计学差异(P0.05),具有可比性。治疗结束后4周时,A组16例中5例痊愈,显效7例,有效3例,无效1例,痊愈率为31.25%,总有效率为75.00%;炎性皮损减退率为74.00%,非炎性皮损减退率为65.00%。B组23例中3例痊愈,显效8例,有效8例,无效4例,痊愈率为13.04%,总有效率为47.83%;炎性皮损减退率为65.00%,非炎性皮损减退率为65.00%。C组22例中4例痊愈,显效10例,有效6例,无效2例,痊愈率为18.18%,总有效率为63.64%;炎性皮损减退率为49.00%,非炎性皮损减退率为49.00%。治疗结束后8周时,A组16例中6例痊愈,显效8例,有效1例,无效1例,痊愈率为37.50%,总有效率为87.50%;炎性皮损减退率为79.00%,非炎性皮损减退率为73.00%。B组23例中4例痊愈,显效8例,有效8例,无效3例,痊愈率为17.39%,总有效率为52.17%;炎性皮损减退率为69.00%,非炎性皮损减退率为65.00%。C组22例中3例痊愈,显效8例,有效8例,无效3例,痊愈率为13.64%,总有效率为50.00%;炎性皮损减退率为60.00%,非炎性皮损减退率为45.00%。治疗结束后4、8周后对三组疗效进行比较,结果A组疗效优于B和C组,其中A组对炎性丘疹及脓疱效果更好,炎性结节明显减退。首次治疗(果酸浓度20%)出现的即刻反应中,39位受试者中14位面颊部或额部出现轻度红斑,25位患者出现中度红斑(尤以皮损处明显),终止治疗后红斑即刻减轻;所有IPL及果酸治疗患者(除个别出现较明显疼痛感(经多次治疗后均能耐受))仅出现微弱的刺痛感。16例患者在使用果酸换肤治疗后出现皮肤干燥,轻微脱屑,经保湿润肤后好转,4例患者在第1次治疗后皮损数量增多,经过多次治疗后皮损明显减少。IPL治疗反应较一致,均出现短暂性红斑反应,持续数小时或经冷敷后消退,无色素沉着及色素减退。结论IPL联合果酸治疗中重度痤疮疗效优于单独治疗。两者治疗中重度痤疮具有协同作用,疗效更好;治疗时间短,几乎没有误工期,治疗过程中出现痛苦较小,患者依从性高,远期疗效较明显。是一种起效快,疗效好,不良反应可控的治疗方法,值得推广。
[Abstract]:Objective to investigate the clinical efficacy and safety of IPL (Intense Pulsed Laser) combined with fruit acid in the treatment of moderate and severe acne. Methods Sixty-one patients with moderate and severe acne were selected according to the criteria of acne diagnosis and severity classification. All the patients, aged between 18 and 35, were randomly divided into three groups: group A, n = 16, group B, n = 23, group C, n = 22. Before treatment, understand the patient's basic situation in detail and explain the matters needing attention carefully to the patient. Before each treatment, the patient's facial skin was thoroughly cleaned. The same observer determined the extent and type of skin lesions and recorded the improvement of the lesions. The curative effect and safety were evaluated. Group A: 1: IPL combined with fruit acid. Group B: group C: simple IPL. The final outcome was evaluated at the end of the 8th week after treatment. Results there was no significant difference in sex, age, course of disease and severity of acne among the three groups (P0.05). In group A, 5 cases were cured, 7 cases were effective, 3 cases were effective, 1 case was ineffective, the cure rate was 31.25 and the total effective rate was 75.000.The rate of inflammatory hypodermosis was 74.00 and that of non-inflammatory lesion was 65.00.B. 8 cases were effective, 4 cases were ineffective, the cure rate was 13.04 and the total effective rate was 47.83, the decrease rate of inflammatory lesions was 65.00, and the rate of non-inflammatory lesions was 65.00. C group, 4 cases were cured, 10 cases were effective, 6 cases were effective, 2 cases were ineffective. The cure rate was 18.18 and the total effective rate was 63.64. The decrease rate of inflammatory lesions and non-inflammatory lesions was 49.00 and 49.00 respectively. In group A, 6 cases were cured, 8 cases were effective, 1 case was ineffective, the cure rate was 37.50, and the total effective rate was 87.50%. Effective 8 cases, ineffective 3 cases, cure rate 17.39%, total effective rate 52.17, inflammatory lesion decrease rate 69.00%, non-inflammatory lesion decline rate 65.00% 3 cases cured, remarkable effect 8 cases, effective 8 cases, ineffective 3 cases. The cure rate was 13.64 and the total effective rate was 50.00.The decrease rate of inflammatory lesions and non-inflammatory lesions was 60.00and 45.00 respectively. The results showed that the curative effect of group A was better than that of group B and C, and group A had better effect on inflammatory papules and pustules, and inflammatory nodules decreased obviously. Mild erythema appeared in 14 of 39 subjects (20%) in the first treatment (20% acid concentration). Mild erythema was found in 25 patients (especially in the lesions), and the erythema was alleviated immediately after the termination of treatment. All patients treated with IPL and fruit acid (except individual patients with obvious pain (which can be tolerated after several treatments) had only weak tingling sensation. 16 patients had dry skin and slightly desquamated skin after skin replacement therapy with fruit acid. After moisturizing and moisturizing the skin, the number of skin lesions in 4 patients increased after the first treatment. After several treatments, the skin lesions decreased obviously. The response of IPL was consistent, and all of them had transient erythema reaction, which lasted for several hours or subsided after cold compress. No pigmentation and hypopigmentation. Conclusion IPL combined with fruit acid is more effective than single treatment in the treatment of moderate and severe acne. The treatment of moderate and severe acne has synergistic effect and better curative effect. The treatment time is short, there is almost no delay period, the pain in the treatment process is small, the patient compliance is high, and the long-term effect is obvious. It is an effective, effective and controllable treatment method with adverse reaction, which is worth popularizing.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.733
本文编号：2123409
[Abstract]:Objective to investigate the clinical efficacy and safety of IPL (Intense Pulsed Laser) combined with fruit acid in the treatment of moderate and severe acne. Methods Sixty-one patients with moderate and severe acne were selected according to the criteria of acne diagnosis and severity classification. All the patients, aged between 18 and 35, were randomly divided into three groups: group A, n = 16, group B, n = 23, group C, n = 22. Before treatment, understand the patient's basic situation in detail and explain the matters needing attention carefully to the patient. Before each treatment, the patient's facial skin was thoroughly cleaned. The same observer determined the extent and type of skin lesions and recorded the improvement of the lesions. The curative effect and safety were evaluated. Group A: 1: IPL combined with fruit acid. Group B: group C: simple IPL. The final outcome was evaluated at the end of the 8th week after treatment. Results there was no significant difference in sex, age, course of disease and severity of acne among the three groups (P0.05). In group A, 5 cases were cured, 7 cases were effective, 3 cases were effective, 1 case was ineffective, the cure rate was 31.25 and the total effective rate was 75.000.The rate of inflammatory hypodermosis was 74.00 and that of non-inflammatory lesion was 65.00.B. 8 cases were effective, 4 cases were ineffective, the cure rate was 13.04 and the total effective rate was 47.83, the decrease rate of inflammatory lesions was 65.00, and the rate of non-inflammatory lesions was 65.00. C group, 4 cases were cured, 10 cases were effective, 6 cases were effective, 2 cases were ineffective. The cure rate was 18.18 and the total effective rate was 63.64. The decrease rate of inflammatory lesions and non-inflammatory lesions was 49.00 and 49.00 respectively. In group A, 6 cases were cured, 8 cases were effective, 1 case was ineffective, the cure rate was 37.50, and the total effective rate was 87.50%. Effective 8 cases, ineffective 3 cases, cure rate 17.39%, total effective rate 52.17, inflammatory lesion decrease rate 69.00%, non-inflammatory lesion decline rate 65.00% 3 cases cured, remarkable effect 8 cases, effective 8 cases, ineffective 3 cases. The cure rate was 13.64 and the total effective rate was 50.00.The decrease rate of inflammatory lesions and non-inflammatory lesions was 60.00and 45.00 respectively. The results showed that the curative effect of group A was better than that of group B and C, and group A had better effect on inflammatory papules and pustules, and inflammatory nodules decreased obviously. Mild erythema appeared in 14 of 39 subjects (20%) in the first treatment (20% acid concentration). Mild erythema was found in 25 patients (especially in the lesions), and the erythema was alleviated immediately after the termination of treatment. All patients treated with IPL and fruit acid (except individual patients with obvious pain (which can be tolerated after several treatments) had only weak tingling sensation. 16 patients had dry skin and slightly desquamated skin after skin replacement therapy with fruit acid. After moisturizing and moisturizing the skin, the number of skin lesions in 4 patients increased after the first treatment. After several treatments, the skin lesions decreased obviously. The response of IPL was consistent, and all of them had transient erythema reaction, which lasted for several hours or subsided after cold compress. No pigmentation and hypopigmentation. Conclusion IPL combined with fruit acid is more effective than single treatment in the treatment of moderate and severe acne. The treatment of moderate and severe acne has synergistic effect and better curative effect. The treatment time is short, there is almost no delay period, the pain in the treatment process is small, the patient compliance is high, and the long-term effect is obvious. It is an effective, effective and controllable treatment method with adverse reaction, which is worth popularizing.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.733
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