重复低能量强脉冲光治疗痤疮的临床观察

袁绍辉+张小敏+陈剑钊+孙志平+王柳均+钟桂连+林欢儿+曾文军

【摘要】 目的 评价重复低能量强脉冲光治疗痤疮的疗效及安全性。方法 80例痤疮患者， 随机分为试验组和对照组， 每组40例。试验组采用重复低能量强脉沖光连续治疗2次， 对照组采用正常能量强脉冲光治疗1次。治疗后评价两组患者的临床疗效及不良反应。结果 两组患者治疗后的皮疹均明显改善。试验组痊愈率为57.5%， 总有效率为85.0%；对照组痊愈率为32.5%， 总有效率为75.0%。试验组痊愈率高于对照组， 差异有统计学意义（P<0.05）， 试验组总有效率略高于对照组， 但差异无统计学意义（P>0.05）。试验组疼痛评分低于对照组， 差异有统计学意义（P<0.05）。两组红斑、水疱、继发性色素沉着等不良反应发生率比较差异无统计学意义（P>0.05）。结论 重复低能量强脉冲光治疗痤疮疗效优于单次高能量强脉冲光， 且不增加不良反应。

【关键词】 痤疮；低能量；强脉冲光；临床观察

DOI：10.14163/j.cnki.11-5547/r.2018.01.012

【Abstract】 Objective To evaluate the efficacy and safety of repeated low-energy intense pulsed light in the treatment of acne. Methods A total of 80 acne patients were randomly divided into experimental group and control group， with 40 cases in each group. The experimental group received repeated low-energy intense pulsed light for 2 consecutive times， and the control group received normal energy intense pulsed light for 1 time. Evaluation were made on clinical efficacy and adverse reactions after treatment between two groups. Results The rash in the two groups was significantly improved after treatment. The experimental group had cure rate as 57.5% and total effective rate as 85.0%， while the control group had cure rate as 32.5% and total effective rate as 75.0%. The experimental group had higher cure rate than the control group， and the difference was statistically significant （P<0.05）. The experimental group had little higher total effective rate than the control group， but the difference was not statistically significant （P>0.05）. The experimental group had lower pain score than the control group， and the difference was statistically significant （P<0.05）. Both groups had no statistically significant difference in incidence of adverse reactions of erythema， blisters， secondary pigmentation （P>0.05）. Conclusion Repeated low-energy intense pulsed light provides better efficacy than single high-energy intense pulsed light without increasing adverse reactions.

【Key words】 Acne； Low-energy； Intense pulsed light； Clinical observation

强脉冲光（intense pulsed light， IPL）是近年发展起来治疗痤疮的新手段， 相较传统的治疗方法， 患者不需要系统用药， 具有简便、不良反应少等优势。本科2016年初采用强脉冲光治疗痤疮， 取得满意的疗效， 尤其采用重复低能量强脉冲光治疗痤疮疗效更好， 且不增加不良反应， 现报告如下。

1 资料与方法

1. 1 一般资料 选取2016年1月～2017年5月本院门诊就诊80例寻常痤疮患者， 其中男35例， 女45例， 年龄18～35岁， 病程3个月～5年。痤疮诊断参考赵辨主编的《中国临床皮肤病学》[1]， 其中Ⅰ级25例， Ⅱ级45例， Ⅲ级10例。患者治疗前1个月均未口服抗生素或其他系统抗痤疮药物， 未口服光敏感药物及其他可能对治疗产生影响的药物。排除妊娠或哺乳期妇女、职业性痤疮、药物或化学物品引起的痤疮、合并红斑狼疮等自身免疫性疾病者、癫痫、瘢痕体质、湿疹等变态反应性疾病者、自身对光过敏者、糖尿病及有严重系统损害的患者、严重免疫功能低下、有精神病史及其他皮肤病史者。所有患者均签署知情同意书。随机将患者分为试验组和对照组， 各40例。endprint