中华皮肤科杂志 ›› 2009, Vol. 42 ›› Issue (2): 81-84.

• 论著 • 上一篇    下一篇

5% 5-氨基酮戊酸光动力疗法治疗痤疮的随机对照研究

林孟盈 丁蕙琳 项蕾红   

  1. 复旦大学附属华山医院皮肤科 上海复旦大学附属华山医院皮肤科 复旦大学附属华山医院皮肤科
  • 收稿日期:2008-04-14 修回日期:2008-11-17 出版日期:2009-02-15 发布日期:2009-02-15
  • 通讯作者: 林孟盈 E-mail:queenofcat@hotmail.com

Photodynamic therapy with 5% 5-aminolevulinic acid in the treatment of acne: a randomized, controlled trial

LIN Mao-Ying Lei-hong Xiang   

  • Received:2008-04-14 Revised:2008-11-17 Online:2009-02-15 Published:2009-02-15
  • Contact: LIN Mao-Ying E-mail:queenofcat@hotmail.com

摘要:

目的 探讨低浓度光敏剂、短时间封包、红光光源的光动力疗法治疗痤疮的临床疗效。方法30例面部痤疮患者随机、单盲分为两组,1组外敷5% 5-氨基酮戊酸(ALA)于右侧面部皮损处,左侧面部外敷安慰剂;另1组外敷5% ALA于左侧面部皮损,右侧面部外敷安慰剂。均采用红光照射全面部,每周1次,共4次。每次随访记录皮损数量、测量皮脂含量和色素指数。同时,记录治疗过程中出现的不良反应。结果 治疗结束后的第2周,试验侧25.9 %的患者皮损改善达到60%以上,而对照侧的皮损改善均低于60%。疗效分析显示,试验侧的疗效要优于对照侧(P < 0.05)。试验侧的所有皮损计数,包括粉刺、丘疹、脓疱、囊肿/结节及总计数,与基线比较皮损的计数都减少(P < 0.05)。而对照侧,只有脓疱和总计数与基线比较计数减少(P < 0.05)。结论 5% ALA-PDT和单用红光治疗痤疮都能使皮损有不同程度的减少,但5%ALA-PDT疗效优于单用红光,不良反应较轻。

关键词: 光动力疗法;5-氨基酮戊酸;痤疮;疗效;不良反应

Abstract:

Objective To investigate the clinical efficacy of photodynamic therapy using low concentration of photosensitizer, short incubation time and red light source in the treatment of acne. Methods Thirty patients with facial acne were equally randomized into two groups, one group applying 5% 5-aminolevulinic acid (ALA) to the facial lesions on the right side and placebo agent on the left side as control, the other applying the same concentration of ALA to the facial lesions on the left side and placebo agent on the right side as control. The whole face of every subject was irradiated with red light once a week for 4 sessions. The lesions were counted by a dermatologist, sebum production was measured by a sebum meter (SHP88) and pigmentation index by Mexameter?誖 MX 18, at the baseline and on week 2, 4, 8 after the last treatment. Adverse effects were also recorded at each visit. Results Two weeks after the last treatment, a sixty percent or more clinical improvement was achieved in the ALA-treated side of 25.9% patients, but no patients experienced sixty or more percent clinical improvement in control side, and the efficacy of ALA was superior to that of the placebo (P < 0.05). A significant reduction was noticed in the count of every kind of lesions, including comedo, papules, pustules, cysts/nodules, as well as the total count of these lesions compared with the baseline (all P < 0.05); meanwhile, only the pustule count and total count of lesions were decreased in the control side (both P < 0.05). Conclusions Both ALA (5%) -PDT and red light-irradiation alone can reduce the number of acne lesions, but the former is more effective than the latter with few side reactions.

Key words: Photodynamic therapy;5-aminolevulinic acid;Acne;Efficacy;Adverse effects