中华皮肤科杂志 ›› 2010, Vol. 43 ›› Issue (4): 245-248.

• 论著 • 上一篇    下一篇

不同浓度氨基酮戊酸光动力治疗中重度痤疮疗效观察

尹锐1,郝飞1,邓军2,周春丽3,阎衡4   

  1. 1. 重庆第三军医大学西南医院皮肤科
    2. 第三军医大学附属西南医院星源激光治疗中心
    3. 重庆市第三军医大学西南医院皮肤科 400038
    4. 重庆市第三军医大学西南医院皮肤科
  • 收稿日期:2009-06-09 修回日期:2009-07-10 出版日期:2010-04-15 发布日期:2010-04-07
  • 通讯作者: 尹锐 E-mail:swyinrui@163.com

Photodynamic therapy with different concentrations of aminolevulinic acid in the treatment of moderate to severe acne

  • Received:2009-06-09 Revised:2009-07-10 Online:2010-04-15 Published:2010-04-07

PDF

278

赞

摘要：

目的 探讨不同浓度氨基酮戊酸光动力疗法（ALA-PDT）治疗中重度痤疮的有效性及安全性。方法 采用随机、自身对照的方法将180例患者分为5％、10%、15%、20% ALA 4个治疗组，患者一侧面部外敷ALA，另一侧面部外敷安慰剂。均采用相同剂量的红光进行照射，每周1次，共4次。在治疗结束后第2周、1个月、3个月、6个月分别进行随访，记录皮损消退情况及不良反应。结果 治疗结束后随访，各治疗组皮损改善情况与对照组相比，差异均有统计学意义（P < 0.05）。至第6个月随访，试验侧有效率5% ALA组为79.55％，10% ALA组为88.37％，15% ALA组为95.24％，20% ALA组为97.73％，疗效均明显优于对照侧，差异有统计学意义（P < 0.05）。试验侧各浓度组间比较，随浓度增加，有效率明显增加，差异有统计学意义（P < 0.05）。从不良反应看，ALA浓度越高，红肿及色素沉着等不良反应的发生率越高，但无瘢痕形成。结论 ALA-PDT治疗中重度痤疮疗效明显优于单用红光治疗，结合临床有效率和安全性，10%和15% ALA-PDT治疗能达到较满意的疗效。

关键词: 痤疮, 光化学疗法, 浓度, 疗效, 氨基酮戊酸

Abstract:

Objective To investigate the efficacy and safety of photodynamic therapy using different concentrations of aminolevulinic acid （ALA） in the treatment of moderate to severe acne. Methods One hundred and eighty patients with moderate to severe acne were randomly divided into 4 groups to apply different concentrations （5%, 10%, 15%, 20%） of ALA to acne lesions on the right side and placebo agent on the left side of faces as control. The whole face was irradiated with red light once a week for 4 sessions. The subsidence of lesions was evaluated by a dermatologist at the baseline and on week 2, 1 month, 3 month, and 6 month after the last treatment. Adverse effects were recorded at each follow-up visit. Results At the end of treatment, a stronger improvement was observed in ALA-treated lesions compared with those treated with red light alone （P < 0.05）. Six months after the last treatment, the effective rates were 79.55％, 88.37％, 95.24％, 97.73％ in lesions treated with ALA of 5%, 10%, 15% and 20% , respectively, significantly higher than those treated with placebo （11.51%, 9.82%, 13.50%, 10.07%, all P < 0.05）. With the elevation of ALA concentration, the effective rate together with incidence of adverse reactions including erythematous swelling and hyperpigmentation increased （all P < 0.05）. No scarring was noted. Conclusions The clinical effect of ALA-PDT is superior to that of red light alone in the treatment of moderate to severe acne. In view of effectiveness and safety, ALA-PDT using 10% or 15% ALA is recommended for the treatment of moderate to severe acne.

Key words: Acne, Aminolevulinic acid, Photochemotherapy, Concentration, Efficacy