中华皮肤科杂志 ›› 2017, Vol. 50 ›› Issue (3): 177-181.

• 论著 • 上一篇    下一篇

强脉冲光及595 nm染料激光治疗面部痤疮后红斑自身对比研究

苏虹1,杨智2,谭雅心1,石航1,陈媛3,姜嵩4,张艺琼1,熊英4,何黎5   

  1. 1. 昆明医科大学第一附属医院
    2. 昆明医学院第一附属医院皮肤科
    3. 云南省第一人民医院
    4. 昆明医科大学第一附属医院皮肤科
    5. 昆明市昆明医学院第一附属医院皮肤科
  • 收稿日期:2016-11-02 修回日期:2016-12-05 发布日期:2017-03-01
  • 通讯作者: 杨智 E-mail:vipyz@126.com
  • 基金资助:
    1064nm激光对小鼠皮肤光老化信号传导通路影响;基于MAPK信号转导通路探讨1064nm激光嫩肤机制研究

A comparative split?face study of intense pulsed light versus 595?nm pulsed dye laser in the treatment of post?acne erythema

  • Received:2016-11-02 Revised:2016-12-05 Published:2017-03-01

摘要: 目的 评价及对比强脉冲光和595 nm染料激光治疗痤疮后红斑的临床疗效及安全性。方法 采用随机自身左右面部对照临床试验研究方法,选取20例患有痤疮后红斑的患者,每例患者的两侧面颊随机分配接受强脉冲光或595 nm染料激光治疗3次,每次间隔4周。分别在每次治疗前以及最后1次治疗1个月后使用VISIA拍照,测量红斑值;通过四分红斑严重程度表评价治疗前后双侧面部红斑严重程度。每次治疗后均填写疼痛评分表、不良反应记录表,最后1次随访通过问卷形式对患者进行满意度调查。结果 强脉冲光侧平均红斑值治疗前472.25 ± 86.02,治疗后357.15 ± 82.71;595 nm染料激光侧治疗前476.40 ± 74.25,治疗后360.05 ± 64.83,经重复测量资料方差分析,可以认为随治疗时间延长,患者红斑值有所降低(F = 197.666,P<0.001);强脉冲光侧治疗效果优于595 nm染料激光侧(F = 1 173.909,P<0.001)。强脉冲光侧治疗前后四分红斑值差异有统计学意义(Z = 28.735,P<0.001),595 nm染料激光侧差异亦有统计学意义(Z = 31.450,P<0.001)。激光术后VAS视觉评分发现,595 nm染料激光治疗侧疼痛度低于强脉冲光,两者差异有统计学意义(t = 2.468,P<0.05)。评价满意和非常满意的患者595 nm染料激光17例,强脉冲光15例,两组差异无统计学意义(Z = 2.696,P>0.05)。强脉冲光不良反应包括红斑、灼烧感、紧绷感、水疱、色素沉着,595 nm染料激光不良反应包括红斑、紫癜反应,均在数小时至数天消失。结论 应用强脉冲光及595 nm染料激光治疗痤疮后红斑均安全有效,适合临床推广应用,强脉冲光相较于595 nm染料激光疗效更优,但疼痛度更高。

Abstract: Su Hong, Yang Zhi, Tan Yaxin, Shi Hang, Chen Yuan, Jiang Song, Zhang Yiqiong, Xiong Ying, He Li Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China (Su H, Yang Z, Tan YX, Shi H, Jiang S, Zhang YQ, Xiong Y, He L); Department of Dermatology and Venereology, First People′s Hospital of Yunnan Province (Chen Y) Corresponding author: Yang Zhi, Email: vipyz@126.com 【Abstract】 Objective To evaluate and compare the clinical efficacy and safety of intense pulsed light (IPL) versus 595?nm pulsed dye laser (PDL) for the treatment of post?acne erythema. Methods A randomized split?face clinical trial was conducted. A total of 20 patients with post?acne erythema were enrolled, and randomized to receive treatment with IPL on one half of the face and 595?nm PDL on the other facial side once every 4 weeks for 3 sessions. Digital photographs were taken using the VISIA, and erythema index was recorded before each treatment and one month after the last treatment. The severity of bilateral facial erythema was evaluated based on a 4?point grading scale before the first treatment and after the last treatment. Pain scores and adverse reactions were recorded using a visual analogue scale (VAS) after each treatment, and a patient satisfaction survey was conducted by questionnaire at the last follow?up. Results The mean erythema index on the IPL side before and after treatment was 472.25 ± 86.02 and 357.15 ± 82.71 respectively, and that on the PDL side before and after treatment was 476.40 ± 74.25 and 360.05 ± 64.83 respectively. Repeated measures analysis of variance (ANOVA) showed that the erythema indices on both treated sides signi?cantly decreased over time (F = 197.666, P < 0.001), and the efficacy of IPL was better than that of PDL (F = 1 173.909, P < 0.001). Erythema severity grades on the IPL side as well as on the PDL side significantly differed between before and after treatment (Z = 28.735, 31.450, respectively, both P < 0.001). As VAS showed, the pain score on the PDL side was significantly lower than that on the IPL side (t = 2.468, P < 0.05). Among the 20 patients, 17 and 15 assessed their improvement as good or excellent after PDL and IPL treatment respectively, but there was no significant difference between the two groups (Z = 2.696, P > 0.05). The adverse reactions included erythema, burning sensation, tense sensation, blistering and hyperpigmentation on IPL?treated side, and erythema and purpuric reactions on the PDL?treated side, which all disappeared in a few hours to several days. Conclusions Both IPL and 595?nm PDL are effective and safe for the treatment of post?acne erythema, and are worthy of clinical promotion and application. IPL shows superiority in the efficacy, but elicits higher pain sensation compared with PDL.

中图分类号: 

  • R751

引用本文

苏虹 杨智 谭雅心 石航 陈媛 姜嵩 张艺琼 熊英 何黎. 强脉冲光及595 nm染料激光治疗面部痤疮后红斑自身对比研究[J]. 中华皮肤科杂志, 2017,50(3):177-181. doi: