关键词: 静脉曲张, 硬化疗法, 葡糖氨基聚糖类, 激光疗法, 治疗结果, 淤积性皮炎

Abstract: Chen Mingyi, Ying Chuanpeng, Luo Dongsheng, Wu Dongmei, Yang Jianing, Dai Gengwu Department of Dermatology, Sichuan Academy of Medical Science and Sichuan Provincial People′s Hospital, Chengdu 610072, China Corresponding author: Chen Mingyi, Email: chenmingyi1980@hotmail.com 【Abstract】 Objective To evaluate the therapeutic effect of endovenous laser ablation（ELA）combined with foam sclerotherapy （FS） and mucopolysaccharide polysulfate（MP）cream on stasis dermatitis. Methods From December 2015 to May 2017, 52 patients with 60 lesional limbs were enrolled from Department of Dermatology of Sichuan Provincial People′s Hospital. The 60 lesional limbs were randomly and equally divided into 3 groups by a random number table and remainder grouping: combination group, MP group and control group. All the 3 groups were firstly treated with ELA in the main great saphenous vein. Then, the combination group was treated with FS followed by topical MP cream for 4 weeks. After the laser therapy, the MP group was treated with topical MP cream for 4 weeks, and the control group was treated with topical mometasone furoate cream alone for 4 weeks. The eczema area and severity index （EASI） and visual analogue scale （VAS） for itching scores in the above 3 group were recorded before treatment and 4 weeks after treatment. Statistical analysis was done by paired t-test for comparisons before and after treatment, one-way analysis of variance （ANOVA） for intergroup comparison, and least significant difference （LSD）-t test for multiple comparisons. Results No significant difference was observed before treatment among the combination group, MP group and control group in the EASI （9.64 ± 4.58, 9.94 ± 4.18, 9.50 ± 4.41 respectively, F = 0.052, P > 0.05） or VAS scores （7.25 ± 1.29, 7.50 ± 1.19, 7.45 ± 1.32 respectively, F = 0.218, P > 0.05）. After 4-week treatment, the combination group, MP group and control group all showed significantly decreased EASI （3.54 ± 1.57, 5.86 ± 2.39, 7.04 ± 2.75 respectively） and VAS scores （2.35 ± 0.67, 3.85 ± 0.67, 4.65 ± 1.23 respectively） compared with those before treatment （t = 4.30 - 18.80, all P < 0.05）. After 4-week treatment, the EASI score was significantly lower in the combination group than in the MP group and control group （both P < 0.05）, while there was no significant difference between the MP group and control group （P > 0.05）. Additionally, the VAS score was significantly lower in the combination group than in the MP group and control group （both P < 0.05）, as well as in the MP group than in the control group （P < 0.05）. Conclusions ELA combined with FS and topical MP cream shows better short-term efficacy for the treatment of stasis dermatitis compared with ELA combined with topical MP cream or mometasone furoate cream. The combination with topical MP cream is superior to that with topical mometasone furoate cream in improving itching. The long-term efficacy needs to be observed further.

Key words: Varicose veins, Sclerotherapy, Glycosaminoglycans, Laser therapy, Treatment outcome, Stasis dermatitis