m22强脉冲光联合595nm染料激光治疗寻常痤疮临床观察

党辉　李微　马瑛

[摘要]目的：研究m22強脉冲光（Intense pulsed light，IPL）联合595nm染料激光治疗寻常痤疮的临床效果。方法：按随机数表法将笔者医院2018年6月-2020年8月诊治的223例寻常痤疮患者分为A组（76例）、B组（70例）和联合组（77例），A组：给予595nm染料激光治疗，B组给予m22 IPL治疗，联合组给予m22 IPL联合595nm染料激光治疗。比较三组患者治疗前后疼痛、红斑皮损情况以及炎症因子水平，评估其生活质量、疗效和安全性。结果：治疗后，联合组患者治疗有效率为96.10%，高于A组（86.84%）、B组（84.29%）（P<0.05）;治疗前，三组患者红斑皮损分级比较无显著性差异（P>0.05）;治疗后，联合组严重程度明显低于A、B组（P<0.05），三组3次治疗疼痛程度比较均无显著性差异（P>0.05），三组患者烧灼感、色素沉着、刺痛以及紫癜发生率比较无显著差异（P>0.05）;治疗前，三组患者TNF-α、IL-6水平比较无显著性差异（P>0.05），治疗后，联合组患者炎症因子水平显著低于A、B组（P<0.05）;治疗前，三组患者生活质量各项评分比较无显著性差异（P>0.05），治疗后联合组分值均显著低于A、B组（P<0.05）。结论：m22 IPL联合595nm染料激光治疗寻常痤疮可有效提高疗效，改善患者红斑、皮损情况，减轻机体炎症反应，提高其生活质量，但并不增加不良反应和治疗疼痛度，值得临床推广应用。

[关键词]m22强脉冲光;595nm染料激光;寻常痤疮;红斑皮损;炎症因子

[中图分类号]R758.73+3    [文献标志码]A    [文章编号]1008-6455（2021）09-0107-04

Clinical Effects of m22 Intense Pulsed Light Combined with 595nm Dye Laser in the Treatment of Acne Vulgaris

DANG Hui，LI Wei，MA Ying

（Department of Plastic Surgery，the First Affiliated Hospital of Air Force Medical University，Xi'an 710032，Shaanxi，China）

Abstract： Objective  To study the clinical effects of m22 intense pulsed light （IPL） combined with 595nm dye laser in the treatment of acne vulgaris. Methods  Using random number table method， 223 patients with acne vulgaris diagnosed and treated in the hospital from June 2018 to August 2020 were divided into group A （76 cases） ， group B （70 cases） and combined group （77 cases）. Group A were treated with 595 dye laser， group B were treated with m22 IPL， and the combined group were treated with m22IPL and 595 dye laser. Pain， erythema skin lesions and levels of inflammatory factors before and after treatment were compared among the three groups. Quality of life， curative effect and safety were evaluated. Results The effective rate of treatment in the combined group was 96.10%， higher than 86.84% in group A and 84.29% in group B （P<0.05）. There was no significant difference in the classification of erythema skin lesions among the three groups before treatment （P>0.05）， but the severity in the combined group was significantly lower than that  in group A and group B after treatment（P<0.05）. No significant differences were found in pain degree during 3 treatments or in the incidences of burning sensation， pigmentation， pricking and purpura purpura among the three groups （P>0.05）. There were no significant differences in the levels of TNF-α and IL-6， and quality of life scores among the three groups before treatment （P>0.05）. After treatment， the levels of inflammatory factors and quality of life scores in the combined group were significantly lower than those in group A and group B （P<0.05）. Conclusion  The m22 IPL combined with 595nm dye laser can effectively improve the curative effect in the treatment of patients with acne vulgaris as it can relieve erythema， skin lesions and inflammatory response， and improve quality of life， without increasing adverse reactions and pain.

Key words： m22 intense pulsed light; 595nm dye laser; acne vulgaris; erythema lesion; inflammatory factor

寻常痤疮是一种由多基因遗传决定的、多种环境因素共同作用引起的慢性炎症性疾病。目前，临床对于寻常痤疮的发生机制尚未明确，多数学者认为是病菌感染、油脂分泌增加、炎症反应、饮食以及压力等多种因素共同作用的结果[1-2]。临床常采用药物及物理治疗，常用药物包括激素类、维生素类及锌制剂等[3]，但药物治疗长期应用均存在一定的局限性，如：激素类药物易导致子宫内膜过度增生，维生素类药物易导致月经紊乱，锌制剂易与胃酸作用等。随着光电类治疗设备的发展，一些新的研究表明物理治疗也具有较好的效果。强脉冲……