皮秒激光联合中药面膜治疗黄褐斑临床治疗效果观察

doi:10.3969/j.issn.1006-7795.2023.05.020

摘要/Abstract

摘要： 目的探索755 nm皮秒激光联合中药面膜治疗黄褐斑的治疗效果与安全性。方法前瞻性招募成年女性黄褐斑患者40例，采用随机数字表法分为观察组(n=20)和对照组(n=20)。观察组每4周接受1次皮秒激光治疗，在第0、4、8周共进行3次治疗，同时加用自制中药面膜外敷，每周2次，共12周；对照组仅接受3次皮秒激光治疗。在患者第一次激光治疗前（0周）、第二次激光治疗前（4周）、末次激光治疗前（8周）、末次激光治疗结束后第4周（12周）、第8周（16周）、第12周（20周）进行改良黄褐斑面积和严重指数（Modified Melasma Area and Severity Index, mMASI）评分统计。第12周时进行医生整体评价（Physician Global Assessment, PGA）评分、有效率、患者满意度评价，治疗期间记录不良反应。结果最终观察组17例患者、对照组20例患者完成了全程治疗与随访。观察组和对照组黄褐斑经治疗后均有不同程度改善，0、4、8、12、16、20周观察组的mMASI评分依次为6.14±1.97、5.05±2.01、4.44±1.79、3.41±2.45、2.66±1.94、2.33±1.99；对照组mMASI评分依次为7.33±2.85、6.74±2.84、5.96±2.39、5.01±2.27、4.48±2.39、4.31±2.37。双因素重复测量方差分析结果显示，各观察时间点mMASI评分差异有统计学意义（P时间 <0.05），各观察时间点的mMASI评分均为观察组低于对照组，组间差异有统计学意义（P组间 <0.05），干预措施与时间之间无交互作用（P>0.05）。2组间PGA评分分布及有效率、患者满意度比较，差异均无统计学意义（P>0.05）。2组均未见明显不良反应。结论 755 nm皮秒激光联合中药面膜疗法治疗黄褐斑安全有效，患者治疗体验好。

关键词: 黄褐斑, 皮秒激光, 中药面膜

Abstract: Objective To analyze the efficacy and safety of 755 nm picosecond laser combined with traditional Chinese medicine mask in the treatment of melasma.Methods Adult female patients with melasma were recruited prospectively and randomly divided into observation group and control group. The observation group received one picosecond laser treatment every 4 weeks, three times at 0, 4 and 8 week, and applied the self-made Chinese medicine facial mask twice a week for 12 weeks. The control group received only three picosecond laser treatments. The score statistics of modified Melasma Area and Severity Index (mMASI) were performed before the first laser treatment (0 week), the second laser treatment (4 week), the last laser treatment (8 week), the fourth week after the last laser treatment (12 week), the eighth week after the last laser treatment (16 week), and the twelfth week after the last laser treatment (20 week). At 12 week, the Physician Global Assessment (PGA) score, effective rate and patient satisfaction were evaluated, and adverse reactions were recorded during treatment.Results A total of 40 patients were included, including 20 patients in the observation group and 20 patients in the control group. Totally 17 patients in the observation group and 20 patients in the control group completed the whole treatment and follow-up. After treatment, melasma in the observation group and the control group improved to varying degrees. The mMASI scores in the observation group at 0, 4, 8, 12, 16 and 20 week were 6.14±1.97, 5.05±2.01, 4.44±1.79, 3.41±2.45, 2.66±1.94, 2.33±1.99 and in the control group were 7.33±2.85, 6.74±2.84, 5.96±2.39, 5.01±2.27, 4.48±2.39, 4.31±2.37. The results of two-way repeated-measures ANOVA showed that there was a statistically significant difference in mMASI scores between observation time points (P time<0.05). The mMASI scores at each observation time point were lower in the observation group than those in the control group, and the differences between groups were statistically significant (P group<0.05). There was no interaction between intervention measures and time (P>0.05). There was no statistically significant difference in the distribution of PGA scores or patient satisfaction between the two groups (P>0.05). There were no obvious side effects in both groups.Conclusions 755 nm picosecond laser combined with traditional Chinese medicine mask is safe and effective in the treatment of melasma, and patients have good treatment experience.

Key words: melasma, picosecond laser, traditional Chinese medicine mask

中图分类号:

尚帅, 梁素蓉, 张文思, 谭安生, 梅雪岭. 皮秒激光联合中药面膜治疗黄褐斑临床治疗效果观察[J]. 首都医科大学学报, 2023, 44(5): 845-851.

Shang Shuai, Liang Surong, Zhang Wensi, Tan Ansheng, Mei Xueling. Clinical efficacy analysis of picosecond laser combined with traditional Chinese medicine mask in the treatment of melasma[J]. Journal of Capital Medical University, 2023, 44(5): 845-851.

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