不同剂量20%盐酸氨基酮戊酸光动力治疗外阴尖锐湿疣患者有效性和安全性比较

Comparison of the efficacy and safety of different doses of 20% aminolevulinic acid photodynamic therapy for patients with vulvar condyloma acuminate

目的探讨不同剂量20%盐酸氨基酮戊酸光动力(ALA-PDT)治疗外阴尖锐湿疣的有效性和安全性。方法选取2014年6月至2017年6月遂宁市中心医院诊治的86例外阴尖锐湿疣患者作为研究对象。将其简单随机分组为观察组和对照组,每组各43例。观察组采用0.5mL20%盐酸氨基酮戊酸光动力治疗,对照组采用0.25mL20%盐酸氨基酮戊酸光动力治疗,比较两组患者的治疗效果和不良反应。结果观察组1次治疗、2次治疗、3次治疗后的总有效率分别为74.4%、95.3%和97.7,均明显高于对照组同期总有效率,差异比较均具有统计学意义(均P<0.05);观察组患者1次治疗、2次治疗、3次治疗后的疣体清除率分别为76.8%、92.9%及96.4%,均明显高于对照组同期疣体清除率,差异比较均具有统计学意义(均P<0.05);治疗8周、12周及24周后,观察组患者的复发率明显低于对照组,差异比较具有统计学意义(P<0.05);观察组共出现不良反应6例(14.0%),对照组出现7例(16.3%),两组不良反应发生率差异无统计学意义(P>0.05)。结论采用0.5mL20%盐酸氨基酮戊酸光动力治疗外阴尖锐湿疣的临床疗效更佳,疣体清除率高、复发率低,且未见不良反应增多,值得在临床上推广应用。

Objective To investigate the efficacy and safety of different doses of 20%aminolevulinic acid photodynamic therapy for patients with vulvar condyloma acuminate(CA).Methods The 86 patients with vulvar CA in our hospital from June 2014 to June 2017 were selected and randomly divided into observation group(n=43)and control group(n=43).The observation group was treated with 0.5 mL20%hydrochloride aminolevulinic acid photodynamic therapy,and the control group was treated with 0.25 mL20%hydrochloric acid aminolevulinic acid photodynamic therapy.The treatment effect and adverse reaction of the two groups were compared.Results The total effective rate of the observation group was 74.4%,95.3%and 97.75%respectively after 1,2 and 3 times of treatment,which was significantly higher than that of the control group accordingly,with statistically significant differences(all P<0.05).The verruca clearance rate of the observation group was 76.8%,92.9%and 96.4%after 1,2 and 3 times of treatment,which was significantly higher than that of the control group accordingly,with statistically significant differences(all P<0.05).After 8,12 and 24 weeks of treatment,the recurrence rate of the patients in the observation group was significantly lower than that in the control group,with statistically significant differences(P<0.05).There were 6 cases of adverse reactions in the observation group(14%)and 7 cases in the control group(16.3%),without statisticlaly significant difference between the two groups(P>0.05).Conclusions Photodynamic therapy with 0.5 mL20%aminolevulinic acid is effective for the treatment of vulva CAwith high verruca clearance rate,andlow recurrence rate and incidence of side effects,which is worthy of clinical application.