5-氨基酮戊酸-光动力联合小剂量异维A酸治疗玫瑰痤疮的疗效及安全性研究

Efficacy and Safety Analysis on 5-Aminolevulinic Acid-Photodynamic Combined with Low-Dose Isotretinoin in the Treatment of Acne Rosacea

目的:探讨5-氨基酮戊酸(ALA)-光动力(PDT)联合小剂量异维A酸治疗玫瑰痤疮(AR)的疗效及安全性。方法:选取2022年1月至2023年1月新疆医科大学第二附属医院收治的AR患者86例,采用随机数字表法分为联合组和对照组,各43例。对照组患者采用小剂量异维A酸治疗,联合组患者采用ALA-PDT联合小剂量异维A酸治疗。比较两组患者的临床疗效,治疗前后皮肤红斑指数(EI)、痤疮特异性生活质量量表(Acne-QOL)评分、皮肤生理功能[经皮水分流失量(TEWL)、角质层含水量和pH]、角质层完整性指标(丝氨酸蛋白酶活性、粘脱蛋白质含量)及不良反应发生情况。结果:联合组患者的总有效率为95.35%(41/43),较对照组的79.07%(34/43)更高,差异有统计学意义(P<0.05)。治疗后,联合组患者的EI低于对照组,Acne-QOL评分高于对照组;联合组患者的TEWL、pH低于对照组,角质层含水量高于对照组;联合组患者的丝氨酸蛋白酶活性、粘脱蛋白质含量低于对照组,上述差异均有统计学意义(P<0.05)。联合组、对照组患者不良反应发生率分别为9.30%(4/43)、11.63%(5/43),差异无统计学意义(P>0.05)。结论:ALA-PDT联合小剂量异维A酸治疗AR,可修复患者皮肤屏障功能,改善EI,提高生活质量,疗效显著,安全性高。

OBJECTIVE:To probe into the efficacy and safety of 5-aminolevulinic acid(ALA)-photodynamic(PDT)combined with low-dose isotretinoin in the treatment of acne rosacea(AR).METHODS:A total of 86 patients with AR admitted into the Second Affiliated Hospital of Xinjiang Medical University from Jan.2022 to Jan.2023 were selected to be divided into combination group and control group via random number table method,with 43 cases in each group.The control group was treated with low-dose isotretinoin,the combination group was given ALA-PDT combined with low-dose isotretinoin.The clinical efficacy,the skin erythema indexes(EI),Acne Specific Quality of Life Scale(Acne-QOL)scores,skin physiological function[transdermal water loss(TEWL),water content of stratum corneum and pH],cuticle integrity indexes(serine protease activity,mucin content)and incidences of adverse drug reactions before and after treatment were compared between two groups.RESULTS:The total effective rate of the combination group was 95.35%(41/43),higher than 79.07%(34/43)in the control group,with statistically significant difference(P<0.05).After treatment,the EI was lower and the Acne-QOL score was higher in the combination group than those in the control group;the TEWL and pH of the combination group were lower than those of the control group,the water content of stratum corneum of the combination group was higher than that of the control group;the serine protease activity and mucin content of the combination group were lower than those of the control group,with statistically significant differences(P<0.05).The incidences of adverse drug reactions of the combination group and control group were respectively 9.30%(4/43)and 11.63%(5/43),the difference was not statistically significant(P>0.05).CONCLUSIONS:The combination of ALA-PDT with low-dose isotretinoin in the treatment of AR can repair skin barrier function,improve EI and promote patients’quality of life,with significant efficacy and high safety.