5-氨基酮戊酸光动力疗法治疗中重度痤疮的临床观察

Photodynamic therapy with 5% 5-aminolevulinic acid in the treatment of moderate to severe acne

目的:探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗中重度痤疮的安全性及有效性。方法:将42例中重度痤疮患者随机单盲分为两组:治疗组21例,给予ALA-PDT治疗,每周治疗1次,共治疗1～4次;对照组21例,单用红光照射,每周治疗1次,共治疗1～4次。在治疗后第2、4、6周对两组患者进行疗效判断和比较,同时,记录治疗过程中出现的不良反应。结果:21例接受ALA-PDT治疗的患者经过1～4次治疗后,总有效率95.2%;对照组第6周总有效率为42.9%,治疗组疗效明显优于对照组(P<0.05)。另外,ALA-PDT组复发程度明显轻于对照组,且病情控制时间明显延长。治疗组的所有皮损,包括粉刺、丘疹、脓疱、囊肿、结节等,均比对照组明显减少。结论:5%ALA-PDT和单用红光照射治疗中重度痤疮都能使痤疮皮损有不同程度的减少,但是5%ALA-PDT疗效明显优于单用红光治疗,因此,我们认为ALA-PDT是一种简单、高效、不良反应轻微的治疗中重度痤疮的新方法。

Objective To investigate the clinical efficacy and safety of photodynamic therapy using topical aminolevulinic acid in the treatment of moderate to severe acne. Methods Fourty two patients with moderate to severe facial acne were equally randomized into two groups, one group applying 5% 5-aminolevulinic acid （ALA） to the facial lesions for 1～4 sessions with an interval of 1 week, the other applying red light to the facial lesions once a week for 4 sessions as control. The patients were evaluated for efficacy on week 2, 4 and 6 after the initial treatment. Adverse effects were also recorded at each vist. Results The total effective rate was 95.2% in ALA-PDT group after 1～4 sessions of treatment, 42.9% in the control group and the difference was significant between th two groups（P〈0.05）.The lesions tended to recur more slightly with a longer remission period in ALA-PDT group than in the control group. A significant reduction was noticed in the count of every kind of lesions, including comedo, papules, pustules, cyst/nodules. Conclusions Both 5% ALA-PDT and red light-irradiation alone can reduce the number of moderate to severe acne lesions, but the former is more effective than the latter. Topical ALA-PDT is a simple and effective treatment option for moderate to severe acne with few side reaction.