强脉冲光与红光治疗糖皮质激素依赖性皮炎临床疗效分析

Intense pulsed light and red light emitting diode for the treatment of steroid-dependent dermatitis

目的回顾性分析比较强脉冲光与红光治疗糖皮质激素（简称激素）依赖性皮炎的临床疗效及不良反应。方法应用强脉冲光治疗以面部毛细血管扩张为主要表现的激素依赖性皮炎患者70例，能量密度20～23J／cm2，其中脉宽为2．6～5．0ms，延迟时间为15～20ms，间隔4周治疗1次，平均3．49次。使用波长（633±3）nm红光治疗以面部皮肤敏感为主要表现的激素依赖性皮炎患者197例，能量密度128J／cm2，每次照射20min，每周治疗2次，平均4．23次。对每次治疗的疗效及不良反应进行评价。结果强脉冲光治疗激素依赖性皮炎的总有效率为88．57％；红光治疗的总有效率为83．76％。强脉冲光3脉冲治疗组和2脉冲治疗组的疗效差异有统计学意义（x2=8．14，P〈0．05）。所有患者均未出现严重不良反应。结论强脉冲光和红光治疗激素依赖性皮炎均有较好疗效。

Objective To retrospectively review the efficacy and side effects of intense pulsed light （IPL） and red light emitting diode （LED） in the treatment of steroid-dependent dermatitis. Methods Seventy patients with steroid-dependent dermatitis mainly manifesting as facial telangiectasis were treated with IPL for an average of 3.49 sessions with a 4-week interval. The energy density of IPL varied from 20 to 23 J/cm2, pulse width from 2.6 to 5.0 ms, and delay from 15 to 20 ms. Meantime, 197 patients with steroid-dependent dermatitis, who mainly presented with facial skin sensitivity, were treated with red LED （633 ± 3 nm wave length） twice a week for an average of 4.23 sessions. The energy density of red LED was 128 J/cm2, and the irradiation lasted 20 minutes at each treatment. The efficacy and adverse reactions were assessed and recorded for each treatment. Results The total response rate was 88.57% for IPL, and 83.76% for red LED. There was a significant difference in the clinical efficacy between triple-pulse and double-pulse IPL （X2 = 8.14, P 〈 0.05 ）. No severe adverse reaction was observed in any of the patients. Conclusion IPL and red LED are both effective in treating steroid-dependent dermatitis.