光动力治疗中重度痤疮的疗效观察

Photodynamic therapy in the treatment of moderate to severe acne

目的探索5-氨基酮戊酸光动力疗法(5-aminolevulinic acid photodynamic therapy,ALA-PDT)治疗中重度痤疮的安全性及不同浓度疗效比较。方法将160例中重度痤疮患者随机分成4组,其中1组不敷药(0%)直接红光照射,另3组分别予以5%、10%、20%ALA外敷3 h后红光照射,每周1次,共4次。在第2周、第4周、第6周时分别进行疗效及不良反应的比较。结果治疗结束后第6周各组(0%、5%、10%、20%)有效率分别为35.0%、67.5%、77.5%、92.5%,给予不同浓度ALA组疗效优于直接光照组(P<0.05),各浓度组间随浓度增加,有效率增加(P<0.05),不良反应的发生率亦越高。结论 ALA-PDT治疗中重度痤疮疗效优于单用红光治疗,ALA浓度越高,PDT治疗疗效越好,但不良反应发生率越高。

Objective To investigate the safety and compare the efficacy of different concentrations of 5-aminolevulinic acid photodynamic therapy（ALA-PDT）in the treatment of moderate to severe acne.Methods 160 Patients with moderate to severe acne were randomly divided into four groups.One of these groups was directly irradiated with red light（0%）,and the other three groups were applied with different concentrations（5%,10%,20%）of ALA for 3 hours before been irradiated with red light.The treatment were conducted once a week for 4 times in total.The patients were evaluated at the second week,the fourth week,and the sixth week after the last treatment.Adverse effects were recorded at each visit.Results Six weeks after the last treatment,the different effective rates of each group（0%、5%、10%、20%） were 35.0%、67.5%、77.5%、92.5% respectively.The efficacy of different concentrations（5%,10%,20%）of ALA was superior to that of red light alone.With the elevation of different ALA concentrations,both the effective rate and incidence of adverse reactions increased（all P0.05）.Conclusion The clinical effect of ALA-PDT is more effective than that of red light alone in the treatment of moderate to severe acne.The efficacy increases with the increase of ALA concentration,and the incidence of adverse reactions increase as well.