5-氨基酮戊酸光动力疗法联合CO_2激光和咪喹莫特治疗尖锐湿疣的疗效观察

Observation on Curative Effect of Combined Therapy of ALA-PDT,CO_2 Laser and Imiquimod on Condylomata Acuminataon

目的观察5-氨基酮戊酸光动力疗法(5-aminolaevulinic acid-based photodynamic therapy,ALA-PDT)、CO2激光、咪喹莫特联合治疗(简称三联疗法)尖锐湿疣疗效。方法尖锐湿疣患者109例,随机分两组。治疗组55例,先用CO2激光清除疣体,之后采用ALA-PDT治疗,ALA-PDT治疗后1周皮损处外用咪喹莫特乳膏;对照组54例,仅采用CO2激光清除疣体,治疗后1周皮损处外用咪喹莫特乳膏治疗。两组患者术后1、2、4和6个月随访,比较两组的疗效和复发率。结果治疗组的治愈率和6个月后的复发率分别是89.09%和10.91%。对照组的治愈率和6个月后的复发率分别是70.37%和29.63%。治疗组的治愈率明显高于对照组,而治疗组的复发率显著低于对照组,两组比较差异有显著意义(P<0.05)。结论使用三联疗法治疗尖锐湿疣,能明显提高治愈率,降低复发率。

Objective To explore the efficacy of the combined therapy of ALA-PDT,CO2 laser and Imiquimod（Triple Therapy） on condyloma acuminata（CA）. Methods Altogether 109 patients with CA were divided into two groups randomly. Fifty five patients in the treatment group,35 males and 20 females,were firstly treated with CO2 laser to remove warts,then with ALA-PDT 2-3 times,and one week later with imiquimod to cure skin lesions 3 times a week for 8 weeks. Fifty four patients in the control group,39 males and 15 females,were treated similar-ly with CO2 laser and imiquimod but without ALA-PDT. Both groups were followed up for 6 months after the treatment,and the cure rate and the recurrence of the two groups were compared. Results The cure rate and the recurrence rate of the treatment group was 89. 1% and 10. 9% respectively,and those of the control group were 70. 4% and 29. 6% respectively. The cure rate of the teatment group was significantly higher than that of the control group, while the recurrence rate of teatment group was obviously lower than that of the control group. Both the cure rates and recurrence rates of the two groups were significantly different（P 0. 05）. Conclusions The Triple Therapy can raise the cure rate and reduce the recurrence rate of CA.