强脉冲光联合近红外光治疗面部皮肤光老化的临床体会

Clinical Experience in Treating Facial Skin Photoaging Jointly with Intense Pulsed Light and Near-Infrared Light

目的评价强脉冲光（intense pulsed light,IPL）联合近红外光（near-infrared light,NIR）治疗面部光老化的临床疗效和安全性。方法面部光老化患者30例,随机分为3组,每组10例。A组：IPL治疗组,采用570 nm、540 nm手具治疗,能量密度14～18J/cm^2,根据皮肤类型选择合适的脉宽。B组：NIR治疗组,选用NIR手具,波长900～1 600 nm,波峰1 300 nm区域滑动治疗。C组：IPL联合NIR治疗组,先行IPL治疗,冷敷面膜30 min后再行NIR治疗。比较各组治疗前后患者面部细小皱纹、毛孔粗大、皮肤松弛、毛细血管扩张的改善情况。结果 IPL治疗面部色斑、肤色灰暗、毛细血管扩张效果好。NIR治疗皮肤细纹增多、皮肤松弛、肤色灰暗等效果明显。三组患者治疗后2个月的有效率差异有显著意义（P〈0.05）,其中IPL联合NIR疗法的疗效最好;治疗后6个月,三组的临床疗效比较差异无显著意义。结论强脉冲联合近红外光能有效提高面部皮肤光老化的疗效,是一种安全、有效、不良反应小的方法。

Objective To evaluate the clinical and adverse effects of the combined therapy of intense pulsed light and near-infrared light in treating facial photoaging.Methods Altogether 30 patients with facial photoaging problems were randomly divided into 3 groups,each having 10 patients.Group A,being the IPL treatment group,adopted 14-18 J/cm^2 intense pulsed light with the wavelength of 570 and 540 nm.For Group B,the NIR treatment group,NIR hand,of which the wavelength is set at 900-1 600 nm and the peak wavelength at 1 300 nm,was used toslide along the treating area.The accumulated energy was 10 kJ/cm2 and 15-20 kJ/cm2 at forehead and unilateral cheek respectively after the temperature was maintained at a specified level.For Group C,the IPL and NIR treatment group,the IPL treatment energy remains the same,but the accumulated energy created by NIR hand were changed to 5 kJ/cm^2 and 8 kJ/cm^2 respectively at forehead and unilateral cheek.The improvements of three groups in facial fine wrinkles,big pores,skin flabby and capillary expansion are compared after the treatment were compared.Results Whereas IPL treatment was most effective in improving facial spots,dark skin and capillary expansion,NIR treatment improved skin fine lines,sagging skin and dark skin remarkably.The combined treatment of IPL and NIR had a much better therapeutic effect than the sole treatment of IPL or NIR.Six months after the combined treatment of IPL and NIR,6 patients（60.0%） were very satisfied or satisfied with the results.Conclusions Improving effectively the therapeutic effect,the combined treatment of IPL and NIR is a safe and effective therapy for facial skin photoaging with a few side effects.