Q开关Nd:YAG激光联合左旋维生素C离子导入治疗黄褐斑的临床观察

Clinical Observation of Chloasma Treated by Q-switched Nd: YAG Laser in Combination with L-vitamin C Iontophoresis

目的:探讨Q开关Nd:YAG激光联合左旋维生素C离子导入治疗黄褐斑的临床疗效和安全性,为黄褐斑的治疗提供疗效确切并安全的治疗方法。方法:将90例黄褐斑的患者随机分为3组,每组30例。治疗组给予Q开关Nd:YAG激光联合左旋维生素C离子导入治疗;对照1组单纯给予Q开关Nd:YAG激光治疗;对照2组单纯给予左旋维生素C离子导入治疗。激光治疗每两周1次,左旋维生素C离子导入每周1次,共治疗16周。分别在治疗8周后和16周后通过MSAI评分进行疗效分析,并在治疗结束后以水疱、座疮以及色素沉着和色素减退来进行不良反应分析。结果:在治疗8周后,联合治疗组与对照1组疗效差异无统计学意义(P>0.05),与对照2组疗效差异有统计学意义(P<0.05);16周时治疗组有效率为73.33%,对照l组为73.33%,对照2组为36.67%,差异有统计学意义(P均<0.05);治疗组不良反应发生率为20.00%,对照l组为33.33%,对照2组为3.33%,差异无统计学意义(P>0.05)结论:治疗8周后,Q开关Nd:YAG激光联合左旋维生素C离子导入治疗的方法疗效并不优于单纯激光治疗,但优于单纯左旋维生素C离子导入的方法;治疗16周后,Q开关Nd:YAG激光联合左旋维生素C离子导入治疗黄褐斑比两者单独应用效果好;安全性有保障,值得临床推广。

Objective： To explore the clinical efficacy and safety of chloasma treated by using Q-switched Nd： YAG laser in combination with L-vitamin C iontophoresis.To provide curative effect and safe treatment method for chloasma.Methods： 90 patients with chloasma were randomly divided into three groups, 30 cases of each group. The treatment group were given Q-switched Nd： YAG laser combined with L-vitamin C iontophoresis treatment; The control group 1 were given a simple Q-switched Nd： YAG laser treatment; The control group 2 were .given a simple L -vitamin C iontophoresis treatment.Q switched Nd： YAG laser treatment once every two weeks, L -vitamin C iontophoresis treatment 1 times a week, and treatment of 16 weeks.At 8 and 16 weeks after treatment, respectively by MSAI score for curative effect analysis, and at 16 weeks ob serve the adverse reactions after treatment.Results： In 8 weeks after treatment, combined treatment group compared with con trol group 1, there was no statistical significance difference effect（P 〉 0.05）, and the control group 2 curative effect difference was statistically significant （P 〈 0.05）.The markedly effective rate of combination group was 73.33 % and that of control 1 and 2 group was 43.33 % and 36.67 % respectively;the markedly effective rate of controll and 2 group in 16th week was significant ly lower than that of treatment group （P〈0.05）.There was no significant difference of adverse effects rate among combination group （20.00%）,control 1 （33.33%） and 2 group （3.33%）（P〉0.05）.Conclusions： After 8 weeks treatment, In 8th week, treat chloasma by using Q switched Nd： YAG laser in combination with L-vitamin C iontophoresis was not effective than simplylaser therapy,but is effective than simply L,vitamin C iontophoresis.In 16th week,treat chloasma by using Q switched Nd： YAG laser in combination with L-vitamin C iontophoresis is effective than either alone, and it is sat^y.So the combinative treatment is worth for spreading in clinical practice.