光动力联合疗法在尖锐湿疣治疗中的应用

Utilization of photodynamic combination therapy in treatment of condylomata acuminata

目的观察光动力联合疗法治疗尖锐湿疣的疗效并探讨其机制。方法将220例尖锐湿疣患者按就诊先后顺序数字法随机分为两组:微波联合光动力治疗组和微波联合咪喹莫特对照组,每组110例。按推荐标准治疗,患者均随访6个月。同时用酶联免疫吸附试验(ELISA)检测30例患者血清中的细胞因子,包括肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-3)、IL-6、IL-8和IL-10的水平。结果治疗组清除率为86.79%,复发率为13.21%;对照组清除率为61.90%,复发率为38.10%;两组差异有统计学意义(P<0.05)。两组有效观察病例211例中,159例患者出现治疗部位轻度刺激反应,患者都能忍受并坚持治疗。30例患者血清中细胞因子TNF-α、IL-3、IL-6、IL-8和IL-10的水平,治疗前后均在正常范围,并且与正常人对照组相比差异无统计学意义。结论光动力联合微波治疗尖锐湿疣,在降低尖锐湿疣的复发率方面优于微波联合咪喹莫特。光动力、微波、咪喹莫特外用均不能改变患者外周血清中细胞因子TNF-α、IL-3、IL-6、IL-8和IL-10的水平。

Objective To explore the efficacy of photodynamic combination therapy in treatment of condylomata acuminata. Methods Two hundred and twenty patients were randomized into two groups according to visiting time： microwaves combined with Photodynamic as treatment group and microwaves combined with imiquimod as control group. Patients were followd up for six months. TNF-α, IL-3, IL-6, IL-8 and IL-10 were detected with ELISA in 30 patients. Results The clearance rate of treatment group was 86.79% and relapse rate was 13.21%, In control group it was 61.9% and 38.10%, respectively. There were statistically significant different between two groups （P〈0.05）. Of the 211 valid cases, 159 occurred mild stimulating response in treatment sites. All patients could tolerate and insist on treatment. Serum levels of TNF-α, IL-3, IL-6, IL-8 and IL-10 were normal and there were no significant differences compared with general population. Conclusion Microwaves combined with photody- namic therapy has a lower relapse rate in treating condylomata acuminata than microwaves combined with imi- quimod. Photodynamic, microwaves and imiquimod therapy may not influence serum levels of TNF-α, IL-3, IL-6, IL-8 and IL-10.