异维A酸口服联合CO_2激光或光动力疗法治疗尖锐湿疣临床观察

The clinical observation of oral isotretinoin with CO_2-laser or ALA-PDT in the treatment of condyloma accuminatum

目的观察口服异维A酸胶囊联合CO2激光或光动力疗法治疗尖锐湿疣的临床疗效和复发率。方法将120例门诊确诊的尖锐湿疣患者随机分为4组,每组各30例。A组行单纯光动力治疗;B组行光动力治疗联合异维A酸10 mg,每日3次口服,直到疣体完全消失,改为异维A酸10 mg,每日1次口服,维持1个月后停药;C组行单纯CO2激光治疗;D组行CO2激光治疗联合异维A酸口服,服法同B组。所有患者均每2周随访1次,记录皮损改善情况及不良反应。CO2激光或光动力疗法治疗均维持到疣体完全消失,随访6个月。结果 A组痊愈19例,显效9例,无效2例;B组痊愈26例,显效3例,无效1例;C组痊愈10例,显效13例,无效7例;D组痊愈15例,显效11例,无效4例。AB组与CD组的组内疗效比较差异有统计学意义(AB:χ2=6.788,P<0.05;CD:χ2=6.652,P<0.05)。4组患者的复发率分别为21.1%、11.5%、60.0%、40.0%。AB组与CD组的组内复发率比较差异有统计学意义(AB:χ2=0.756,P<0.05;CD:χ2=0.962,P<0.05)。结论异维A酸联合CO2激光或光动力疗法对尖锐湿疣具有较好的治疗作用,且复发率较低。

Objective To observe therapeutic effect and recurrence rate of oral isotretinoin with CO2-laser or ALA-PDT therapy in the treatment of condyloma accuminatum. Methods Totally 120 cases of condyloma accuminatum patients diagnosed in outpatient were randomly divided into 4 groups. Group A：30 cases, only ALA-PDT treatment. Group B：30 cases, ALA-PDT treatment with oral isotretinoin 10 mg, 3 times a day, and turning to 10 mg per day till the lesion disappearing clearly, stopping after 1 month. Group C：30 cases, only CO2-laser treatment. Group D：30 cases, CO2-laser treatment with oral isotretinoin, same to Group B. All groups have observation the other week, recorded lesion condition and adverse effect. Physical therapy until the lesion disapearing clearly. Follow up 6 months. Results Group A：19 cases heal, 9 cases excellence, 2 cases inefifcacy. Group B：26 cases heal, 3 cases excellence, 1 cases inefifcacy. Group C：10 cases heal, 13 cases excellence, 7 cases inefifcacy. Group D：15 cases heal, 11 cases excellence, 4 cases inefifcacy. There was signiifcant difference between Group AB and group CD in therapeutic effect, respectively （AB：χ2=6.788, P＆lt;0.05;CD：χ2=6.652, P＆lt;0.05）. Recurrence rate：Group A：21.1%;Group B：11.5%;Group C：60.0%;Group D：40.0%. There was signiifcant difference between GroupAB and group CD in recurrence rate （AB：χ2=0.756, P＆lt;0.05;CD：χ2=0.962, P＆lt;0.05）. Conclusion Oral Isotretinoin with CO2-laser or ALA-PDT has great therapeutic effect and low recurrence rate.