5-氨基酮戊酸光动力疗法联合微波治疗尖锐湿疣疗效观察

Curative effect of topical 5-aminolevulinic acid photodynamic therapy combined with microwave in treatment of condyloma

目的观察5-氨基酮戊酸光动力疗法（ALA—PDT）联合微波治疗尖锐湿疣的疗效和安全性。方法将入选的66例尖锐湿疣患者随机分为治疗组和对照组，分别采用ALA—PDT联合微波治疗和微波单独治疗，联合治疗组33例在原疣体部位局部外敷20％5-氨基酮戊酸霜剂，治疗范围为病损边缘向外扩大约0．5cm，薄膜封包3h后使用光动力激光治疗仪照射20min，照射距离5～10cm，能量密度100J／cm2，每周治疗一次，连续3次；对照组33例经微波治疗后不使用任何药物，仅每周随访1次，观察有无复发，如有复发者再行微波治疗。比较2组患者的疗效和复发率。结果所有患者均在最后一次治疗后完成3个月的随访。治疗组的治愈率为84．85％，对照组的治愈率为60．61％，2组治愈率差异具有统计学意义（P〈0．05）。2组患者均未发生明显不良反应。结论5一氨基酮戊酸光动力疗法联合微波治疗尖锐湿疣治愈率高，复发率低，患者依从性好。

Abstract ： Objective The aim of this study was to observe the efficacy and safety of combination therapy with Topical 5- aminolevulinic acid photodynamic therapy （ALA-PDT） and microwave for condyloma. Methods Sixty-six patients were divided into two groups randomly. One group was treated by both ALA-PDT and microwave and the other by microwave only as control. A photosensitizer, 20% ALA cream was applied on the lesions and covered with an occlusive film. The range of cream should be 0.5 cm beyond the edge of prior CA. The applied areas were irradiated with the Photodynamic therapeutic apparatus for 20 min after 3 hours. The irradiation distance was 5 - 10 cm and the energy density was 100 J/ cm2. Two treatments should be carried out with 1 week interval. A comparative analysis was performed to assess the effica- cy and the recurrence of two groups was compared. Results All of the patients were followed up for 3 months after the last treatment. The cure rate in 3 months of the treatment group was 84.85% while in the control group was 60.61%, showing statistical significance between two groups （ P 〈 0.05 ）. There were no obvious adverse effects in two groups. Conclusion The combination therapy of ALA-PDT with microwave can raise the cure rate and reduce the recurrence rate of condvloma, with food tolerance.