羟基乙酸治疗黄褐斑的临床效果研究

Clinical effect study of glycolic acid in the treatment of chloasma

目的探讨羟基乙酸治疗黄褐斑的临床效果。方法选取2010年2月-2013年6月在本院就诊并治疗的56例黄褐斑患者作为研究对象,采用患处涂抹羟基乙酸进行治疗,每2周1次,4次为1个疗程,连续治疗2个疗程,比较治疗前后的MASI评分及治疗总有效率,同时观察不良反应发生情况。结果所有患者均完成2个疗程的治疗,第2个疗程后的总有效率显著高于第1个疗程,差异有统计学意义（P〈0.01）。第1个疗程后的MASI评分显著低于治疗前,差异有统计学意义（P〈0.01）。第2个疗程后的MASI评分显著低于第1个疗程后及治疗前,差异有统计学意义（P〈0.01）。表皮型黄褐斑的总有效率为76.7%,显著高于混合型的38.5%,差异有统计学意义（P〈0.01）。Ⅳ型黄褐斑的总有效率为75.0%,显著高于Ⅲ型的40.0%,差异有统计学意义（P〈0.05）。所有患者治疗后均出现瘙痒、刺痛感,经对症处理后症状消失,未出现严重不良反应。结论羟基乙酸治疗黄褐斑安全有效,尤其是对于表皮型及Fitzpatrick-Pathak分型Ⅳ型黄褐斑效果显著,值得临床推广使用。

Objective To explore the clinical effect of glycolic acid in the treatment of chloasma. Methods 56 patients with chloasma in our hospital from February 2010 to June 2013 were selected as the research object.Glycolic acid was used for covering on the affected part once every two weeks.One course of treatment contained 4 times and the treat-ment last two courses of treatment.The scores of melasma area and severity index （MASI）,the total therapeutic effective rate before and after treatment was compared.At the same time,the occurrence of adverse reaction was observed. Results All participants were persisted on two courses of treatment.The total effective rate at the termination of the second course was higher than that in the first course,with significant difference （P〈0.01）.The scores of MASI at the termination of the first course was lower than that before treatment,with significant difference（P〈0.01）.The scores of MASI at the termina-tion of the second course was lower than that in the first course and before treatment,with significant difference （P〈0.01）.The total effective rate of chloasma in epidermal type was 76.7%,which was higher than 38.5%in mixed type,with significant difference （P〈0.01）.The total effective in typeⅣ chloasma was 75.0%,which was higher than 40.0% in typeⅢ,with significant difference （P〈0.05）. There were symptoms like skin itching and pricking in all patients after treat-ment,but which were both disappeared after symptomatic treatment.There was no severe adverse reaction occurred. Conclusion Glycolic acid is safe and effective in the treatment of chloasma,especially obtains better effect on epider-mal-type and type-Ⅳ chloasma based on Fitzpatrick-Pathak classification,it is worthy of clinical promotion and appli-cation.