Q开关1064nm激光联合氨甲环酸治疗黄褐斑临床观察

Clinical efficacy of using Q-switch 1064 nm combined with tranexamic acid clinical observation for the treatment of malasma

目的：探讨单纯运用Q开关1 064nm激光与联合口服氨甲环酸片治疗黄褐斑的疗效及安全性。方法：将36例确诊为黄褐斑的患者随机平均分为A、B两组。A组：采用Q开关1 064nm Nd：YAG激光联合口服氨甲环酸片治疗;B组：单纯激光治疗。激光治疗间隔为4周,共8次,光斑直径6mm,能量密度3.0-3.5J/cm^2,脉冲频率10Hz;氨甲环酸片每日2次,每次250mg,连续口服6个月。治疗过程中记录不良反应,由两位医师对每次治疗前及疗程结束后1个月照片进行m MASI评分,同时患者接受满意度调查,并进行相关统计学分析。结果：A、B两组间治疗前后的m MASI评分下降率有统计学差异（P〈0.05）,A组患者平均起效时间为2.47个月,B组为4.69个月;A组患者满意率72.22%,B组患者满意率61.11%,两组间满意率比较有统计学差异（P〈0.05）。所有激光治疗患者未见严重不良反应,口服氨甲环酸片的患者中有1例胃肠道反应,1例患者自觉月经量减少。结论：口服氨甲环酸片联合Q开关1 064nm激光治疗黄褐斑与单纯激光治疗相比,具有起效快、疗效高等优点。

Objective To compare the clinical efficacy and safety of using Medlite C6 Q-switch Nd：YAG Iaser and combined with tranexamic acid for the treatment of melasma. Method 36 female patients with melasma were divided into two groups,A and B,n=18.Group A were given Q-switch Nd：YAG 1 064 nm laser every 4 weeks for 8 times,6mm spot,3.0- 3.5J/cm^2 energy,combined with oral tranexamic acid tablets for 6 month,500mg/day,twice a day.While group B were only treated with laser.The side effects were recorded and therapeutic efficacy were assessed by m MASI score and patient satisfaction rates. Result Both groups had achieved significant decrease from base line in m MASI score.Satisfaction rate of group A was 72.22%,while in group B it was 61.11%,there were statistically significant between the two groups（P〈0.05）.No severe adverse reactions were seen,exclude gastrointestinal reaction had happened on one patient,and another one complain of menstrual quantity decreases in group B. Conclusion Compare with laser-alone group,combination therapy can promote the efficacy of melasma and without severe side-effects.