点阵饵激光联合外用表皮生长因子治疗面部痤疮凹陷性瘢痕的临床观察

Clinical Observation on Effect of Joint Application of Fractional Er:YAG Laser and Dressing of a Recombinant Human Epidermal Growth Factor on Atrophic Facial Acne Scars

目的观察重组人表皮生长因子(recombinant human epidermal growth factor,rhEGF)对点阵饵激光治疗面部痤疮凹陷性瘢痕术后的修复作用及安全性。方法轻至重度痤疮后凹陷性瘢痕患者96例,随机分为治疗组和对照组,每组患者48例。治疗组采用点阵饵激光联合rhEGF治疗;对照组采用点阵饵激光联合金霉素软膏治疗。外用药均匀涂抹于皮损处,每日2次,连续使用15 d。治疗后随访6个月,观察治疗后有效率、经济负担情况、痂皮脱落时间、患者舒适度评价、误工期、炎症后色素沉着率及其他不良反应发生情况。结果治疗组和对照组的总有效率分别为91.7%和75.0%。治疗组经济负担、痂皮脱落时间、激光术后自身舒适度评价均优于对照组(P<0.05);治疗组炎症后色素沉着率和误工期均低于对照组(P<0.05)。两组患者均无新发生的瘢痕。结论点阵饵激光术后联合应用rhEGF能加快创面愈合,增强疗效,同时减少术后不良反应发生率,虽然增加经济负担但提高患者满意度。

Objective To evaluate the efficacy and safety of the dressing of a recombinant human epidermal growth factor（rhEGF） for healing the wounds of patients of atrophic facial acne scars receiving fractional Er：YAG laser treatment.Methods Ninety-six patients with atrophic facial acne scars were recruited and randomly divided into a treatment group and a control group.The patients in both groups were given three sessions of fractional Er：YAG laser at an interval of a month.After each session of the laser therapy,those in the treatment group were typically applied with a rhEGF dressing twice a day for 15 consecutive days,and those in the control group were given chlorotetracycline ointment dressing.All the patients were followed up for 6 months.The efficacy was evaluated by the economic burden,time needed for crust shedding and patient comfort level.The length of downtime as well as incidence of post-inflammatory hyperpigmentation and other adverse reactions were also assessed.Results The effective rates of the treatment group and control group were 91.7%and 75.0%respectively.Compared with the control group,the treatment group showed a decrease in the time needed for crust shedding（P〈0.05）,incidence rate of post-inflammatory hyperpigmentation（P〈0.05） and length of downtime（P〈0.05）,but an increase in the self-reported comfort level（P〈0.01） and economic burden（P〈0.05）.No new scar formed in any of these patients.Conclusions The rhEGF dressing is effective in reducing incidence of adverse reactions and improving satisfaction degree of patients with atrophic facial acne scars after fractional Er：YAG laser therapy.