低能量激光治疗雄激素性秃发的临床疗效研究

Clinical efficacy of low-level laser therapy for androgenetic alopecia

目的：评价低能量激光治疗雄激素性秃发的有效性及安全性，比较单纯低能量激光与低能量激光联合非那雄胺片治疗雄激素性秃发的疗效。方法39例男性雄激素性秃发患者随机分为低能量激光组和联合治疗组，治疗时间均为6个月。低能量激光组21例，单独使用低能量激光治疗，每周2次，每次30 min；联合治疗组18例，采用低能量激光联合非那雄胺片（口服非那雄胺片1 mg/d）治疗。每组患者均在治疗前、治疗3个月和6个月后拍照，毛发镜下计数头皮纵轴中心单位面积内毛发数量，观察秃发分级改变，填写自觉症状问卷。结果低能量激光组治疗6个月时毛发密度[（184.59±21.17）根/cm2]显著高于治疗3个月[（169.24±29.21）根/cm2，P〈0.05]及治疗前[（166.67±32.94）根/cm2，P〈0.05]，而治疗3个月与治疗前差异无统计学意义（P〉0.05）。联合治疗组毛发密度治疗3个月[（186.39±17.97）根/cm2]、6个月[（201.80±16.55）根/cm2]均显著高于治疗前[（157.85±27.97）根/cm2，均P〈0.05]，且治疗6个月时毛发密度显著高于治疗3个月（P〈0.05）。治疗前，2组间毛发密度差异无统计学意义（P〉0.05），治疗3、6个月后联合治疗组毛发密度均显著高于低能量激光组（均P〈0.05）。治疗6个月后，低能量激光组17例有效，4例无效；而联合治疗组16例有效，2例无效，2组间有效率差异无统计学意义（χ2=0.057，P〉0.05）。在治疗过程中，62%（24例）患者自觉头皮油腻减轻，56%（22例）自觉脱发减少。除了局部温热感之外，无1例发生不适。结论低能量激光治疗雄激素性秃发疗效肯定，且无不良反应。

Objective To evaluate the efficacy and safety of low？level laser therapy（LLLT）for androgenetic alopecia, and to compare the therapeutic effect of LLLT alone versus in combination with finasteride tablets. Methods Thirty？nine male patients were randomly divided into the LLLT group（n=21）and combination group（n=18）to be treated with LLLT alone or in combination with oral finasteride tablets（1 mg/d）for 6 months. LLLT was given twice a week, and each session lasted 30 minutes. All the patients were photographed and asked to fill a questionnaire about subjective symptoms, and hair density （the number of hairs per unit area on the scalp） was determined by using a dermatoscope to evaluate the grade of alopecia, before the treatment, and 3 and 6 months after the treatment. Results The hair density in the LLLT group was significantly higher after 6 months than after 3 months of treatment and before the treatment（184.59 ± 21.17 vs. 169.24 ± 29.21 and 166.67 ± 32.94 hairs/cm2, both P〈0.05）, but was insignificantly different between before and after 3 months of treatment （P 〉 0.05）. The hair density in the combination group significantly increased after 6 and 3 months of treatment compared with that before the treatment（201.80 ± 16.55 and 186.39 ± 17.97 vs. 157.85 ± 27.97 hairs/cm2, both P 〈 0.05）, and was significantly higher after 6 months than after 3 months of treatment（P〈0.05）. No significant difference was observed in hair density between the two groups before the treatment（P〉0.05）, but the combination group showed increased hair density compared with the LLLT group after 3 and 6 months of treatment（both P〈0.05）. After 6 months of treatment, LLLT alone was effective in 17 patients, but ineffective in 4 patients, and the combination therapy was effective in 16 patients, but ineffective in 2 patients, with no significant difference in the response rate between the LLLT group and combination group （χ2 = 0.057, P 〉 0.05）. During the treatment, 24（62%）patients felt less greasy, and 22（56%）reported less hair loss, with no discomforts reported by the patients except local warm feeling. Conclusion LLLT is indeed effective for the treatment of androgenetic alopecia with no adverse reactions.