窄谱强脉冲光联合调Q激光治疗痤疮后红斑、色素沉着的临床效果及对患者生活质量的影响

Effect of narrow-band pulsed light combined with Q-switched laser on erythema and pigmentation after acne and its influence on the quality of life of patients

目的 :探讨窄谱强脉冲光(DPL)联合调Q激光治疗痤疮后红斑、色素沉着的临床效果及对患者生活质量的影响。方法:选择随机抽签法将入选的168例痤疮后红斑、色素沉着的患者均分为两组,对照组采用单纯DPL治疗,观察组则DPL联合调Q激光法进行治疗。对比两组治疗前后红斑、色素沉着程度积分、自我皮损程度评分变化;采用中文版皮肤病生活质量指数(DLQI)对两组治疗前后生活质量进行评估;统计两组红斑及色素沉着临床疗效。结果:治疗后,两组红斑、色素沉着程度积分及自我皮损程度评分均明显下降(P<0.05),且与对照组比,观察组红斑、色素沉着程度积分及自我皮损评分下降更明显(P<0.05);同时两组在DLQI量表中瘙痒或疼痛、尴尬或自卑、购物家务、穿戴着装、社交休闲、体育活动、学习工作、亲朋关系8项评分及总评分亦明显下降(P<0.05),且观察组上述各项评分及总评分下降程度明显优于对照组(P<0.05)。对照组红斑治疗总有效率为78.57%,色素沉着治疗总有效率为83.33%,观察组则分别为90.48%和94.05%。两组在红斑及色素沉着临床总有效率间差异具有统计学意义(P<0.05)。结论:DPL联合调Q激光疗法在痤疮后红斑及色素沉着治疗中具有良好功效,可有效改善患者生活质量,且属于无创疗法,值得临床推广。

Objective：To investigate the clinical effects of narrow-band intense pulsed light（DPL）combined with Q-switched laser in the treatment of acne erythema and pigmentation and the effect on quality of life of patients.Methods：The 168 patients with erythema and hyperpigmentation after acne were randomly divided into two groups.The cases of the control group were treated with simple DPL;the cases of the observation group were treated with DPL and Q-switched laser.The changes in erythema,pigmentation,and skin lesion scores before and after treatment in both groups were compared;chinese version of dermatological quality of life index（DLQI）was used to evaluate the quality of life before and after treatment in both groups;The clinical efficacy of erythema and pigmentation was compared between the two groups.Results：After treatment,the scores of erythema,hyperpigmentation,and skin lesions in both groups decreased significantly（P〈0.05）,and compared with the control group,the scores of erythema,hyperpigmentation and self-skin lesions in the observation group decreased more significantly（P〈0.05）.At the same time,the scores of itchiness or pain,squatting or low self-esteem,shopping housework,wearing,social and leisure activities,sports activities,study work,family and friends and total scores on the DLQI also decreased significantly in two groups（P 0.05）,the scores of the above-mentioned scores and total scores in the observation group were significantly better than those in the control group（P〈0.05）.The total effective rate of erythema treatment in the control group was 78.57%,the total effective rate of pigmentation treatment was 83.33%,and that of the observation group was 90.48% and 94.05%,respectively.There was a significant difference between the two groups in the total clinical efficacy of erythema and pigmentation（P〈0.05）.Conclusion ：DPL combined with Q-switched laser therapy has good efficacy in the treatment of erythema and pigmentation after acne.It can effectively improve the quality of life of patients and is a non-invasive therapy that is worthy of clinical promotion.