超脉冲点阵CO_2激光联合氨甲环酸治疗豚鼠黄褐斑模型的观察

Effects of Ultrapulsed Fractional CO_2 Laser Associated Tranexamic Acid on Melasma Model of Guinea Pig

目的探讨超脉冲点阵CO_2激光联合氨甲环酸外用对豚鼠黄褐斑黑素细胞及黑素颗粒变化的影响。方法应用黄体酮注射联合中波紫外线照射20只健康雌性豚鼠背部皮肤诱导建立黄褐斑模型,测定背部皮肤超氧化物歧化酶和丙二醛含量,并进行病理学检查以评估建模是否成功。成功建模后,在每只豚鼠模型中选择背部色素均匀沉着处皮肤,随机分成4组:空白对照组、照射组(超脉冲点阵CO_2激光治疗)、外敷组(氨甲环酸注射液外敷)、联合组(超脉冲点阵CO_2激光照射+氨甲环酸注射液外敷)。肉眼观察豚鼠造模前后和治疗后背部皮肤色素沉着改善情况。取正常豚鼠背部皮肤、造模后背部皮肤、治疗后第3、14、30天豚鼠背部皮肤,行苏木精-伊红染色、Masson-Fontana染色观察黑素颗粒含量及面积的变化。结果成功构建豚鼠黄褐斑模型。治疗30天后照射组和联合组豚鼠皮肤色素评分、黑素颗粒含量、银染颗粒面积百分比均低于空白对照组和外敷组,差异均有统计学意义(P <0. 05),且联合组豚鼠皮肤色素评分、黑素颗粒含量、银染颗粒面积百分比均明显低于照射组(P均<0. 05),空白对照组与外敷组差异无统计学意义(P> 0. 05)。结论超脉冲点阵CO_2激光辅助的氨甲环酸注射液外敷治疗豚鼠黄褐斑模型安全、有效,超脉冲点阵CO_2激光与氨甲环酸存在协同作用,可能与CO_2激光为氨甲环酸注射液建立了药物传输途径,促进了皮肤的药物吸收率有关。

Objective To investigate the effect of uhrapulsed fractional CO2 laser and tranexamic acid on melanin and melanin granules. Methods The model of melasma was induced by progesterone injection combined with UVB irradiation on the dorsal skin of 20 healthy female guinea pigs. The content of superoxide dismutase and malondialde- hyde in the dorsal skin was measured and pathological examination was performed to evaluate the success of modeling. The pigmentation area were randomly divided into four groups： control group, irradiation group （ultrapulsed fractional CO2 laser treatment）, external application group （tranexamic acid external application）, combined group （ultrapulsed fractional CO2 laser ＋ tranexamic acid external application）. The dorsal skin of the guinea pigs on the 3rd, 14th and 30th day after treatment were stained with hematoxylin-eosin and Masson-Fontana staining to observe the content and area of the melanin granules. Results Melasma model of guinea pig was successfully established. After 30 days of treatment, the skin pigmentation scores, the content of melanin granules and the percentages of silver staining granules in laser group and combined group were lower than those in control group and external application group, and the difference was statistically significant （ P 〈 0. 05 ）. The skin pigmenta- tion score, the content of melanin granules and the percentage of silver staining granules in guinea pigs in the combined group were significantly lower than those in the irradiation group （ P 〈 O. 05 ）. There was no significant difference between the control group and the external application group （ P 〉 0. 05 ）. Conclusion Uhrapulsed fractional CO2 laser assisted tranexamic acid external application treatment of melasma guinea pig model is safe and effective, and there is synergistic effect between ultra- pulsed fractional CO2 laser and tranexamic acid, which may establish a drug delivery route with CO2 laser for tranexamic acid, increasing the transdermal absorption of tranexamic acid.