点阵式二氧化碳激光与超声聚焦在治疗外阴慢性单纯性苔藓中的比较

The comparison of fractional CO2 laser and focused ultrasound in the treatment of lichen simplex chronicus

目的探讨点阵式二氧化碳（carbon dioxide, CO2）激光和超声聚焦治疗外阴慢性单纯性苔藓的疗效。方法选择2016年7月至2017年2月郑州大学第三附属医院外阴慢性单纯性苔藓患者48例,采用点阵式CO2激光（激光组）和超声聚焦（超声聚焦组）治疗各24例,并采用视觉模拟评分法（visual analoguescale, VAS）对患者治疗前后瘙痒、皲裂、皮肤颜色和性交痛的严重程度进行评估。结果激光组治疗后患者瘙痒、皲裂和性交痛评分与治疗前比较,差异均有统计学意义（P 〈0.05）,但皮肤颜色评分与治疗前比较,差异无统计学意义（P〉0.05）。超声聚焦组治疗后患者瘙痒、皮肤颜色评分与治疗前比较,差异均有统计学意义（P 〈0.05）,但皲裂和性交痛评分与治疗前比较,差异无统计学意义（P〉0.05）。激光治疗组治疗后VAS瘙痒评分较超声聚焦组明显降低（P 〈0.05）,而超声聚焦组外阴皮肤颜色改善程度更为明显（P 〈0.05）。结论点阵式CO2激光和超声聚焦均为治疗外阴单纯性苔藓有效方式,前者对瘙痒及皲裂症状改善较为明显,而后者对皮肤颜色的恢复可能更为有效。

Objective To explore the efficacy of fractional CO2 laser and focused ultrasound in the treatment of lichen simplex chronicus. Methods 24 patients with lichen simplex chronicus and another 24 patients with focused ultrasound were enrolled prospectively from July 2016 to February 2017 in the Third Affiliated Hospital of Zhengzhou University. Visual analogue scale（VAS） was assessed the degree of vulvar pruritus, skin chapping, skin colour, dyspareunia before and after treatment. Result Compared with that before treatment, there were significant difference in vulvar pruritus, skin chapping, dyspareunia in laser group（P〈0.05）. While the skin color have no obvious change（P〈0.05）. The vulvar pruritus and skin color score of patients with focused ultrasound were improved significantly after treatment（P〈0.05）, However, no statistically significant difference was found between the scores of chapped and coital pain and those before treatment（P〈0.05）. The vulvar pruritus score of patients with fractional CO2 laser were significantly lower than those with focused ultrasound（P〈0.05）, but skin color score of patients with focused ultrasound were improved more after treatment than those with fractional CO2 laser（P〈0.05）. Conclusions The use of fractional CO2 laser and focused ultrasound for lichen simplex chronicus both have curative effect. The former improves pruritus and chapped symptoms significantly, while the latter may be more effective in restoring skin color.