高压氧综合治疗雄激素性秃发患者的临床疗效观察

Clinical effect of hyperbaric oxygen on androgenic alopecia

目的探讨高压氧(HBO)综合治疗雄激素性秃发(AGA)患者的临床疗效.方法选取2014年1月至2016年12月在湘雅医院诊治的雄激素性秃发患者71例为研究对象,按照治疗方法分为HBO组(38例)和对照组(33例),对照组采用常规药物非那雄胺和米诺地尔治疗,HBO组在对照组治疗的基础上联合HBO治疗.治疗6个疗程后,比较2组患者疗效;采用脱发及新生发积分、皮肤病生活质量指数问卷(DLQI)、汉密尔顿抑郁量表(HAMD)得分评定治疗效果;并检测治疗前后血清游离睾酮(FT)、5α-双氢睾酮(5α-DHT)水平.结果治疗6个疗程后,HBO组治疗有效率(90.91%)明显高于对照组(70.53%)(P<0.05);与治疗前比较,2组患者脱发评分均明显下降,且HBO组评分明显低于对照组,差异均有统计学意义(P<0.05或P<0.01);与治疗前比较,2组患者新生发评分均明显下降,且HBO组评分明显低于对照组,差异均有统计学意义(P<0.05或P<0.01);2组患者DLQI评分均明显提高,且HBO组评分明显高于对照组,差异均有统计学意义(P<0.05或P<0.01).2组患者HAMD评分均明显降低,且HBO组评分明显低于对照组,差异均有统计学意义(P<0.01);治疗6个疗程后,与治疗前比较,2组患者血清FT和DHT水平均明显降低(P<0.01),但HBO组治疗后FT和DHT水平与对照组比较无明显差异(P>0.05).结论 HBO综合治疗能进一步提高AGA患者的临床疗效,并能减少患者头发脱落,增加新发生长,改善患者抑郁情绪,提高生活质量.

Objective To investigate the clinical effect of hyperbaric oxygen (HBO) on the patients with androgenetic alopecia (AGA).Methods A total of 71 patients with AGA admitted into the Xiangya Hospital from January 2014 to December 2016 were enrolled for the study,and were divided into the HBO group (n =38) and control group (n =33),according to different treatment methods.The patients in the control group were treated with conventional drugs,while the patients in the HBO group received HBO therapy in addition to the treatment received by the control group.Following 6 courses of treatment,therapeutic effects were compared between the patients of the 2 groups.Therapeutic effects were evaluated by using hair loss and new hair growth scores,Dermatology Life Questionnaire Index (DLQI) and Hamilton Depression Rating Scale (HAMD),and the levels of free testosterone (FT) and 5α-dihydrotestosterone (5α-DHT) were detected before and after treatment.Results Following 6 courses of treatment,the therapeutic efficacy of the HBO group (90.91%) was significantly higher than that of the control group (70.53%)(P < 0.05),As compared with the scores before treatment,the hair loss scores of the 2 groups all decreased obviously,and the scores of the HBO group were considerably lower than those of the control group,with statistical significance (P < 0.05 or P <0.01).As compared with the scores before treatment,the new hair growth scores of the 2 groups all decreased obviously,and the scores of the HBO group were obviously lower than those of the control group,also with statistical significance (P < 0.05 or P < 0.01).The DLQI scores of the 2 groups all significantly elevated,and those of the HBO group were markedly higher than those of the control group,with statistical significance (P <0.05 or P <0.01).The HAMD scores of the 2 groups all decreased significantly,and those of the HBO group were obviously lower than those of the control group,also with statistical significance (P < 0.01).After 6 courses of treatment,the levels of FT and DHT in the patients of the 2 groups all considerably dropped,as compared with those before treatment (P < 0.01).However,after HBO treatment,no significant differences could be noted in the levels of FT and DHT in the HBO group,as compared with the control group (P > 0.05).Conclusion Comprehensive HBO therapy could further improve clinical efficacy on the patients with AGA,reduce hair loss,increase new hair growth,improve the emotion of the patients with depression,and could ultimately increase their daily life quality.