ALA-PDT联合盐酸丁卡因胶浆治疗尖锐湿疣的临床效果及对血清因子的影响

Effect of ALA-PDT combined with tetracaine hydrochloride mucilage on the treatment of condylomata acuminata and influence of serum factors

目的观察5-氨基酮戊酸光动力学疗法(5-aminolevulinic acid photodynamic treatment,ALA-PDT)联合盐酸丁卡因胶浆治疗尖锐湿疣(condylomata acuminata,CA)效果及对淋巴细胞趋化因子(lymphotactin,LTN)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)和P物质(substance P,SP)的影响。方法将84例尖锐湿疣患者随机分为对照组和观察组各42例。对照组进行ALA-PDT治疗,观察组进行ALA-PDT联合盐酸丁卡因胶浆治疗。对比2组治疗效果、复发情况、不良反应及治疗前后血清中LTN、TNF-α、SP水平。结果观察组临床疗效和总有效率均高于对照组(P<0.05);观察组复发率和复发疣体个数均明显低于或少于对照组(P<0.05);治疗后对照组和观察组血清中LTN均明显高于治疗前(P<0.05),2组TNF-α、SP均明显低于治疗前(P<0.05);治疗后观察组血清中LTN明显高于对照组(P<0.05),TNF-α、SP明显低于对照组(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05)。结论ALA-PDT联合盐酸丁卡因胶浆治疗尖锐湿疣效果优异,复发率低,不良反应少,可通过升高LTN水平和降低TNF-α、SP水平调节局部细胞免疫,值得临床应用。

Objective To explore effect of 5-aminolevulinic acid photodynamic treatment(ALA-PDT)combined with tetracaine hydrochloride mucilage on the treatment of condylomata acuminata and influence of serum of lymphotactin(LTN),tumor necrosis factorα(TNF-α)and substance P(SP).Methods Eighty-two cases of condylomata acuminata patients were equally divided into control group and observation group by the digital random table.Patients in the control group were treated with ALA-PDT,patients in the observation group were treated with ALA-PDT combined with tetracaine hydrochloride mucilage.The clinical effect,recurrence,adverse reactions and the serum level of LTN,TNF-α,SP of two greoups were compared.Results The clinical efficacy and total effective rate of the observation group were higher than those of the control group(P<0.05).The recurrence rate and the average number of recurrence warts in the observation group were significantly lower than those in the control group(P<0.05).The serum LTN in the control group and the observation group after treatment was significantly higher than that before treatment(P<0.05),and the serum TNF-a and SP in the two groups were significantly lower than those before treatment(P<0.05).The serum LTN in the observation group was significantly higher than that in the The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05),while the incidence of TNF-αand SP in the observation group was significantly lower than that in the control group(P<0.05).Conclusion ALA-PDT combined with tetracaine hydrochloride gel has excellent curative effect on condyloma acuminatum,low recurrence rate and less adverse reactions.It can regulate local cellular immunity by increasing LTN level and decreasing TNF-alpha and SP level,which is worthy of clinical reference and application.