光动力联合异维A酸及阿奇霉素治疗重度痤疮疗效研究

Study on the Efficacy of Photodynamic Therapy Combined with Isotretinoin and Azithromycin in the Treatment of Severe Acne

目的:观察光动力联合异维A酸及阿奇霉素治疗重度痤疮的临床疗效。方法:选取笔者医院2015年1月-2017年1月就诊的80例重度痤疮患者,每组40例。对照组使用异维A酸胶丸口服治疗,治疗组在对照组基础上联合阿奇霉素及ALA光动力治疗。结果:对治疗后两组患者进行4周随访,治疗组有效率(75.00%)高于对照组(52.50%);治疗后8周随访,治疗组有效率(92.50%)高于对照组(70.00%),差异均具有统计学意义。随访6个月,治疗组4例复发,复发率为11.43%;对照组12例复发,复发率为26.67%,差异有统计学意义(P<0.05);两组不良反应发生率比较,无统计学差异(P>0.05)。结果显示治疗组血清睾酮(T)以及局部痤疮处雄激素受体(AR)水平均优于对照组,差异有统计学意义(P<0.001)。结论:光动力联合异维A酸及阿奇霉素治疗重度痤疮患者,起效快、有效率显著高于传统口服药物治疗,且复发率低,值得临床推广应用。

Objective To observe the effect of photodynamic therapy combined with isotretinoin and azithromycin on severe acne.Methods The 80 patients with severe acne treated in our hospital from January 2015 to January 2017 were selected for the study.The efficacy and adverse reactions were observed in a one-year follow-up.There were 40 patients in the treatment group and 40 patients in the control group.The control group was treated with isotretinoin pellets orally,and the treatment group was treated with azithromycin combined with ALA photodynamic therapy on the basis of the control group.Results The patients in the two groups were followed up for 4 weeks after treatment.The response rates of the treatment group(75.00%)were higher than those of the control group(52.50%).After 8 week follow-up,there was a statistically significant difference in the effective rate between the treatment group and the control group,and the effective rate in the treatment group(92.50%)was higher than that in the control group(70.00%).Four patients in the treatment group were followed up for 6 months,with a recurrence rate of 11.43%.The recurrence rate of 12 patients in the control group was 26.67%.The difference between the two groups was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(P>0.05).In addition,the serum testosterone(T)and androgen receptor(AR)levels of the treatment group were significantly higher than those of the control group(P<0.001).Conclusion Photodynamic therapy for severe acne has a quick onset,a significantly higher effective rate than traditional oral drug therapy,and a low recurrence rate,which is worthy of clinical promotion.