调Q激光联合复合性修复寡肽治疗黄褐斑的临床效果分析

Clinical efficacy of Q-modulated laser combined with compound repair of oligosaccharides in the treatment of melisma

目的探讨调Q激光联合复合性修复寡肽治疗黄褐斑的临床效果及安全性。方法将2017年1月至2018年12月,北部战区总医院整形外科收治的90例女性黄褐斑患者,根据随机数字表法平均分为调Q激光治疗组(对照组)和调Q激光联合复合性修复寡肽治疗组(试验组),每组45例。试验组患者微针导入寡肽与调Q激光治疗,间隔2周,交替进行,各治疗4次,疗程4个月,共完成8次治疗。对照组仅采用调Q激光治疗,每例患者治疗4次,每个月1次,疗程4个月。均于治疗前及治疗完成1个月时进行评估。评估指标:(1)黄褐斑严重指数(MASI),计算其下降率,分析黄褐斑改善情况;(2)采用visia皮肤分析仪评估棕色斑特征计数,计算其下降率;(3)医生主观评价患者色素斑遗留情况;(4)患者自评。计量资料采用t检验,计数资料采用卡方检验。结果所有受试者均完成治疗。2组患者经治疗后黄褐斑大多显著改善,对照组MASI下降率为75.61%,无效1例、好转13例、显著28例、痊愈3例;试实验组MASI下降率为85.25%,无效0例、好转6例、显著27例、痊愈12例。比较2组改善情况,试验组优于对照组,差异具有统计学意义(χ2=9.00,P=0.03)。2组患者治疗后黄褐斑棕色斑计数大多明显改善,对照组棕色斑计数下降率为(1.59±1.33)%,试验组为(3.45±1.54)%,试验组优于对照组,2组差异具有统计学意义(P=0.01)。医生对于治疗效果的整体评价结果显示试验组清除率大于75%的患者占95.56%(43/45),优于对照组的86.67%(39/45),组间比较差异具有统计学意义(P=0.03)。患者自评结果显示,试验组改善率大于75%的为66.67%(30/45),优于对照组的37.78%(17/45),差异具有统计学意义(P=0.04)。结论调Q激光联合复合性修复寡肽能够有效治疗黄褐斑,不良反应小。

Objective To observe the clinical efficacy and safety of Q-modulated laser combined with compound repair of oligosaccharides in the treatment of melasma.Methods From January 2017 to December 2018,90 patients with chloasma were divided into Q-switched laser treatment group(control group)and Q-switched laser combined repair oligopeptide treatment group(experimental group)according to random number table method.In the experimental group,the interval between microneedle introduction of oligopeptide and Q-switched laser therapy was 2 weeks,and the treatment was carried out alternately.Each treatment lasted for 4 months,with a total of 8 treatments completed.The control group was treated with Q-switched laser only.Each patient was treated four times,once a month for four months.All patients were evaluated before treatment and 1 month after treatment.Evaluation indicators:(1)Macular severity index(MASI),calculating its decline rate,analyzing the improvement of chloasma;(2)Applying Visia skin analyzer to evaluate the characteristic count of brown spots,calculating its decline rate;(3)Doctors Subjectively Evaluate Patient Pigmentation Legacy;(4)Patient self-evaluation.Measuring data were tested by t-test and counting data by Chi square test.Results All subjects completed the treatment.Most of the chloasma in the two groups improved significantly after treatment.In the control group,the MASI decreased by 75.61%,1 case of inefficiency,13 cases of improvement,28 cases of marked improvement and 3 cases of recovery.In the experimental group,the MASI decreased by 85.25%,0 cases of inefficiency,6 cases of improvement,27 cases of significant improvement and 12 cases of recovery.Comparing the improvement of the two groups,the experimental group was better than the control group,the difference was statistically significant(χ2=9.00,P=0.03).After treatment,the number of chloasma brown spots in the two groups improved significantly.In the control group,the decrease rate of chloasma brown spots was(1.59±1.33)%and in the trial experiment was(3.45±1.54)%.The experimental group was better than the control group,and the difference between the two groups was statistically significant(P=0.01).The overall evaluation of therapeutic effect by doctors showed that 95.56%(43/45)of the patients in the experimental group had clearance rate greater than 75%,which was better than 86.67%(39/45)of the control group.There was a significant difference between the two groups(P<0.05).The self-evaluation result showed that the improvement rate of the experimental group was 66.67%(30/45)which was more than 75%,which was better than 37.78%(17/45)of the control group.The difference was statistically significant(P=0.04).Conclusions Q-switched laser combined with compound repair oligopeptide can effectively treat chloasma with less adverse reactions.