光动力疗法联合复方倍他米松对增生性瘢痕患者负性情绪和瘢痕组织p-STAT3、Egr-1表达的影响

Effect of Photodynamic Therapy Combined with Compound Betamethasone on Negative Emotion and Expression of p-STAT3 and Egr-1 in Hypertrophic Scar Patients

目的:探讨光动力疗法联合复方倍他米松注射液局部封闭治疗增生性瘢痕(HS)的临床疗效及对患者负性情绪和瘢痕组织酪氨酸磷酸化STAT3(p-STAT3)、早期生长因子-1(Egr-1)表达的影响。方法:选取我院于2016年1月~2017年6月期间收治的HS患者118例,采用随机数字表法将患者随机分为对照组(n=59)和研究组(n=59),对照组给予复方倍他米松注射液治疗,研究组在对照组基础上联合光动力疗法治疗,两组患者均治疗4个月。比较两组患者临床疗效、瘢痕评分、负性情绪、瘢痕组织p-STAT3、Egr-1表达量,记录两组治疗期间不良反应发生情况。结果:研究组患者治疗后的临床总有效率为81.36%(48/59),高于对照组的54.24%(32/59)(P<0.05)。治疗后随着时间的延长,温哥华瘢痕评定量表(VSS)、北卡罗来纳大学瘢痕量表评分不断下降,且研究组低于对照组(P<0.05)。两组患者治疗后1年焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于治疗前,且研究组低于对照组(P<0.05)。两组患者治疗后1个月瘢痕组织p-STAT3、Egr-1表达量低于治疗前,且研究组低于对照组(P<0.05)。治疗期间两组不良反应发生率比较无差异(P>0.05)。结论:光动力疗法联合复方倍他米松注射液局部封闭治疗HS,安全有效,可有效改善瘢痕症状,减轻患者负性情绪,降低瘢痕组织中p-STAT3、Egr-1表达。

Objective: To investigate the clinical efficacy of photodynamic therapy combined with local blocking of compound betamethasone injection in the treatment of hypertrophic scar(HS) and its influence on patients’ negative emotions and expression of scar tissue tyrosine phosphorylation STAT3(p-STAT3) and early growth factor(Egr-1). Methods: A total of 118 patients with HS, who were treated in Changzheng Hospital Affiliated to Naval Military Medical University of the PLA from January 2016 to June 2017, were selected and were randomly divided into control group(n=59) and study graoup(n=59). The control group was treated with compound betamethasone injection, and the research group was treated with photodynamic therapy on the basis of the control group’s therapy.After four months of treatment, the clinical efficacy, epilepsy score, negative emotions,expression of scar tissue p-STAT3 and Egr-1 were compared between the two groups, and the occurrence of adverse reactions during the treatment of the two groups were recorded. Results: After treatment, the total effective rate [81.36%(48/59)] of the study group was significantly higher than that[54.24%(32/59)] of the control group(P<0.05);the scores of Vancouver Scar Rating Scale(VSS) and University of North Carolina Scar Rating Scale(UCSC) declined with time, and the scores of the study group were lower than those of the control group(P<0.05). The Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) scores in the two groups 1 year after treatment were lower than those before treatment, and the scores in the study group were lower than those in the control group(P<0.05). The expression of scar tissue p-STAT3 and Egr-1 in the two groups 1 month after treatment was lower than that before treatment, and the expression in the study group was lower than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05). Conclusion: Photodynamic therapy combined with local blocking of compound betamethasone injection for HS is safe and effective. It can effectively improve scar symptoms, alleviate the negative emotions of patients, and reduce the expression of p-STAT3 and Egr-1 in epileptic tissues.