复方丙酸氯倍他索软膏联合二氧化碳点阵激光对增生性瘢痕患者VSS评分及复发率的影响

Effect of compound clobetasol propionate ointment combined with carbon dioxide lattice laser on VSS score and recurrence rate in patients with hypertrophic scars

目的探讨复方丙酸氯倍他索软膏联合二氧化碳(CO2)点阵激光治疗增生性瘢痕(HS)患者的临床效果.方法选取2017年7月~2018年6月我院HS患者60例,按随机数字表法分为试验组(n=30)与对照组(n=30),对照组予以复方丙酸氯倍他索软膏,试验组予以复方丙酸氯倍他索软膏联合CO2点阵激光.对比两组疗效、不良反应发生率,记录两组治疗前后温哥华瘢痕量表(VSS)、视觉模拟评分法(VAS)评分及血清血管内皮生长因子(VEGF)、转化生长因子-β(TGF-β)水平;随访1年,对比两组复发率.结果试验组总有效率96.67%(29/30)较对照组80.00%(24/30)高(P<0.05);治疗后,试验组VSS、VAS评分较对照组低(P<0.05);治疗后,试验组血清VEGF、TGF-β水平较对照组低(P<0.05);试验组不良反应发生率10.00%(3/30)与对照组6.67%(2/30)对比无显著差异(P>0.05);试验组复发率3.70%(1/27)较对照组23.81%(5/21)低(P<0.05).结论复方丙酸氯倍他索软膏联合CO2点阵激光治疗HS患者效果显著,可减轻疼痛,下调血清VEGF、TGF-β水平,促使瘢痕恢复,降低复发率,且未明显增加不良反应发生率,值得临床推广应用.

Objective To investigate the clinical effect of compound clobetasol propionate ointment combined with carbon dioxide(CO2)lattice laser treatment in patients with hypertrophic scar(HS).Methods Sixty patients with HS in our hospital from July 2017 to June 2018 were selected and divided into experimental group(n=30)and control group(n=30)according to the random number table method.The control group was given compound clobetasol propionate ointment,and the test group was given compound clobetasol propionate ointment combined with CO2 lattice laser.The efficacy and the incidence of adverse reactions were compared between the two groups,the Vancouver Scar Scale(VSS),visual analogue scale(VAS)score,serum vascular endothelial growth factor(VEGF)and transforming growth factor-β(TGF-β)levels before and after treatment were recorded between the two groups;One year follow-up,the recurrence rate of the two groups was compared.Results The total effective rate in the test group was 96.67%(29/30)higher than the control group 80.00%(24/30)(P<0.05);After treatment,the VSS and VAS scores in the experimental group were lower than those in the control group(P<0.05);After treatment,the serum VEGF and TGF-βlevels in the test group were lower than those in the control group(P<0.05);The incidence of adverse reactions in the experimental group was 10.00%(3/30)and the control group was 6.67%(2/30)without significant difference(P>0.05);The recurrence rate in the experimental group was 3.70%(1/27)lower than that in the control group 23.81%(5/21)(P<0.05).Conclusion The effect of compound clobetasol propionate ointment combined with CO2 lattice laser on patients with HS is significant,it can relieve pain,reduce the levels of VEGF and TGF-βin serum,promote the recovery of scar and reduce the recurrence rate,and it did not significantly increase the incidence of adverse reactions,which is worthy of clinical promotion and application.