皮肤微针辅助治疗斑秃的疗效与临床评估

Beneficial effect of skin micro-needling in the treatment of alopecia areata and its clinical assessment

目的观察1.5 mm皮肤微针辅助治疗斑秃(AA)的临床疗效以及探讨0.5 mm皮肤微针对小鼠背部毛囊生长的影响。方法招募2018年3月至2019年8月在武汉大学人民医院皮肤科门诊就诊AA患者52例,随机分为2组。对照组予以5%米诺地尔酊和0.05%卤米松乳膏外用治疗;微针组予以微针针刺皮肤联合药物治疗。此外,将C57BL/6小鼠背部脱毛后,随机分为模型组、米诺地尔组和微针组。造模后第2天分别给予相应处理,连续14 d。拍照观察生长期毛囊相关皮肤色素变化与毛发生长情况;HE染色观察毛囊的形态和数量变化;免疫组化检测毛囊上皮干细胞标记蛋白K15的表达。结果治疗12周后,微针组患者治疗总有效率优于对照组(P<0.05)。微针组小鼠背部皮肤变黑时间较模型组缩短(P<0.05);新生毛发长度较模型组长(P<0.05);毛囊数量、K15阳性细胞数目也较模型组增多(P<0.05)。结论微针可能通过激活毛囊上皮干细胞促进毛发生长,有助于提高AA疗效。

Objective To investigate the effects of skin micro-needling in the treatment of alopecia areata(AA)using a dermaroller of 1.5 mm sized needles and in the stimulation of mouse dorsal hair growth using a dermaroller of 0.5 mm sized needles.Methods Fifty-two patients with AA were recruited from the outpatient department of Renmin Hospital of Wuhan University(Mar 2018 to Aug 2019)and further divided into two group,5%minoxidil spray and 0.05%halomethasone cream were applied topically to the control group.The micro-needling group received micro-needling treatment combined with 5%minoxidil spray and 0.05%halomethasone cream.Moreover,the dorsal hair of C57BL/6 mouse was removed and then divided into model group,minoxidil group and micro-needling group.From the next day,the corresponding treatment was given to the mice for 14 consecutive days.Anagen-associated pigmentation changes and hair growth were recorded using a digital camera.The morphology and number of anagenic hair follicles were observed using HE staining,the expression of K15 in the hair follicle was detected by an immunohistochemistry staining.Results The effective rate of the micro-needling group was superior to that of the control group(P<0.05),after 12 weeks of treatment.As compared with the model group,the skin darkening appeared earlier and the hair length longer in the micro-needling group(P<0.05),the number of hair follicles andthe K15 expression level were greatly increased in the micro-needling group compared with those in the model group(P<0.05).Conclusions The hair follicle epithelial stem cells may be activated by micro-needling and thus stimulates hair growth and treats AA.