精准脉冲光联合长脉冲1064 nm Nd:YAG激光治疗玫瑰痤疮的疗效观察

Efficacy of Delicate Pulsed Light Combined with Long Pulsed 1064 nm Nd:YAG Laser in the Treatment of Rosacea

目的观察精准脉冲光(DPL)联合长脉冲1 064 nm Nd:YAG激光(LPND)治疗玫瑰痤疮的临床疗效及安全性。方法本研究共纳入44例红斑毛细血管扩张型及45例丘疹脓疱型玫瑰痤疮患者,分别随机分为实验组和对照组。所有患者均接受DPL治疗,实验组同时给予长脉冲1 064 nm Nd:YAG激光治疗,每4周1次,3次为1疗程,根据红斑评定量表(CEA)、研究者整体评价法(IGA)、患者自身评定法(PSA),评价各亚型临床疗效并记录不良反应。结果 3次治疗后,两种亚型实验组和对照组比较,IGA评分和PSA评分差异均有统计学意义(P<0.05);CEA评分差异均无统计学意义(P>0.05);临床有效率实验组均高于对照组,其中丘疹脓疱型患者两组有效率比较差异有统计学意义(P<0.05)。所有患者均未发生明显不良反应。结论 DPL联合长脉冲1 064 nm Nd:YAG激光治疗玫瑰痤疮疗效优于单独使用DPL,对丘疹脓疱型效果更显著。

Objective To observe the efficacy and safety of delicate pulsed light(DPL) combined with long Pulse Neodymium-Yttrium Aluminum-Garnet 1 064 nm(Nd: YAG) laser for rosacea.Methods Forty-four erythemato-telangiectatic patients and forty-five papulopustular patients with rosacea were enrolled and randomly divided into the treatment group and control group.Both group were treated with DPL, while patients in the treatment group received long pulsed 1 064 nm Nd: YAG laser treatment in addition.The treatment was administered every four weeks, three times in total.The therapeutic efficacy of treatment was evaluated by using clinician erythema assessment(CEA), investigator′s global assessment(IGA) score and patient-self assessment(PSA) score.Moreover, adverse reactions were assessed.Results After three treatments, the IGA and PSA scores in the treatment group were significantly higher than in the control group for both rosacea subtypes(P<0.05), while there was no difference in CEA scores(P>0.05).The clinical effective rate in the treatment group was higher than in the control group.Moreover, the papulopustular subtype benefited significantly more from the treatment than the erythemato-telangiectatic type(P<0.05).No serious adverse effects were observed in all patients.Conclusion The combination therapy using DPL and long pulsed 1 064 nm Nd: YAG laser is significantly better than DPL only, especially in papulopustular subtype of rosacea.