光动力疗法联合异维A酸治疗中重度痤疮的疗效

Clinical effectiveness of photodynamic therapy combined with oral isotretinoin for moderate to severe facial acne

目的探讨光动力疗法(PDT)联合口服异维A酸治疗面部中重度痤疮的疗效及安全性。方法2018年1-6月,吉林大学中日联谊医院皮肤科将中黾度痤疮患者90例[男42例.女48例;年龄18〜35(23.98±4.25)岁]分为PDT联合异维八酸组(联合组)、PDT组、异维A酸组,每组30例。治疗10、20、30 d记录患者皮损改善数目及不良反应;治疗30、60 d进行疗效判定;治疗结束后定期随访。结果治疗10、20、30 d联合组非炎性皮损、总皮损清除率优于PDT组;炎性、非炎性及总皮损清除率优于异维A酸组。治疗30 d.联合组疗效优于PDT组(x^(2)=13.169,P<0.05)及异维A酸组(x^(2)=19.606,P<0.05)。联合组较PDT组疗程短(P<0.05)。治疗结束6个月,联合组复发率低于异维A酸组(x^(2)=4.941,P<0.05),联合组及PDT组不良反应发生率差异无统计学意义(P>0.05)。结论PDT联合异维A酸治疗中重度痤疮可提高疗效、缩短疗程、减少复发、不良反应少,为中重度痤疮的治疗提供了思路。

Objective To investigate the efficacy and safety of photodynamic therapy(PDT)combined with oral isotretinoin in the treatment of moderate to severe acne.Methods Ninty patients with moderate and severe acne[42 males and 48 females;aged 18-35(23.98±4.25)]in the Depart mcnt of Dermatology,China Japan Friendship Hospital of Jilin University from January to June.2018,were divided into three groups:PDT combined with isotretinoin group(combined group),PDT group and isotretinoin group,with 30 patients in each group.The curative effect was evaluated on the 30th and 60th day of the treatment and the follow-up was carried oul regularly.Results At 10,20.and 30 days of the treatment,ihe clearance rates of non-inflammatory skin lesions and total skin le sions were better than that of the PDT group;the clearance rates of inflammatory,non-inflammatory and total skin lesiorivS in the combined group were better than those of the isotretinoin group.Al 30 days of treatment,the efficacy of the combined group was better than that of the PDT group(x^(2)=13.169,P<0.05)and isotretinoin group(x^(2)=19.606,P<0.05).The treatment course of the com hined group was shorter than that of the PDT group(P<0.05).vSix months after the treatment,the recurrence rate of the combined group was lower than that of the isotretinoin group(x^(2)=4.941,P0.05).And there was no significant difference of the incidence of adverse reactions between the above two groups(P0.05).Conclusions The combination of photodynamic therapy and oral isotretinoin therapy for moderate to severe acne can improve the efficacy,shorten the course of treatment,and reduce the recurrence rate and adverse reactions,which provides a new idea for the treatment of acne.