CO_(2)点阵激光联合表皮生长因子凝胶治疗痤疮瘢痕的有效性研究

Study on Effectiveness to Treat Acne Scars Jointly with CO_(2) Fractional Laser and Epidermal Growth Factor

目的观察CO_(2)点阵激光联合基因重组人表皮生长因子凝胶治疗痤疮瘢痕的有效性。方法选择2020年1月至2021年2月,痤疮瘢痕患者80例,按照随机数字表法分为对照组和联合治疗组,每组患者各40例。其中,对照组采用CO_(2)点阵激光治疗;联合治疗组采用CO_(2)点阵激光治疗后外敷基因重组人表皮生长因子治疗。两组的激光治疗参数均为能量10 mJ,功率1~2 W,能量密度10 J/cm^(2),脉宽<1 ms,两组患者均行3次激光治疗,每次治疗间隔1~2个月。比较两组患者完成3次治疗后1 d评估患者皮肤情况、角质层水分含量、面部肌肤pH改变;同时评估皮肤屏障功能和角质层蛋白质含量变化。比较两组患者血清白介素-2(interleukin-2,IL-2)、白介素6(interleukin-6,IL-6)水平。同时,记录两组患者色素沉着、瘢痕增生等不良反应发生情况。结果治疗后联合治疗组角质层含水量为(44.6±5.6)au显著高于对照组(37.0±4.8)au,两组比较差异具有统计学意义(P<0.05)。治疗后联合治疗组乳酸刺激试验评分及黏脱蛋白质含量为(1.31±0.1)分、(30.1±3.2)μg;对照组为(2.05±0.2)分,(35.1±3.5)μg,联合治疗组显著低于对照组(P<0.05)。治疗后联合治疗组血清IL-2、IL-6水平为(16.4±2.2)ng/l、(26.7±3.0)ng/l,对照组为(23.7±3.3)ng/l、(34.2±3.9)ng/l,联合治疗组显著低于对照组(P<0.05)。治疗后联合治疗组红斑、色素斑、纹理评分为(0.26±0.1)分、(0.36±0.1)分、(0.39±0.1)分,对照组为(0.61±0.2)分、(0.71±0.2)分、(0.75±0.3)分,联合治疗组显著低于对照组(P<0.05)。联合治疗组不良反应发生率(7.50%)显著低于对照组(25.0%)(P<0.05)。结论CO_(2)点阵激光联合表皮生长因子凝胶治疗痤疮瘢痕可显著抑制患者皮肤炎症,恢复皮肤屏障功能,提高患者皮肤评分,不良反应发生率低。

Objective To observe the effectiveness to treat acne scars jointly with CO_(2)fractional laser and gene recombinant human epidermal growth factor gel.Methods Totally 80 patients with acne scars treated in our hospital during the period from Jan.2020 to Feb.2021 were selected and divided randomly into the control group and combined treatment group,40 patients in each group.The patients in the control group were treated with CO_(2)fractional laser and those in the combined treatment group with CO_(2)fractional laser plus recombinant human epidermal growth factor.The laser treatment parameters of the two groups were given as below:10 mJ(energy),1~2 W(power),10 J/cm^(2)(lenergy density)and<1 ms(pulse width).The patients in both groups were given 3 laser treatments at an interval of 1~2 months.Upon the completion of 3 treatments,the skin condition,stratum corneum moisture content and changes in facial skin pH of both groups were evaluated and compared.At the same time,the skin barrier function and stratum corneum protein content changes of both groups were also evaluated.The serum levels of interleukin-2(IL-2)and interleukin-6(IL-6)were compared between the two groups.Meanwhile,the occurrence of adverse reactions such as hyperpigmentation and scarring of the two groups was recorded.Results After the treatment,the water content of the stratum corneum was(44.6±5.6)au in the combined treatment group,and(37.0±4.8)au in the control group.The figure of the combined treatment group was significantly higher than that of the control group(P<0.05).After the treatment,the lactic acid stimulation score and mucin protein content were(1.31±0.1)score and(30.1±3.2)μg in the combined treatment group(2.05±0.2)score and(35.1±3.5)μg in the control group.The scores of the combined treatment group were significantly lower than those of the control group(P<0.05).After the treatment,the serum IL-2 and IL-6 levels were(16.4±2.2)ng/l and(26.7±3.0)ng/l in the combined treatment group,and(23.7±3.3)ng/l and(234.2±3.9)ng/l in the control group,and the figures of the combined treatment group were significantly lower than those of the control group(P<0.05).After the treatment,the scores of erythema,pigment spots and texture were(0.26±0.1),(0.36±0.1)and(0.39±0.1)score respectively in the combined treatment group,and(0.61±0.15),(0.71±0.23)and(0.75±0.25)score respectively in the control group,and the scores of the combined treatment group were significantly lower than those of the control group(P<0.05).The adverse reaction rate was 7.50%in the combined treatment group and 25.0%in the control group,and the figure in the combined treatment group was significantly lower than that of the control group(P<0.05).Conclusions While treating acne scars,combined application of CO_(2)fractional laser and genetic recombinant human epidermal growth factor gel will significantly inhibit skin inflammation in patients,restore skin barrier functions,improve skin scores of patients,and have a low incidence of adverse reactions.