Q开关1064nm激光联合氨甲环酸射频导入治疗黄褐斑疗效观察

Observation on the curative effect of Q-switched 1064nm laser combined with tranexamic acid introduction in the treatment of chloasma

目的 探究Q开关1064nm激光联合氨甲环酸导入治疗黄褐斑疗效。方法 研究对象选定2021年1月-2022年4月在广州医科大学附属第四医院皮肤科就诊的黄褐斑患者64例,将其按照随机数表法分为对照组和试验组,各32例。对照组进行Q开关1064nm激光治疗,试验组给予射频导入氨甲环酸联合Q开关1064nm激光治疗,两组均治疗半年。对比两组的临床疗效,治疗前后的黄褐斑恢复情况[平均面积和严重程度指数(MASI)评分、整体评价(PGA)评分]、性激素[黄体生成激素(LH)、卵泡刺激素(FSH)]、血清指标[促黑素(MSH)、环氧化酶(COX-2)]的变化及不良反应发生率。结果 治疗后,试验组的总有效率(84.38%)高于对照组(62.50%,P<0.05);两组患者的MASI评分下降,且试验组低于对照组(P<0.05);治疗后3个月、6个月试验组的PGA评分均高于对照组(P<0.05);试验组的不良反应发生率(12.50%)低于对照组(34.38%,P<0.05)。结论 Q开关1064nm激光联合氨甲环酸导入治疗黄褐斑具有良好的临床效果,能调节血清异常表达,安全性和临床推广价值较高。

Objective To explore the efficacy of Q-switched 1064nm laser combined with tranexamic acid introduction in the treatment of melasma.Methods The research subjects selected 64 patients with chloasma who visited the Department of Dermatology of the Fourth Affiliated Hospital of Guangzhou Medical University from January 2021 to April 2022,and divided them into a control group and an experimental group according to the random number table method,with 32 cases in each.The control group received Q-switched 1064nm laser therapy,while the experimental group received radiofrequency introduction of tranexamic acid combined with Q-switched 1064nm laser therapy.Both groups were treated for half a year.The clinical efficacy of the two groups was compared,and the recovery of melasma before and after treatment[mean area and severity index (MASI) score,global assessment (PGA) score],sex hormones[luteinizing hormone (LH),follicle-stimulating hormone (FSH)],serum indexes[melanin-stimulating (MSH),cyclooxygenase (COX-2)]changes and the incidence of adverse reactions.Results The total effective rate of the test group (84.38%) was higher than that of the control group (62.50%,P<0.05);The Masi score of the two groups decreased,and that of the test group was lower than that of the control group (P<0.05);The PGA scores of the test group were higher than those of the control group at 3 and 6 months after treatment (P<0.05);The incidence of adverse reactions in the test group (12.50%) was lower than that in the control group (34.38%,P<0.05).Conclusion Q-switched 1064nm laser combined with tranexamic acid introduction in the treatment of chloasma has a good clinical effect,can regulate abnormal serum expression,and has high safety and clinical promotion value.