复合酸、果酸、水杨酸治疗轻中度痤疮的疗效比较研究

Therapeutic effect of compound acid,alpha hydroxyl acid and salicylic acid on acne vulgaris:a comparative study

目的分析复合酸治疗轻中度痤疮的效果,并与果酸、水杨酸治疗痤疮效果进行比较,探讨复合酸治疗痤疮的疗效及不良反应。方法2019年8月至2020年5月,苏州市立医院皮肤科治疗轻中度痤疮患者105例[男21例,女84例;年龄15~47(27±6)岁],根据治疗药物分为复合酸组(n=36)、果酸组(n=37)、水杨酸组(n=32),每3周治疗1次,共4次。分别于治疗前,治疗1、2、3、4次后第3周评估疗效。记录患者面部非炎性皮损(粉刺)和炎症皮损(丘疹、脓疱)数量。于患者治疗前和治疗4次后,用VISIA图像分析仪记录患者右侧面部紫质、红色区、棕色斑、紫外线色斑、斑点、毛孔、皱纹、纹理区域百分比,记录患者治疗期间不良反应发生情况。结果复合酸组、果酸组、水杨酸组总有效率分别为77.8%、70.3%、71.9%,差异无统计学意义(χ^(2)=0.58,P=0.750);非炎症性皮损有效率,3组差异无统计学意义(χ^(2)=4.58,P=0.101)。炎症性皮损有效率,复合酸组和水杨酸组高于果酸组,差异有统计学意义(χ^(2)=6.45,P=0.040)。治疗4次后,复合酸组和水杨酸组紫质、红色区、斑点百分数均高于治疗前,差异均有统计学意义(均P<0.05),而果酸组治疗4次后紫质高于治疗前,差异有统计学意义(t=3.51,P=0.010),红色区改变差异无统计学意义(P>0.05)。结论复合酸治疗轻中度痤疮安全有效,对痤疮炎症性皮损和非炎症性皮损均有效,不良反应较少,值得临床应用。

Objective To evaluate the curative effect and adverse reactions of compound acid,alpha hydroxyl acid(AHA),and salicylic acid(SA)in the treatment of mild to moderate acne.Methods A total of 105 patients admitted in Suzhou Municipal Hospital from August 2019 to May 2020 were divided into three groups randomly and treated with compound acid,AHA and SA,once every 3 weeks,4 times totally.The efficacy was evaluated before treatment,3 weeks after 1 time,2 times,3 times,and 4 times.The number of non-inflammatory lesions(comedos)and inflammatory lesions(papules or pustules)were recorded.VISIA image was used to record the patient's facial characteristics before treatment and 3 weeks after 4 times.The occurrence of adverse reactions was recorded.Results Three groups were all safe and effective.The efficiency of non-inflammatory lesions showed that there was no statistically significant difference between the 3 groups(χ^(2)=4.58,P=0.101).The effective rate of inflammatory lesions in the compound acid and SA groups were higher than that of AHA group,and the difference was statistically significant(χ^(2)=6.45,P=0.040).After 4 times,the clinical data of purpurin,red area,and spot in compound acid and SA groups were higher than those before treatment,and the difference was statistically significant(P<0.05).While in the AHA group,the purple matter was higher than that before treatment after 4 times,the difference was statistically significant(t=3.506,P=0.010),and the change in the red area was not statistically significant(P>0.05).Conclusions The compound acid is safe and effective in treating mild and moderate acne.It is effective for acne inflammatory and non-inflammatory lesions.It has less adverse reactions and is worthy of clinical application.