温热疗法治疗跖疣的皮肤镜下疗效及对CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平的影响研究

Study on the Therapeutic Effect of Thermotherapy on Plantar Warts under Dermoscopy and Its Effects on Levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)

目的:观察温热疗法治疗跖疣的皮肤镜下疗效及对CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平的影响。方法:选取2016年12月-2019年12月笔者医院收治的116例跖疣患者为研究对象,随机分为观察组和对照组,每组58例。观察组采用局部温热治疗仪治疗,对照组采用他扎罗汀凝胶治疗,两组均持续治疗2个月。比较两组治疗后皮肤镜下疗效、治疗前后皮损积分、视觉模拟疼痛评分(VAS)、T淋巴细胞(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平及不良反应发生率,随访半年,观察复发情况。结果:治疗后,观察组临床治疗总有效率(67.24%)显著高于对照组(48.28%)(P<0.05);治疗前,两组皮损积分、疼痛评分及T细胞亚群比较差异无统计学意义(P>0.05);治疗后,两组皮损积分、疼痛评分较治疗前显著下降,CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)值显著上升(P<0.05),观察组皮损积分、疼痛评分显著低于对照组,CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)值显著高于对照组(P<0.05);两组均无严重不良反应发生,复发率(1.72%vs 10.34%)比较差异无统计学意义(P>0.05)。结论:温热疗法治疗跖疣疗效确切,有助于促进皮损消退,改善机体免疫功能,安全性高。

Objective To study the dermoscopic efficacy of hyperthermia in the treatment of plantar warts and determine the related factors. Methods A total of 116 patients with plantar warts admitted to our hospital from December 2016 to December 2019 were randomly divided into the observation group and the control group with 58 cases in each group.The observation group was treated with local hyperthermia apparatus,while the control group was treated with zhaloxin gel.The two groups were treated for 2 months.The curative effects of the two groups under dermoscopy,skin lesion score,visual analog pain score(VAS),T lymphocyte(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)) and the incidence of adverse reactions were compared before and after treatment.The patients were followed up for half a year to observe the recurrence. Results The total effective rate of clinical treatment in the observation group(67.24%) was significantly higher than that in the control group(48.28%)(P<0.05).There was no significant difference between the two groups(P>0.05). After treatment,the skin lesion score and pain score of the two groups decreased significantly compared with those before and after treatment,and the values of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)increased significantly(P<0.05).The skin lesion score and pain score of the observation group were significantly lower than those of the control group,and the values of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than those of the control group(P<0.05).There were no serious adverse reactions between the two groups,and there was no significant difference in the recurrence rate(1.72%,10.34%)(P>0.05). Conclusion Hyperthermia is effective in the treatment of plantar warts,which is helpful to promote the regression of skin lesions and improve the immune function.