CO_(2)点阵激光双模式联合复方倍他米松对增生性瘢痕患者皮肤屏障功能和EGF、BMP-7的影响

The effect of CO_(2) dot matrix laser dual mode combined with compound betamethasone on skin barrier function,EGF,BMP-7 in patients with hypertrophic scars

目的 探讨CO_(2)点阵激光双模式联合复方倍他米松对增生性瘢痕患者皮肤屏障功能和EGF、BMP-7的影响。方法按随机数字表方法,选择安阳第六人民医院2021年1月至2023年1月间68例增生性瘢痕患者作对照组(34例)和观察组(34例)。对照组患者采用复方倍他米松注射液进行治疗,观察组患者采用CO_(2)点阵激光双模式联合复方倍他米松超声波导入治疗。两组均1次/月,4次/疗程。比较两组临床疗效,治疗前后的瘢痕指标,包括瘢痕面积、厚度与温哥华瘢痕量表(VSS)评分,皮肤屏障功能(包括角质层含水量、表皮水分丢失量与pH值),以及血清EGF、TGF-β1、BMP-7水平。结果 观察组临床疗效较对照组更佳(P<0.05)。两组经治疗瘢痕面积均减少,观察组明显少于对照组;瘢痕厚度均减小,观察组明显小于对照组;VSS评分均降低,观察组明显低于对照组(P<0.05)。两组经治疗角质层含水量均升高,观察组升幅更大;表皮水分丢失量与pH值均降低,观察组降幅更大(P<0.05)。两组经治疗血清EGF、TGF-β 1水平均降低,观察组降幅更大;BMP-7水平均升高,观察组升幅更大(P<0.05)。结论 CO_(2)点阵激光双模式联合复方倍他米松治疗增生性瘢痕疗效确切,可有效缩小患者瘢痕面积,减小瘢痕厚度,改善皮肤屏障功能,降低EGF、TGF-β 1表达,提高BMP-7表达,促进瘢痕消退。

Objective Explore the effffects of CO_(2) dot matrix laser dual mode combined with compound betamethasone on skin barrier function,EGF,BMP-7 in patients with hypertrophic scars.Methods Using a random number table method,68 patients with hypertrophic scars from Anyang Sixth People's Hospital from January 2021 to January 2023 were selected as the control group(34 cases)and the observation group(34 cases).The control group patients were treated with compound betamethasone injection,while the observation group patients were treated with CO_(2) dot matrix laser dual mode combined with compound betamethasone ultrasound induction.Both groups received 1 dose per month and 4 doses per course of treatment.Compare the clinical effifficacy of two groups,including scar indicators before and after treatment,including scar area,thickness,and Vancouver Scar Scale(VSS)score,skin barrier function(including stratum corneum water content,epidermal water loss,and pH value),as well as serum EGF and TGF-β1,BMP-7 level.Results The clinical effifficacy of the observation group was better than that of the control group(P<0.05).The scar area of both groups decreased after treatment,and the observation group was signifificantly less than the control group;The thickness of scars decreased signifificantly in the observation group compared to the control group;The VSS scores decreased signifificantly in the observation group compared to the control group(P<0.05).After treatment,the water content in the stratum corneum of both groups increased,while the observation group showed a greater increase;The amount of epidermal water loss and pH value decreased,with a greater decrease in the observation group(P<0.05).Two groups of treated serum EGF and TGF-β1 All levels decreased,with a greater decrease in the observation group;The levels of BMP-7 all increased,with a greater increase in the observation group(P<0.05).Conclusion The combination of CO_(2) dot matrix laser dual mode and compound betamethasone has a defifinite therapeutic effffect on hypertrophic scars,which can effffectively reduce the scar area and thickness of patients,improve skin barrier function,and reduce EGF and TGF-β1 expression,increase BMP-7 expression,promote scar regression.