不同浓度马来酸噻吗洛尔联合窄谱强脉冲光治疗增生性瘢痕的效果

Study on the Efficacy of Different Concentrations of Timolol Maleate Combined with Narrow-spectrum Intense Pulsed Light in the Treatment of Hypertrophic Scars

目的:探讨不同浓度马来酸噻吗洛尔联合窄谱强脉冲光治疗增生性瘢痕的效果。方法:选取2022年1—12月珠海市人民医院皮肤科、整形外科收治的90例增生性瘢痕患者为研究对象。将患者按照随机数表法分为三组,实施窄谱强脉冲光治疗的30例为对照组,实施低浓度马来酸噻吗洛尔联合窄谱强脉冲光治疗的30例为低浓度观察组,实施高浓度马来酸噻吗洛尔联合窄谱强脉冲光治疗的30例为高浓度观察组。比较三组临床疗效、治疗前及治疗后3个月瘢痕形态[温哥华瘢痕量表(VSS)]、疼痛程度[视觉模拟评分法(VAS)评分]、血清血管内皮细胞生长因子(VEGF)水平,并记录三组治疗期间不良反应发生情况。结果:三组疗效等级及总有效率比较,差异有统计学意义(P<0.05);高浓度观察组总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗后3个月,三组VSS及VAS评分均较治疗前下降,高浓度观察组VSS、VAS评分低于对照组及低浓度观察组,低浓度观察组VSS、VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后3个月,三组VEGF水平均较治疗前下降,高浓度观察组VEGF水平低于对照组及低浓度观察组,低浓度观察组VEGF水平低于对照组,差异有统计学意义(P<0.05)。三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:高浓度马来酸噻吗洛尔联合窄谱强脉冲光可进一步提高增生性瘢痕治疗效果,能改善瘢痕形态,降低患者疼痛,且高浓度马来酸噻吗洛尔临床疗效更好。

Objective:To investigate the effect of different concentrations of Timolol Maleate combined with narrow-spectrum intense pulsed light in the treatment of hypertrophic scars.Method:From January to December 2022,90 patients with hypertrophic scars in the early stage of wound healing admitted to the Dermatology and Plastic Surgery Department of Zhuhai People's Hospital were selected as the research objects.The patients were divided into three groups according to the random number table method,30 patients treated with narrow-spectrum intense pulsed light were selected as the control group,30 patients treated with low-concentration Timolol Maleate combined with narrow-spectrum intense pulsed light were selected as the low-concentration observation group,and 30 patients treated with high-concentration Timolol Maleate combined with narrow-spectrum intense pulsed light were selected as the high-concentration observation group.The clinical efficacy,scar morphology[Vancouver scar scale(VSS)],pain degree[visual analogue scale(VAS)score],serum vascular endothelial growth factor(VEGF)level before treatment and 3 months after treatment were compared among the three groups,and the occurrence of adverse reactions during treatment was recorded.Result:There were statistically significant differences in efficacy grade and total effective rate among the three groups(P<0.05).The total effective rate of high-concentration observation group was significantly higher than that of control group,the difference was statistically significant(P<0.05).Three months after treatment,the VSS and VAS scores of the three groups were decreased compared with those before treatment,the VSS and VAS scores of the high-concentration observation group were lower than those of the control group and the low-concentration observation group,and the VSS and VAS scores of the low-concentration observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Three months after treatment,VEGF levels in the three groups were decreased compared with those before treatment,the VEGF level in the high-concentration observation group was lower than that in the control group and the low-concentration observation group,and the VEGF level in the low concentration observation group was lower than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:Timolol Maleate combined with narrow-spectrum intense pulsed light can further improve the therapeutic effect of hypertrophic scars,improve the scar morphology and reduce the pain of patients,and the clinical effect of high concentration of Timolol Maleate is better.