口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑疗效观察

Curative Effect of Oral Administration Combined with Intradermal Injection of Tranexamic Acid in the Treatment of Melasma

目的:研究口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑的临床疗效。方法:选取2019年1月-2022年1月于笔者医院皮肤科就诊的黄褐斑患者168例,随机数字法分为对照组和实验组,每组84例;对照组采用口服氨甲环酸治疗,实验组采用口服氨甲环酸联合皮内注射氨甲环酸治疗,比较两组治疗前后的临床疗效、皮肤颜色评分、皮损面积评分、症状总分、黄褐斑面积及严重程度(Melasma area severity index,MASI)评分,及治疗1个月、3个月后整体评价(Physician's global assessment,PGA)评分。结果:两组治疗后疗效等级比较差异有统计学意义(P<0.05),实验组的总有效率为97.62%高于对照组的总有效率84.52%(P<0.05);两组治疗后皮肤颜色评分、皮损面积评分及症状总分显著低于治疗前,且实验组治疗后皮肤颜色评分、皮损面积评分及症状总分显著低于对照组(P<0.05);两组治疗3个月后PGA评分较治疗1个月后PGA评分显著下降,且实验组PGA评分显著低于对照组(P<0.05);两组治疗后MASI评分较治疗前显著下降,且实验组MASI评分显著低于对照组(P<0.05);观察组不良反应发生率为2.38%,与对照组的1.19%比较无统计学意义(P>0.05)。结论:口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑疗效显著。

Objective This research aims to investigate the clinical effect of oral administration combined with intradermal injection of tranexamic acid in the treatment of melasma.Methods A total of 168 patients with melasma admitted to the author's hospital from January 2019 to January 2022 were selected,and divided into control group and experimental group by random number table method,with 84 cases in each group,receiving oral administration of tranexamic acid,and oral administration combined with intradermal injection of tranexamic acid,respectively.The two groups were compared in terms of clinical effect,skin color score,skin lesion area score,total symptom score,Melasma Area and Severity Index(MASI)score,and Physician Global Assessment(PGA)score.Results The grades of curative effect in the two groups were significantly different(P<0.05).The total response rate in the experimental group(97.62%)was higher that in the control group(84.52%)(P<0.05).After treatment,skin color score,skin lesion area score and total symptom score were significantly decreased in the two groups,which were significantly lower in the experimental group than in the control group(P<0.05).The PGA scores of the two groups were significantly lower after 3 months of treatment than after 1 month of treatment,and the experimental group had significantly lower scores than the control group(P<0.05).The incidence rates of adverse reactions in the observation group and the control group were 2.38%and 1.19%,without statistically significant difference between the groups(P>0.05).Conclusion Oral administration combined with intradermal injection of tranexamic acid is effective in the treatment of melasma.