光动力疗法联合口服异维A酸治疗中重度痤疮的临床疗效及安全性分析

Clinical Efficacy and Safety Analysis of Photodynamic Therapy Combined with Oral Isotretinoin in the Treatment of Moderate to Severe Acne

目的:探讨光动力疗法联合口服异维A酸治疗中重度痤疮的临床疗效及安全性。方法:纳入2020年6月-2022年6月笔者医院收治的中重度痤疮患者84例,随机分为异维A酸组、光疗组和联合治疗组,各28例。异维A酸组予以口服异维A酸治疗,光疗组予以光动力疗法,联合治疗组予以光动力疗法联合口服异维A酸治疗,评估三组治疗效果,观察治疗前及治疗8周后患者皮损数量及生活质量,记录治疗期间不良反应。结果:联合治疗组总有效率(82.14%)显著高于异维A酸组(46.43%)和光疗组(57.14%)(均P<0.05)。治疗后,联合治疗组非炎性皮损数量显著低于异维A酸组和光疗组(P<0.05),联合治疗组和光疗组治疗后炎性皮损数量显著低于异维A酸组(P<0.05)。治疗后,三组患者Acne-Qol各维度评分较治疗前均有明显上升(P<0.05),且联合治疗组明显高于异维A酸组和光疗组(P<0.05)。联合治疗组和光疗组患者的红斑水肿、反应性痤疮、色素沉着发生率均高于异维A酸组(P<0.05),三组间干燥脱屑比较差异无统计学意义(P>0.05)。结论:光动力疗法联合口服异维A酸治疗中重度痤疮可有效提高临床疗效,明显改善皮损情况及患者生活质量。

Objective To investigate the clinical efficacy and safety of photodynamic therapy combined with oral isotretinoin in the treatment of moderate to severe acne.Methods From June 2020 to June 2022,84 patients with moderate to severe acne admitted to the author's hospital were randomly divided into isotretinoin group,phototherapy group,and combined treatment group,with 28 patients in each group.The isotretinoin group was treated with oral isotretinoic,the phototherapy group was treated with photodynamic therapy,and the combined treatment group was treated with photodynamic therapy combined with oral isotretinoic.The treatment effect was evaluated,and the number of skin lesions and quality of life of patients before and after 8 weeks of treatment were observed.The adverse reactions during treatment were recorded.Results The total effective rate of 82.14%in the combined treatment group was significantly higher than 46.43%in the isotretinoin group and 57.14%in the phototherapy group(all P<0.05).After treatment,the non inflammatory skin lesions in the combined treatment group were significantly lower than those in the isotretinoin group and the phototherapy group(P<0.05),while the inflammatory skin lesions in the combined treatment group and the phototherapy group were significantly lower than those in the isotretinoin group(P<0.05).After treatment,the Acne-Qol scores in all dimensions of patients in the three groups were significantly higher than before treatment(P<0.05),and the combined treatment group was significantly higher than the isotretinoin group and the phototherapy group(P<0.05).The incidence of erythema edema,reactive acne,and pigmentation in the combined treatment group and the phototherapy group were higher than those in the isotretinoin group(P<0.05).There was no statistically significant difference in dry desquamation among the three groups(P>0.05).Conclusion Photodynamic therapy combined with oral isotretinoin in the treatment of moderate to severe acne can effectively improve the clinical efficacy,significantly improve the condition of skin lesions and quality of life of patients.