A型肉毒毒素联合红蓝光治疗轻中度痤疮的疗效观察

Efficacy of botulinum toxin type A combined with red and blue light in the treatment of mild to moderate acne

目的观察A型肉毒毒素真皮内给药联合红蓝光治疗轻中度痤疮的疗效及对患者皮肤屏障功能相关蛋白的影响。方法自2019年5月至2021年4月,解放军联勤保障部队第九八〇医院烧伤整形科选取轻中度痤疮患者60例,随机分成两组,30例/组。对照组予以阿达帕林凝胶联合红蓝光治疗,观察组予以A型肉毒毒素真皮内给药联合红蓝光治疗。比较两组临床疗效、不良反应发生率、满意度及治疗前后痤疮综合分级系统(global acne grading system,GAGS)评分、痤疮瘢痕权重(echelle d'evaluation clinique des cicatrices d'acne,ECCA)评分、黏脱蛋白质含量、皮脂腺分泌率、Toll样受体2(toll-like receptor,TLR2)、TLR4表达情况。结果观察组治疗总有效率(96.67%)较对照组(73.33%)高(P<0.05),两组不良反应发生率无统计学意义(P>0.05);观察组治疗后1个月、治疗后3个月GAGS评分、ECCA评分黏脱蛋白质含量、皮脂腺分泌率及TLR2、TLR4表达水平较对照组低(P<0.05)。结论A型肉毒毒素真皮内给药联合红蓝光治疗轻中度痤疮,可有效减轻炎症反应,减少皮脂腺分泌,改善皮肤屏障功能及瘢痕,治疗效果显著,安全性较高。

Objective To investigate the efficacy of intra-dermal administration of botulinum toxin type A combined with red and blue light in the treatment of mild to moderate acne and the effect on proteins related to skin barrier function in patients.Methods There were 60 patients with mild to moderate acne were randomly divided into two groups,with 30 cases in each group.The control group was treated with adapalene gel combined with red and blue light,and the experimental group was treated with botulinum toxin A intradermal administration combined with red and blue light.The clinical efficacy,adverse reaction rate,satisfaction rate,and acne comprehensive grading system(GAGS)score,acne scar weighted score(ECCA),content of mucin,secretion rate of sebaceous gland,expression of toll-like receptor 2(TLR2)and TLR4 before and after treatment were compared between the two groups.Results The total effective rate(96.67%,73.33%)in the experimental group were higher than those in the control group(P<0.05),while there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The GAGS score,ECCA score,mucin content,sebaceous gland secretion rate,and TLR2 and TLR4 expression in the experimental group were lower than those in the control group 1 month and 3 months after treatment(P<0.05).Conclusion Intradermal administration of botulinum toxin type A combined with red and blue light therapy for the treatment of mild to moderate acne can effectively reduce inflammatory reactions,reduce sebum secretion,improve skin barrier function and scarring,with significant efficacy,high safety,and high patient satisfaction.