bFGF凝胶联合超脉冲CO_(2)点阵激光治疗面部痤疮凹陷性瘢痕疗效对患者皮损状态的影响

Efficacy of bFGF gel combined with ultra-pulsed CO_(2) fractional laser on facial acne depressed scars and influence on skin lesion status

目的研究重组牛碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)凝胶联合超脉冲CO_(2)点阵激光治疗面部痤疮凹陷性瘢痕的疗效。方法选取自2022年2月至2023年2月于青岛西海岸新区人民医院皮肤科就诊的60例面部痤疮凹陷性瘢痕患者,随机分为bFGF凝胶+CO_(2)激光组(超脉冲CO_(2)点阵激光后联合bFGF凝胶涂抹)和CO_(2)激光组(超脉冲CO_(2)点阵激光),30例/组。每3个月治疗1次,共治疗2次。治疗后随访3个月,对比两组患者临床疗效,症状改善情况,治疗前、治疗后皮肤生理情况[角质层含水量和经表皮水分丢失(transepidermal water loss,TEWL)、瘙痒评分、皮肤纹理值]、瘢痕改善情况[面部痤疮瘢痕评分(echelled'evaluationclinique descicatricesd'acne,ECCA)、面部整体美容效果改善量表(global aesthetic improvement scale,GAIS)],统计两组患者不良反应发生率及患者满意度。结果bFGF凝胶+CO_(2)激光组临床总有效率(96.67%),明显高于CO_(2)激光组(80.00%),差异有统计学意义(P<0.05);bFGF凝胶+CO_(2)激光组症状持续时间及创面愈合时间均短于CO_(2)激光组(P<0.05);治疗后1个月和3个月,两组患者皮肤角质层含水量、皮肤纹理值均高于治疗前(P<0.05),且bFGF凝胶+CO_(2)激光组高于CO_(2)激光组(P<0.05),两组患者TEWL、皮肤瘙痒程度均下降(P<0.05),且bFGF凝胶+CO_(2)激光组低于CO_(2)激光组(P<0.05);治疗后1个月和3个月,两组患者ECCA评分均低于治疗前(P<0.05),GAIS评分均高于治疗前(P<0.05),且组间比较差异有统计学意义(P<0.05);bFGF凝胶+CO_(2)激光组总不良反应率(6.67%)显著低于CO_(2)激光组(26.67%),差异有统计学意义(P<0.05);bFGF凝胶+CO_(2)激光组的满意率(93.33%)显著高于CO_(2)激光组(73.33%),差异有统计学意义(P<0.05)。结论bFGF凝胶联合超脉冲CO_(2)点阵激光治疗面部痤疮凹陷性瘢痕疗效确切,可显著改善皮肤生理状态,促进受损皮肤修复,不良反应较少,美容满意度较高,值得推荐。

Objective To study the efficacy of recombinant bovine basic fibroblast growth factor(bFGF)gel combined with ultra-pulsed CO_(2) fractional laser in the treatment of facial acne depressed scars.Methods Sixty patients with facial acne depressed scars who were treated in department of plastic surgery from February 2022 to February 2023 were selected and randomly divided into gel+CO_(2) group(ultra-pulsed CO_(2) fractional laser followed by bFGF gel smear treatment,n=30)and CO_(2) group(ultra-pulsed CO_(2) fractional laser,n=30),and both groups were followed up for 3 months after the end of treatment.The clinical efficacy,symptom improvement status,skin physiological condition[water content of stratum corneum,transepidermal water loss(TEWL),itching score,skin texture value]and scar improvement[Vancouver Scar Scale(VSS)score,echelled'evaluationclinique descicatricesd'acne(ECCA),global aesthetic improvement scale(GAIS)]before and after treatment were compared between both groups.The adverse reaction rate and follow-up aesthetic satisfaction were counted in the two groups.Results The total clinical effective rate in gel+CO_(2) group was 96.67%,which was significantly higher than 80.00%in CO_(2) group(P<0.05).After laser treatment,the symptom duration and wound healing time in gel+CO_(2) group were shorter than those in CO_(2) group(P<0.05).After 1 month and 3 months of treatment,the water content of stratum corneum and skin texture value were higher in both groups than those before treatment(P<0.05),and the indicators were higher in gel+CO_(2) group than those in CO_(2) group(P<0.05),and the TEWL and skin itching degree were decreased in both groups(P<0.05),and the indicators in gel+CO_(2) group were lower than those in CO_(2) group(P<0.05).The ECCA score in both groups was gradually reduced after 1 month and 3 months of treatment(P<0.05),and the score in gel+CO_(2) group was lower than that in CO_(2) group(P<0.05),and the GAIS score in both groups were higher than those before treatment(P<0.05),and the scores in gel+CO_(2) group were significantly higher than those in CO_(2) group(P<0.05).The total adverse reaction rate in gel+CO_(2) group(6.67%)was significantly lower than that in CO_(2) group(26.67%)(P<0.05).The satisfaction in gel+CO_(2) group(93.33%)was significantly higher than 73.33%in CO_(2) group(P<0.05).Conclusion bFGF gel combined with ultra-pulsed CO_(2)fractional laser has a definite efficacy in the treatment of facial acne depressed scars,and it can significantly improve the skin physiological status and promote the repair of damaged skin,it has few adverse reactions and high aesthetic satisfaction.