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1.
目的 探讨景天祛斑片联合丝白祛斑软膏治疗气滞血瘀型黄褐斑的临床疗效。方法 选取2021年3月—2021年6月60例符合入组条件的黄褐斑病例为研究对象,随机分为观察组与对照组,每组30例。观察组采用景天祛斑片联合丝白祛斑软膏治疗,对照组仅口服景天祛斑片治疗,疗程12周。两组均于治疗前后进行VISIA拍摄、黄褐斑面积及严重程度评分(MASI)及皮肤病生活质量指数评分(DLQI),在治疗后进行医生整体评价(PGA),同时监测治疗中出现的不良反应。结果 观察组和对照组治疗后的MASI及DLQI评分别较治疗前均明显降低,具有显著性差异(P <0.05)。治疗后观察组的MASI及DLQI评分低于对照组,观察组的MASI及DLQI差值高于对照组,均具有明显统计学意义(P <0.05)。治疗后观察组的PGA评分优于对照组,具有显著性差异(P <0.05)。分析两组治疗前后VISIA图像,均可见面部黄褐斑好转。结论 景天祛斑片联合丝白祛斑软膏可有效改善和治疗气滞血瘀型黄褐斑,治疗过程未见不良反应。  相似文献   

2.
目的 研究黄褐斑患者的病因、加重因素及对生活质量的影响。 方法 通过问卷形式收集166例女性黄褐斑患者的人口学资料、行为学资料、临床资料,并计算黄褐斑面积及严重程度评分(MASI)、皮肤病生活质量评分(DLQI)、黄褐斑生活质量评分(MELA-SQOL)。通过多元线性回归分析,寻找黄褐斑严重程度及患者生活质量影响因素。 结果 33.13%(55/166)的患者在发病前1年内有怀孕史。4.82%(8/166)的患者发病前1个月内有明确日光暴晒史。患者MASI评分(5.99 ± 4.01)分,DLQI评分(4.34 ± 4.41)分,MELASQOL评分(30.54 ± 17.91)分。黄褐斑MELA-SQOL评分随着年龄的增长降低(β = -0.220,t = 2.874,P < 0.05),随着皮损颜色的加深上升(β = 0.217,t = 2.827,P < 0.05)。绝经前黄褐斑患者随着年龄的增长MASI评分增加(β = 0.244,t = 3.387,P = 0.001),Fitzpatrick皮肤分型为Ⅳ型的患者MASI评分较Ⅲ型皮肤高(β = 0.322,t = 4.615,P < 0.001)。 结论 黄褐斑的发病与激素水平波动和日晒有关。黄褐斑颜色越深、年龄越小的患者生活质量受黄褐斑的影响越大。FitzpatrickⅣ型患者较Ⅲ型的患者黄褐斑更重。绝经前黄褐斑患者随着年龄增长皮损有加重趋势。  相似文献   

3.
【摘要】 目的 评估长脉宽1 064 nm Nd:YAG 激光联合含滇山茶和三七的外用乳剂治疗黄褐斑的疗效。方法 选取2019年6月至2020年6月宁夏回族自治区人民医院皮肤科门诊收治的80例黄褐斑患者,按随机数字表法随机分为对照组和观察组。对照组40例,采用长脉宽1 064 nm Nd:YAG激光治疗,每2周1次,6次为1个疗程;观察组40例,在对照组治疗的基础上联合外用含滇山茶和三七的外用乳剂,每天2次,3个月为1个疗程。比较两组治疗前后黄褐斑皮损面积和严重度指数(MASI)、临床疗效、患者满意度以及安全性。结果 观察组治疗后4周、8周MASI评分分别为(14.57 ± 3.22)分、(10.00 ± 2.94)分,对照组为(14.74 ± 3.11)分、(11.31 ± 3.00)分,两组差异均无统计学意义(P>0.05)。治疗后12周,观察组MASI评分为(4.80 ± 2.78)分,对照组 (7.07 ± 3.22)分,两组差异有统计学意义(t = -3.38,P <0.01)。治疗后3个月观察组有效36例(90%),对照组31例(77.5%),组间差异有统计学意义(χ2 = 4.58,P < 0.001);患者满意度87.5%(35例),对照组(72.5%,29例),两组差异无统计学意义(χ2 = 7.26,P = 0.06)。观察组不良反应发生率12.5%(5例),对照组为17.5%(7例),两组差异无统计学意义(P>0.05)。结论 联合外用含滇山茶和三七的外用乳剂比单用长脉宽1 064 nm Nd: YAG激光治疗黄褐斑皮损改善更明显,患者满意度更高,且不良反应发生率降低。  相似文献   

4.
皮果酸治疗黄褐斑的临床疗效观察   总被引:1,自引:0,他引:1  
目的:观察羟基乙酸(果酸)治疗黄褐斑的临床疗效和安全性,掌握果酸治疗的适应证及方法.方法:应用质量浓度分别为20%、35%、50%、70%的果酸对64例黄褐斑患者进行治疗,每2周1次,4次治疗为1个疗程.由两名资深皮肤科医生对患者进行黄褐斑皮损面积和严重程度指数(MASI)评分,采用自身前后对照进行疗效观察,记录患者出现的不良反应.结果:随着疗程的增加,患者的MASI评分逐渐下降.共有63例患者完成第1个疗程,表皮型黄褐斑有效率81.82%,混合型有效率40.00%,表皮型比混合型患者MASI下降更显著(P < 0.05);Ⅲ型皮肤黄褐斑患者有效率39.13%,Ⅳ型有效率75.00%,Ⅳ型皮肤比Ⅲ型皮肤患者MASI下降更显著(P<0.05).完成2个疗程的41例患者中,第1个疗程结束时有效率为41.46%,第2 个疗程结束时有效率为78.05%,MASI值下降有统计学差异(P<0.05).63例患者能耐受质量浓度为70%的果酸.刺痛、瘙痒等不良反应均在对症处理后消失.结论:果酸治疗黄褐斑,是一种安全有效且不良反应少的治疗方法;对于表皮型黄褐斑患者及Ⅳ型皮肤黄褐斑患者疗效尤佳.  相似文献   

5.
目的研究口服氨甲环酸联合Q开关Nd∶YAG激光治疗黄褐斑的临床疗效和安全性。方法 57例黄褐斑患者随机分为试验组和对照组,试验组在接受Nd∶YAG激光治疗的同时口服氨甲环酸片12周,对照组仅接受Nd∶YAG激光治疗。治疗后4、8、12周对患者进行黄褐斑皮损面积和严重度指数(MASI)评分,观察临床治疗效果并记录不良反应。结果随着治疗时间增加,患者的MASI评分逐渐下降。治疗后8周、12周,试验组和对照组患者MASI评分比较差异有统计学意义(P0.05)。两组患者无明显不良反应发生。结论 Q开关Nd∶YAG激光联合氨甲环酸口服治疗黄褐斑安全有效,且不良反应少。  相似文献   

6.
目的探讨微针滚轮联合外用药物治疗黄褐斑的临床疗效和安全性。方法 51例黄褐斑患者随机分为两组,治疗组27例,接受微针滚轮治疗,并湿敷维生素C,然后外涂类人胶原蛋白修复敷料及氢醌乳膏;对照组24例,单纯外用类人胶原蛋白修复敷料及氢醌乳膏治疗,观察疗效及不良反应。结果治疗结束后,治疗组MASI评分8.38±0.88,有效率51.85%;对照组MASI评分14.94±2.09,有效率20.83%,差异均有统计学意义(均P0.05),但是治疗组患者满意率(77.78%)和对照组患者满意率(54.17%)差异无统计学意义(P0.05),且两组患者均未见严重不良反应。结论微针滚轮联合维生素C、类人胶原蛋白以及氢醌乳膏可提高黄褐斑疗效,且不良反应小。  相似文献   

7.
 目的 探究口服氨甲环酸片联合应用LED黄光治疗黄褐斑的临床效果。 方法 选择符合黄褐斑诊断的80例女性患者为研究对象,将其随机分为对照组和实验组,每组40例,对照组患者给予口服氨甲环酸片,实验组在此基础上同时给予LED黄光治疗,共治疗20周,比较两组患者的临床疗效和满意度。 结果 实验组有效率为60.00%,高于对照组的37.50%,差异有统计学意义(X2=4.05,P<0.05)。实验组治疗后MASI评分下降值大于对照组,差异有统计学意义(t=2.18,P<0.05);满意度高于对照组患者,差异有统计学意义(X2=9.75,P<0.05)。 结论 口服氨甲环酸片联合LED黄光治疗是一种简单实用、安全、有效的黄褐斑治疗方法,值得在临床中推广应用。  相似文献   

8.
目的:评估淡斑美白精华液改善黄褐斑的临床疗效及安全性。方法:采用双中心、随机、开放试验研究,将80例黄褐斑患者随机分为试验组(41例)和对照组(39例),分别于黄褐斑皮损处外用淡斑美白精华液及润白保湿乳,每天2次。在使用产品前以及使用后第2、4、8、12周评估黄褐斑皮损面积及严重程度指数(MASI)变化,皮肤色度仪定量测量皮肤颜色以及受试者自评。结果:在使用产品12周后,试验组和对照组的MASI下降率分别为55.44%和42.98%,属好转。治疗组有效率为95.1%,对照组为92.3%。两组疗效比较差异无统计学意义(P0.05)。结论:淡斑美白精华液对黄褐斑有效,耐受性良好。  相似文献   

9.
 目的:探讨浅表婴儿皮肤血管瘤(IH)皮损特点与疗效的关系。方法:纳入77例未经任何治疗的浅表IH患儿,按照初诊时皮损分布特点分为散在分布组(A组)41例和融合分布组(B组)36例。两组均使用激光联合外敷马来酸噻吗洛尔滴眼液治疗,每次激光治疗后1周开始外敷药水,瘤体基本消退时停止治疗。取入选病例皮损周边正常皮肤作为对照组。分别于治疗前、治疗后4、8、12、16、20周,检测血红素 (EI) 值。治疗后每4周评价疗效、记录激光次数及不良反应。结果:①治疗4周后,A组有效率为21.95%,B组有效率为5.56%,差异有统计学意义(X2=4.21,P<0.05)。治疗时间越长,两组有效率差异越明显。②A组平均激光治疗(1.54±0.81)次,B组平均激光治疗(2.89±1.21)次,两组比较差异有统计学意义(t=5.67,P<0.01)。③治疗前B组 EI值(811.91±198.86)明显高于A组(676.14±158.14)及对照组(314.58±27.00),三组比较差异有统计学意义(F=91.95,P<0.01)。治疗16周后,A组 EI值已明显下降,与对照组比较差异无统计学意义(P>0.05);B组EI值仍明显高于A组及对照组,三组比较差异有统计学意义(F=50.42,P<0.01)。结论:散在分布的浅表IH比融合分布的浅表IH激光治疗次数少,疗程短,有效率高。  相似文献   

10.
目的 探讨消银汤联合卡泊三醇软膏治疗进展期血热型轻/中度(PASI评分 < 10)寻常性银屑病疗效和对IL-17、IL-22、TNF-α水平影响。方法 60例进展期血热型轻/中度寻常性银屑病患者分为治疗组及对照组,每组各30例。治疗组予消银汤口服;对照组予安慰剂口服,2组同时外用卡泊三醇软膏;另选志愿者30例作为健康对照组;疗程12周。记录治疗前、后PASI评分,检测治疗前、后Th17细胞、TNF-α、IL-22、IL-17水平。结果 治疗前,与健康对照组相比,治疗组及对照组在Th17细胞水平及血清IL-17、IL-22和TNF-α水平差异有统计学意义(P < 0.05),治疗组及对照组水平高于健康对照组;治疗后,上述指标与治疗前比较,差异有统计学意义(P < 0.05)。治疗组治疗后PASI评分为(1.83 ± 1.28),对照组为(2.91 ± 1.42),差异有统计学意义(P < 0.05)。治疗组总有效率为93.33%,与对照组总有效率73.33%比较差异有统计学意义(P < 0.05)。治疗组在PASI评分,治疗总有效率及细胞因子水平改善方面优于对照组。结论 Th17细胞及血清IL-17、IL-22和TNF-α水平在轻/中度寻常性银屑病患者存在异常,消银汤联合卡泊三醇软膏对此有改善作用。  相似文献   

11.
目的:探讨羟基乙酸化学脱皮治疗妇女黄褐斑的疗效和安全性。方法:35例女性黄褐斑患者先用8%羟基乙酸霜治疗2周,继而每周以20%的羟基乙酸乳液化学脱皮一次。两次化学脱皮期间仍外用8%羟基乙酸。治疗4次后判断疗效。结果:基本治愈4例(11.4%),显效8例(22.9%),有效17例(48.6%),无效6例(17.1%)。结论:羟基乙酸化学脱皮可以安全有效的治疗妇女黄褐斑。  相似文献   

12.
Melasma is a common acquired disorder of facial hyperpigmentation. In this study we investigated the efficacy and safety of a combined treatment regimen including serial glycolic acid peels, topical azelaic acid cream and adapalene gel in the treatment of recalcitrant melasma. Twenty-eight patients with recalcitrant melasma were enrolled in a prospective, randomized, controlled trial lasting 20 weeks. The patients of the group receiving chemical peels underwent serial glycolic acid peels in combination with topical azelaic acid 20% cream (b.i.d.) and adapalene 0.1% gel (q.i.d., applied at night). The control group received only topical treatment including topical azelaic acid and adapalene. The clinical improvement was assessed with the Melasma Area Severity Index (MASI) at baseline and monthly during the 20-week treatment period. The results showed a prominent decrease in MASI scores at the end of the treatment in both groups, although the results were better in the group receiving chemical peels (P=0.048). All patients tolerated the topical agents well with minimal irritation observed in the first few weeks of the therapy. Three patients in the glycolic acid peel group developed a mild-degree postinflammatory hyperpigmentation with total clearance at the end of the treatment period. Therefore, the present study suggests that combined treatment with serial glycolic acid peels, azelaic acid cream and adapalene gel should be considered as an effective and safe therapy in recalcitrant melasma.  相似文献   

13.
BACKGROUND: Melasma is a common disorder of facial hyperpigmentation. Many modalities of treatment are available, but none is satisfactory. MATERIALS AND METHODS: Twenty-five nonpregnant female patients with a minimum melasma area and severity index (MASI) of 15 were recruited in the study. After a detailed history and clinical examination under natural light and Wood's light, MASI was calculated and color photographs were taken of all patients. Patients were advised to carry out a prepeel program of daily application of topical sunscreens (sun protection factor-15, SPF-15) and 10% glycolic acid lotion at night for 2 weeks. Patients were then treated with 50% glycolic acid facial peel once per month for three consecutive months. At regular intervals and at the end of the follow-up period (3 months) after the last peel, the degree of improvement in pigmentation was assessed by remeasuring MASI. Side-effects, if any, were also recorded. The data obtained were statistically analyzed using Student's paired t-test and Spearman rank correlation coefficient test. RESULTS: Improvement in melasma (reduction in MASI) was observed in 91% of patients (P < 0.01). Patients with epidermal-type melasma demonstrated a better response to treatment than those with mixed-type melasma (P < 0.05). CONCLUSIONS: The prepeel program followed by 50% glycolic acid facial peel once per month for three consecutive months proved to be an effective treatment modality in Indian patients without any significant side-effects.  相似文献   

14.
Glycolic acid (GA), lactic acid (LA) and trichloroacetic acid (TCA) peels have been used in various combinations for treating melasma patients, but none of the studies have compared their therapeutic efficacy and improvement in quality of life (QOL) index with these three peeling agents in melasma. Our study aims to compare the clinical efficacy, safety, tolerability and improvement in QOL index between 30% GA, 92% LA, and 15% TCA peeling in epidermal melasma. Ninety patients were divided into three groups with 30 in each. First group was treated with 30% GA peel, second with 92% LA peel, and third with 15% TCA peel at every 2 weeks interval for 12 weeks. Melasma area severity index (MASI) and QOL index (Melasma quality of life and Health related quality of life index) were used for clinical evaluation. Patients were observed for side effects and tolerability. The mean MASI score after therapy was significantly lower in patients treated with GA and TCA peels as compared with the group receiving LA peel. However, there was no significant difference in the mean MASI scoring at 12 weeks between GA peel and TCA peel groups. The improvement in QOL index was higher among patients undergoing GA peel followed by TCA and LA peel. Adverse effects were noted mostly with TCA peels followed by GA and LA peel. Thus, GA and TCA peels were equally efficacious and more effective than LA peels. LA peel had minimum side effects and better tolerability than GA and TCA peels.  相似文献   

15.
BACKGROUND: Melasma, also known as mask of pregnancy, is a common, acquired hypermelanosis seen in women with Fitzpatrick skin types II-V, and is often recalcitrant to treatment with depigmentation agents. Glycolic acid has been added to hydroquinone formulations in the past to enhance their depigmentation effects, but may cause irritation, leading to postinflammatory hyperpigmentation. AIM: To assess the safety and efficacy of a cream containing 4% hydroquinone, 10% buffered glycolic acid, vitamins C and E, and sunscreen (Glyquin, ICN Pharmaceuticals, Costa Mesa, USA) vs. a cream containing sunscreen alone in the depigmentation of epidermal melasma of the face. METHODS: Thirty-nine Hispanic women, Fitzpatrick skin types III-V, with bilateral epidermal melasma were enrolled in a randomized controlled trial lasting 12 weeks. Patients underwent twice-daily full-face application with the study cream or with the cream containing sunscreen only. Changes in pigmentation were measured using a mexameter, the melasma area and severity index (MASI), and a global evaluation by the patient and blind investigator. Safety evaluations were performed at each follow-up visit. RESULTS: Thirty-five patients completed the trial. Irritation was more common with the study cream, but resolved with temporary cessation of cream application and the addition of moisturizers. Mexameter results demonstrated a significant decrease in the degree of pigmentation using the study cream compared with the cream containing sunscreen alone (P < 0.0001). Fifteen of 20 patients (75%) using the study cream improved, whereas only two of 15 patients (13%) improved using sunscreen alone. CONCLUSIONS: A cream containing 4% hydroquinone, 10% buffered glycolic acid, vitamins C and E, and sunscreen is safe and effective in the treatment of melasma.  相似文献   

16.
目的 观察复方甘草酸苷注射液治疗黄褐斑的疗效。方法 2015年5月至2016年7月在杭州市第三人民医院皮肤科门诊收集皮肤镜血管评分为++或+++以及反射式共聚焦显微镜(RCM)黑素评分为++或+++的黄褐斑患者30例。所有患者按照抽签法随机分为两组:实验组静脉滴注复方甘草酸苷注射液40 ml/次,每3天1次,连续使用8次;同时口服维生素C片每日3次每次0.2 g;维生素E片每日1次,每次0.1 g;对照组仅口服维生素C片和维生素E片,剂量同试验组。治疗前及治疗开始3个月后使用黄褐斑面积和严重指数(MASI)评估疗效,同时用RCM、皮肤镜和VISIA皮肤检测仪评估皮损,计算黑素评分、血管评分以及棕色斑和红色区指数。结果 实验组治疗开始3个月后与治疗前相比,RCM黑素评分分布(z = 2.773,P = 0.006)、皮肤镜血管评分分布(z = 3.135,P = 0.002)差异有统计学意义, VISIA棕色斑指数下降(38.3 ± 3.1比43.9 ± 5.8,z = 3.091,P = 0.002),VISIA红色区指数亦下降(26.5 ± 5.6比33.3 ± 7.7,t = 2.752,P = 0.010)。治疗开始3个月后,对照组RCM黑素评分较治疗前明显下降(P = 0.023),而皮肤镜血管评分和VISIA指数与治疗前相比差异均无统计学意义(P>0.05)。治疗开始3个月后,实验组显效9例,好转6例;对照组显效3例,好转11例,无效1例,实验组疗效显著优于对照组(z = 2.276,P = 0.029)。结论 复方甘草酸苷注射液治疗黄褐斑有效,RCM、皮肤镜和VISIA皮肤检测仪可辅助黄褐斑疗效评估。  相似文献   

17.

Objective

To investigate the efficacy and safety of broadband light (BBL) combined with intradermal injection of tranexamic acid for treating melasma.

Methods

120 women with melasma admitted to our hospital from January 2021 to April 2022 were randomly categorized into the following groups: control group, treated with 250 mg tranexamic acid given orally twice daily, except during menstruation; group I, treated with BBL (Sciton, Inc., USA) monthly; group II, received intradermal injections of tranexamic acid monthly; and group III, treated with BBL with intradermal injection of tranexamic acid monthly. Treatment in each group lasted three months. The MASI (Melasma Area Severity Index) and VISIA (Canfield VISIA Complexion Analysis) were used for evaluation.

Results

After treatment course, MASI scores and VISIA brown spot and red zone ranking improved in all four groups (p < 0.05). The decrease in MASI scores and improvement rates of VISIA brown spot and red zone rankings were not significantly different among the control group, group I, and group II; however, the decreased MASI scores and improvement rates of VISIA brown spot and red zone rankings were significantly higher in group III than in the other three groups (p < 0.05).

Conclusion

The effect of BBL combined with the intradermal injection of TA in the treatment of melasma is remarkable. This combination therapy can be an alternative and effective treatment for managing melasma.  相似文献   

18.
Background  Melasma is a common disorder of pigmentation characterized by relatively symmetric, brown or gray–brown patches on sun-exposed facial areas. Hydroquinone, the most effective agent in melasma, is known to irritate the skin, and so new alternatives in the treatment of melasma are required. We sought to assess the clinical response of a new depigmenting agent in melasma.
Methods  Ninety-six Mexican female patients with melasma were enrolled in this open, comparative, 12-week study. The patients received 1% dioic acid cream (twice daily) or 2% hydroquinone cream (twice daily).
Results  There was a significant difference in the Melasma Area Severity Index (MASI) scores from baseline to the end of the study using treatment with dioic acid (baseline, 14.52 3.4; after 12 weeks of treatment, 6.05 ± 1.2; P  = 0.001) and hydroquinone (baseline, 15.22 ± 2.4; after 12 weeks of treatment, 6.34 ± 1.3; P  = 0.001); however, there were no significant differences between treatments (baseline, P  = 0.311; after 12 weeks of treatment, P  = 0.287). The side-effects were similar with both medications; however, pruritus was more common in patients using hydroquinone.
Conclusions  Dioic acid is an effective and highly tolerated skin product, although further controlled, blind, multicenter studies are required to support these results.  相似文献   

19.

Background:

Numerous therapeutic options have been tried in the management of melasma.

Aims and Objectives:

This prospective randomized study was planned to assess the efficacy of low potency triple combination (TC) cream (TC-hydroquinone 2%/tretinoin 0.05%/fluocinolone 0.01%) versus glycolic acid (GA) peels/azelaic acid (AA) 20% cream (GA/AA) combination in melasma.

Materials and Methods:

Forty patients with melasma were recruited into this study and randomized into two groups. Group A consisting 20 patients received TC cream once a day for night time application for 3 months. Group B comprising of 20 patients received GA/AA 20% cream combination for 3 months. The disease severity was monitored with digital photography, melasma area and severity index (MASI) score, which was calculated at baseline, 6 weeks and 12 weeks, and visual analog scale (VAS) score, which was calculated at baseline and 12 weeks.

Results:

Of 40 patients, 38 were completed the study. A significant reduction in MASI and VAS was recorded after 6 weeks and 12 weeks of treatment in both groups A and B (P = 0.001). However, there was no significant difference in the mean MASI scores between the two groups at baseline, 6 weeks and 12 weeks. Similarly, there was no difference in the mean VAS scores between the two groups at baseline and 12 weeks. Four patients in group A and 3 in group B experienced adverse effects such as irritation, dryness, and photosensitivity.

Conclusion:

Both low potency TC cream and GA/AA 20% cream combination are effective in treating melasma among Indian patients.  相似文献   

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