中药石膏倒模术联合红、蓝光治疗面部寻常型痤疮的疗效观察及意义分析

目的综合应用中药石膏倒模术和红、蓝光照射治疗痤疮,观察临床疗效。方法将本院自2010～2011年两年收治的341例痤疮患者使用随机抽样分为治疗组和对照组。治疗组171例患者,每周进行1次的中药石膏倒膜治疗与红、蓝光照射治疗各一次,观察并记录患者的治疗情况;对照组170例患者,每周使用红、蓝光照射治疗各一次,观察并记录患者的治疗情况。八周为一个疗程,一个疗程后观察治疗结果 ,并对患者进行3个月的随访,观察疗效和复发情况以及并发症。结果治疗组的治疗有效率为85.38%,复发率为4.68%;对照组的治疗有效率为54.71%,复发率为30%。两组比较,差异具有统计学意义(P<0.01)。结论中药石膏倒膜治疗联合红、蓝光对治疗痤疮安全、有效,值得在临床实践推广应用。     

1540nm点阵激光辅以类人骨胶原敷料治疗痤疮后早期表浅凹陷性瘢痕的疗效观察

目的：观察1540nm点阵激光辅以类人骨胶原敷料治疗痤疮后表浅凹陷性瘢痕的疗效。方法选择病程小于12个月,愈后留有表浅凹陷性瘢痕的痤疮患者60例,用1540点阵激光的各种不同治疗参数及能量进行治疗,激光治疗每次间隔1周,连续治疗4次。将患者随机分为实验组（36例）和对照组（24例）。实验组使用类人骨胶原敷料,对照组使用无纺布纯净水面膜,激光术后即刻敷用15-20min。每晚使用1次,每次15-20min,连续使用5d。结果实验组瘢痕治疗的有效率为91.67%,对照组的有效率为62.5%,实验组优于对照组,差异具有统计学意义（P〈0.05）。两组红斑治疗后临床评分差异无统计学意义（P〉0.05）。两组患者对保湿度、光滑度、满意度的评分差异有显著的统计学意义（P〈0.01）,实验组优于对照组。结论1540nm点阵激光无创伤,疼痛程度轻,术后不影响工作,辅以胶原蛋白敷料进行修复护理,无明显色素沉着及其他不良反应发生;患者依从性好,适用于对疼痛敏感且无时间休息的患者。     

消痤洁肤乳膏治疗寻常痤疮临床研究

目的探讨消痤洁肤乳膏治疗寻常痤疮的临床疗效。方法对278例寻常痤疮患者随机分为治疗组168例和对照组110例,分别给予消痤洁肤乳膏及复方克林霉素搽剂局部外搽,每日2次。对患者进行细菌学检查、皮脂溢出率测定以及临床疗效评价。结果皮脂溢出率在用消痤洁肤乳膏治疗前为(1.84×10-2±0.63×10-2)g/(m2.m in),治疗4周后为(1.09×10-2±0.43×10-2)g/(m2.m in),治疗前后比较有显著降低(P<0.05)。治疗组与对照组治疗后的细菌清除率分别为85.3%和84.0%,总有效率分别为94.6%和82.7%。结论消痤洁肤乳膏为一种治疗寻常痤疮的安全、有效的外用制剂。     

CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕疗效观察

目的：探讨CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕的疗效。方法选取我院2014年1月至2015年5月收治的面部痤疮凹陷性瘢痕患者84例,采用随机数字表法分为观察组和对照组,每组42例。所有患者均接受CO2点阵激光治疗,观察组外用胶原贴敷料,对照组不作处理。CO2点阵激光治疗结束冰袋冷敷20 min后,进行急性炎症反应的半定量评分;治疗结束后进行疗效评价;治疗结束后6个月记录不良反应等。结果观察组急性炎症反应的半定量评分[(1.52±0.38)分]、误工期[(7.60±2.80) d]、痂皮脱落时间[(6.35±1.50) d]明显低于对照组的[急性炎症反应的半定量评分(2.10±0.52)分、误工期(10.50±3.45) d、痂皮脱落时间(8.25±2.15) d, P<0.05];观察组和对照组的总有效率分别为92.86%和76.19%,两组比较差异有统计学意义(P<0.05);观察组色素沉着发生率为19.05%、持久性潮红发生率为0,感染性脓疱发生率为2.38%,显著低于对照组的30.95%、4.76%、7.14%(P<0.05);两组均未发生瘢痕增生。结论 CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕疗效显著,其具有不良反应低、结痂时间和误工期短的优点,值得临床推荐使用。     

中药消痤汤联合维A酸治疗寻常性痤疮疗效观察

目的:观察中药消痤汤内服联合0.025%维A酸外用治疗寻常性痤疮的临床疗效及安全性。方法:86例寻常性痤疮患者随机分为观察组和对照组各43例,观察组采用中药消痤汤煎服,1剂/d,对照组口服琥乙红霉素0.25 g,tid;两组均每晚1次用0.025%维A酸乳膏外涂,疗程6周。比较两组疗效与药品不良反应。结果:观察组和对照组愈显率分别为69.77%和41.86%,差异有统计学意义(P<0.01);总有效率分别为88.37%和69.77%,差异有统计学意义(P<0.05)。两组复发率分别为10.00%和22.22%,差异无统计学意义(P>0.05),两组均未发生严重不良反应。结论:中药消痤汤内服联合0.025%维A酸外用治疗寻常性痤疮有较好的临床疗效,安全性好。     

Effects of isotretinoin on the inflammatory markers and the platelet counts in patients with acne vulgaris

Objective: Oral isotretinoin is an efficient treatment used commonly in treating the moderate and severe acne. It has various side effects that affect many systems in the body. In this study, we are planning to examine the possible effects of the oral isotretinoin on platelet density, mean platelet volume, neutrophil lymphocyte rate, platelet lymphocyte rate, and red-blood-cell distribution width level.

Methods: Twenty-eight males and 84 females, 112 patients in total, diagnosed with acne vulgaris and receiving oral isotretinoin treatment were examined retrospectively. The full blood parameters of the patients before the treatment and in the third month of the treatment were recorded.

Results: A statistically meaningful increase was observed in the platelet density, hemoglobin levels. And a statistically significant decrease has been determined in the red-blood-cell distribution width level while no meaningful differences were detected in the mean platelet volume, neutrophil lymphocyte rate, platelet lymphocyte rate, and white blood cell count.

Conclusions: The oral isotretinoin treatment has been demonstrated as having increased the platelet density, hemoglobin levels and having decreased red-blood-cell distribution width level significantly.     

1450nm半导体激光联合自拟丹黄散治疗痤疮的疗效观察

目的：探讨1450nm半导体激光联合自拟丹黄散治疗痤疮能否有效缩短治疗周期、提高治疗效果及减少不良反应。方法：150例病例分成3组。激光组：50例,采用波长为1450nm的半导体激光（Smoothbeam,Candela）,光斑直径6mm,动态冷却（DCD）时间为22～26ms,治疗剂量为6～10J/cm2。治疗前常规清洁皮肤,外涂复方利多卡因乳膏,1h后用激光对治疗部位照射。治疗后用冰袋或冰胶原面膜冰敷。间隔一个月治疗一次,3次为一个疗程;中药组：50例。口服自拟丹黄散,隔日一剂,分2次口服,三个月为一疗程。方药：丹参10g、大黄5g、黄芩10g、白芷10g、红花5g、石膏30g、枸杞15g、熟地30g、茯苓15g、甘草5g;激光+中药组：50例。在上述激光组治疗基础上,每次激光治疗后配合中药丹黄散口服,隔日一剂,分2次口服。方药：丹参10g、大黄5g、黄芩10g、白芷10g、红花5g、石膏30g、枸杞15g、熟地30g、茯苓15g、甘草5g。观察每组治疗前后的临床疗效,比较3组在起效时间上的差别;观察3组治疗前后面部皮损的变化程度,记录治疗研究过程中出现的不良反应。结论：3组中,激光+中药组治疗起效时间最短,有效率最高,不良反应发生率最低,具有临床推广价值。     

Isotretinoin: controversies,facts, and recommendations

Introduction: Since it was introduced to the market by Hoffman-La Roche (Roche) in 1982, isotretinoin has remained the most effective treatment for severe and recalcitrant acne. However, it has also been surrounded by controversy due to its teratogenicity and inconsistent associations with depression, suicidality, inflammatory bowel disease, increases in lipid levels, and elevated transaminases.

Areas covered: In this article, we reviewed data regarding safety of isotretinoin and its association with these conditions. A thorough and comprehensive search on the topics was performed using pubmed and google scholar.

Expert commentary: Despite common misperceptions, there is weak evidence for increased incidence of depression, suicidality, or inflammatory bowel disease with isotretinoin use. Furthermore, data indicates that transient increases in transaminases and lipid levels do not typically necessitate discontinuation of therapy. We hope to provide clinicians with information necessary to have meaningful discussions with patients regarding the safety and efficacy of isotretinoin.     

中医经穴平衡美容方法治疗痤疮的疗效观察

目的探讨应用中医经穴平衡美容方法进行中医辨证施治，治疗痤疮的疗效。方法收集痤疮患者80例，分为治疗组50例和对照组30例。治疗组患者通过平衡美容仪和中医经穴电脑测试，依据健康分析曲线表显示，针对患者的不同类型辨证用药，制订出完整的治疗方案，对照组不用美容仪测试，仅用外治法。治疗1个月后观察2组的疗效。结果治疗组治疗总有效率94．0％，无效率6．0％，对照组总有效率73.3％，无效率26．7％。2组疗效比较差异有统计学意义，治疗组疗效优于对照组（x^2=11．088，P〈0．05）。结论应用中医经穴平衡美容方法，可促进面部痤疮的诊断与辨证施治，提高治愈率。     

Does supplementation with green tea extract improve acne in post-adolescent women? A randomized,double-blind,and placebo-controlled clinical trial

BackgroundGreen tea is believed to have beneficial effects in the prevention and treatment of acne.ObjectiveTo examine the effects of a decaffeinated green tea extract (GTE), providing a daily dose of 856 mg of epigallocatechin gallate (EGCG) upon women with post-adolescent acne.MethodsA randomized, double-blind, placebo-controlled clinical trial was conducted from May 2012 through October 2013. A final group of 80 subjects were randomly assigned to receive either 1500 mg of decaffeinated GTE or placebo (cellulose) daily for 4 weeks. Inflammatory lesion counts were used as the major outcome measurement. At baseline and after 4 weeks of treatment, anthropometric measurements, fasting glucose levels and a lipid profile were measured from both groups.ResultsSixty-four of 80 women, from 25 to 45 years of age with moderate-to-severe acne completed the study. Statistically significant differences were noted in inflammatory lesion counts distributed on the nose, periorally and on the chin between the two groups. However, there were no significant differences between groups for total lesion counts. Within-group comparison revealed that the GTE group had significant reductions in inflammatory lesions distributed on the forehead and cheek, and significant reductions in total lesion counts. GTE resulted in significant reductions in total cholesterol levels within the GTE group.ConclusionsGTE resulted in significant reductions in lesions located on the nose, perioral area and chin. More research is required to determine whether a decaffeinated GTE standardized for EGCG content will provide clinical benefits in women with post-adolescent acne.