二氧化碳点阵激光联合胶原贴敷料对凹陷性痤疮瘢痕患者皮肤屏障及ECCA权重评分的影响

目的:探讨二氧化碳点阵激光联合胶原贴敷料对凹陷性痤疮瘢痕患者皮肤屏障及痤疮瘢痕权重评分(ECCA)的影响。方法:选择2017年3月-2018年10月恩施土家族苗族自治州中心医院、湖北民族大学附属民大医院及恩施市中心医院收治的160例凹陷性痤疮瘢痕患者,采用随机数字表法分为研究组和对照组,每组80例。研究组采用二氧化碳点阵激光联合胶原贴敷料治疗,对照组单用二氧化碳点阵激光治疗。治疗前后分别使用ECCA对两组患者进行评价;同时选择角质层含水量、经表皮水分丢失(TEWL)、红斑指数(EI)和黑素指数(MI)进行检测,评价两组治疗对皮肤屏障的影响。结果:两组临床总有效率和显效率比较,差异无统计学意义(P>0.05)。治疗后两组皮肤屏障指标比较:两组TEWL、EI、MI均出现明显上升,角质层含水量则明显下降,研究组TEWL、EI变化幅度低于对照组,差异有统计学意义(P<0.05),但两组间MI变化无显著性差异(P>0.05)。ECCA权重评分比较:两组均随着治疗次数的叠加ECCA下降趋势更加明显,但是每个时间节点上两组之间ECCA比较则无显著性差异。研究组和对照组发生不良反应分别有6例(7.5%)和17例(21.25%),不良反应发生率比较,差异有统计学意义(P<0.05)。结论:二氧化碳点阵激光可明显降低凹陷性痤疮瘢痕患者皮肤ECCA,且随着治疗次数增加改善效果愈加明显,治疗后患者皮肤屏障功能受损,TEWL、EI水平均有明显上升,联用胶原敷贴料可保护皮肤屏障并降低治疗不良反应的发生率,但对MI和ECCA的变化无显著影响。

Effect of Carbon Dioxide Lattice Laser Combine with Collagen Dressing on Skin Barrier and ECCA Weight Score on Patients with Depressed Acne Scar

Objective To inv estigate the effect of CO2 dot matrix laser combined with collagen dressing on skin barrier and acne scar weight score(ECCA)in patients with depressed acne scars.Methods A total of 160 patients with depressed acne scars admitted to Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Minda Hospital Affiliated to Hubei University for Nationalities and Enshi City Central Hospital from March 2017 to October 2018 were randomly divided into study group and control group,with 80 cases in each group.The study group was treated with carbon dioxide lattice laser combined with collagen dressing,while the control group was treated with carbon dioxide lattice laser alone.ECCA score were used to evaluate the two groups of patients before and after treatment.Meanwhile,the water content of cuticle was selected,and the skin water loss(TEWL),erythema index(EI)and melanin index(MI)were tested to evaluate the effect of the two groups on skin barrier.Results There was no significant difference between the two groups in total and marked clinical efficacy(P>0.05).After treatment,the skin barrier indexes of the two groups were compared:TEWL,EI and MI of the two groups were signifi cantly increased,while the water content of cuticle was signifi cantly decreased.The change range of TEWL and EI in the study group was lower than that in the control group,and the difference was signifi cant(P<0.05),but there was no signifi cant difference in MI between the two groups(P>0.05).ECCA score comparison:the two groups showed a more obvious downward trend with the number of times of treatment,while there was no signifi cant difference between the two groups in ECCA score at each time node.There were 6 cases(7.5%)and 17 cases(21.25%)of adverse reactions in the study group and the control group,respectively.The incidence of adverse reactions was significantly different(P<0.05).Conclusion Carbon dioxide lattice laser can signifi cantly reduce the ECCA score of skin in patients with depressed acne scar,and with the increase of treatment times,the improvement effect is more obvious.Collagen dressing can protect skin barrier and reduce adverse reactions with no signifi cant effect on the changes of MI and ECCA.