Q开关Nd:YAG 1 064nm激光联合氨甲环酸片治疗黄褐斑的疗效及对MASI评分的影响

目的:探究Q开关Nd:YAG 1 064nm激光联合氨甲环酸片治疗黄褐斑的疗效及对MASI评分的影响。方法:选取笔者医院2017年2月-2018年10月门诊收治的116例黄褐斑患者,按治疗方案的不同将患者分为对照组和观察组。对照组:51例,采用Q开关Nd:YAG 1 064nm激光治疗;观察组:65例,在对照组治疗的基础上,联合氨甲环酸片治疗。比较两组患者的临床疗效、治疗前后黄褐斑皮损面积和严重度指数(Melasma area severity index,MASI)以及不良反应发生和复发情况。结果:观察组患者治疗后有效率(93.85%)明显高于对照组(74.51%),组间比较差异具有统计学意义(χ^2=8.54,P=0.00);观察组患者治疗4周后MASI评分为(10.63±3.63)分,略低于对照组的(11.38±3.76)分,组间比较差异无统计学意义(P>0.05);观察组患者治疗后8周、12周MASI评分为(8.21±3.28)分、(6.32±3.51)分,均明显低于对照组的(9.56±3.54)分、(8.23±3.40)分,组间比较差异具有统计学意义(P<0.05);观察组患者不良反应发生率12.31%,低于对照组的27.45%,组间比较差异无统计学意义(P>0.05);观察组患者复发率3.08%,明显低于对照组的13.73%,组间比较差异具有统计学意义(P<0.05)。结论:相比单一使用Q开关Nd:YAG 1 064nm激光治疗方案,联合使用氨甲环酸片治疗黄褐斑有效性更明显,可相对减少治疗相关不良反应,且明显降低复发率,可在临床推广使用。

Effect of Q-switch Nd:YAG 1 064nm Laser Combined with Tranexamic Acid Tablets on the Treatment of Chloasma and Its Effect on MASI Score

Objective To explore the effect of Q-switch Nd:YAG 1 064nm laser combined with tranexamic acid tablets on the treatment of chloasma and its effect on MASI score.Methods The study selected 116 patients with melasma who were admitted to our hospital from February 2017 to October 2018,the patients were divided into control group (51 cases) and observation group (65 cases) according to different treatment options.The control group was treated with Q-switched Nd:YAG 1064nm laser treatment,the observation group was treated with a combination of tranexamic acid tablets on the basis of the treatment plan of the control group.The clinical efficacy of the two groups of patients,the area of melasma area and severity index (MASI) before and after treatment,and the occurrence and recurrence of adverse reactions were compared.Results The effective rate after treatment in the observation group (93.85%) was significantly higher than that in the control group (74.51%),and the difference between the groups was statistically significant(χ^2=8.54,P=0.00).The MASI score of the observation group was (10.63±3.63) after 4 weeks of treatment,which was slightly lower than that of the control group (11.38±3.76),there was no significant difference between the groups (P>0.05).The MASI scores of the observation group at 8 weeks and 12 weeks after treatment were (8.21±3.28) and (6.32±3.51),which were significantly lower than those of the control group (9.56±3.54) and (8.23±3.40),the difference between groups was statistically significant (P<0.05).The incidence of adverse reactions in the observation group (12.31%) was lower than that in the control group (27.45%),there was no significant difference between the two groups (P>0.05).The recurrence rate of the observation group (3.08%) was significantly lower than that of the control group (13.73%),the difference between groups was statistically significant (P<0.05).Conclusion Compared with the single-use Q-switched Nd:YAG 1064nm laser treatment protocol,the combination of tranexamic acid tablets in the treatment of chloasma patients can significantly reduce treatment-related adverse reactions and significantly reduce the occurrence of recurrence,it is worth promoting in clinical use.