5-氨基酮戊酸光动力疗法治疗中重度痤疮疗效分析

目的 探索含5- 氨基酮戊酸外敷凝胶光动力疗法（5-aminolevulinie acid photodynamic therapy，5-ALA-PDT） 治疗中重度痤疮的有效性及安全性。方法 选取82 例Ⅲ～Ⅳ级面部痤疮患者，配对分为2 组。治疗组采用3.7% 浓度5-ALA 外敷后联合光动力治疗仪红光照射面部，对照组单纯采用红光照射面部。每周治疗1 次，3 次后结束治疗，分别在开始治疗后2 周、4 周、3 个月和6 个月随访时对两组患者进行疗效判断和比较，并观察治疗过程出现的不良反应。结果 5-ALA-PDT 治疗2周后总有效率44.90％，4 周后为63.41％，随访3 个月时为87.80%，6 个月时为92.68% ；单纯红光照射组在治疗后2 周、4 周、3 个月和6 个月随访时总有效率分别为12.20%、21.95%、33.33% 和48.57%，两组差异有统计学意义（P ＜ 0.05）。随着治疗次数增加，治疗组疗效均逐渐增加，各时间点比较差异有统计学意义（P ＜ 0.05）。不良反应主要表现为治疗组照射时出现局部灼热、疼痛和瘙痒，治疗结束后症状均能自行缓解。治疗组中8 例患者出现局部轻度色素沉着，均在3 个月随访时完全消退。结论 3.7％浓度5-ALA、1.5 h 封包、红光为光源的PDT 治疗中重度痤疮，效果显著，不良反应较轻，是较好的治疗中重度痤疮方案。

Effect of 5-aminolevulinie acid photodynamic therapy on moderate -severe acne

Objective To study the efficacy and safety of 5-aminolevulinie acid photodynamic therapy （5-ALA-PDT） for moderatesevere facial acne. Methods Eighty-two patients with moderate-severe acne were divided into treatment group and control group （41 in each group）. Patients in treatment group were treated with 3.7% 5-ALA followed by red light irradiation with a photodynamic therapy device, once a week, for 3 weeks. Those in control group underwent red light irradiation, once a week, for 3 weeks. The patients were followed up 2 and 4 weeks, 3 and 6 months after treatment, during which the therapeutic effects in two groups were compared and the adverse effects were recorded. Results The total effective rate was significantly higher in treatment group than in control group 2 and 4 weeks, 3 and 6 months after 5-ALA-PDT （44.90% vs 12.20%, 63.41% vs 21.95%, 87.80% vs 33.33%, 92.68% vs 48.57%, P 〈 0.05）. The therapeutic effect was better in treatment group than in control group and increased with the times of treatment （P 〈 0.05）. The major adverse reactions in treatment group were local burning, pain and itching which relieved after treatment. Moderate local pigmentation in 8 patients, found in treatment group, completely disappeared 3 months after treatment. Conclusion The effect of 5-ALA-PDT is significant on moderate - severe acne with mild adverse reactions, and is thus a good treatment modality for moderate - severe acne.