^90Sr-^90Y敷贴治疗寻常性痤疮186例的疗效观察

寻常性痤疮是青春期常见的一种慢性毛囊皮脂腺炎症性疾病。痤疮好发于面部，尤其是前额、双颊部、颏部。不仅痒痛，而且影响容貌。传统治疗痤疮以外用和内服药物、激光等为主。虽有一定疗效，但很难完全消除皮损，而且有时使用药物还会产生副作用。笔者用^90Sr-^90Y敷贴器治疗痤疮186例取得一定疗效，现报告如下：     

火针疗法联合中药治疗寻常痤疮的疗效观察

目的观察火针疗法联合中药治疗寻常痤疮的疗效,为寻常痤疮寻求一种更加有效的治疗方法。方法将90例寻常痤疮患者随机分为治疗组和对照组,治疗组采用火针疗法联合中药治疗;对照组采用克林霉素磷酸酯凝胶联合中药治疗。4周后判定疗效。结果在愈显率、疗效指数、皮损改善方面,治疗组与对照组有显著性差异。结论火针疗法联合中药治疗寻常痤疮的疗效优于克林霉素磷酸酯凝胶联合中药治疗。     

痤疮合剂联合清热暗疮胶囊治疗寻常性痤疮90例

目的:探讨痤疮合剂联合清热暗疮胶囊治疗寻常性痤疮的临床疗效。方法:将180例痤疮患者随机分为对照组和治疗组各90例。对照组:单纯给予清热暗疮胶囊,治疗组:在对照组的基础上加痤疮合剂。结果:治疗组有效率为95.56%,对照组有效率为86.67%,2组比较,差异有统计学意义(P0.05)。结论:痤疮合剂联合清热暗疮胶囊治疗寻常性痤疮疗效显著,适合于临床推广应用。     

强脉冲光治疗面部轻中度痤疮72例分析

目的探讨治疗轻中度痤疮的临床疗效。方法选择72例面部轻中度痤疮患者,采用IPL进行个性化治疗。治疗间隔时间为1月,4次为1疗程。根据治疗前后照片对比及患者满意度评估疗效。结果总有效率为90%。3例术后有极轻微不适,1例术后面部轻度水肿。结论 IPL治疗轻中度痤疮不仅安全、有效,而且能达到较好的美容效果。     

痤疮的病因学与治疗

痤疮是最常见的皮肤病之一,约80～90%的人在青少年患过不同程度的痤疮。聚合性痤疮可损坏皮肤造成不可恢复的疤痕。病因学二十年来痤疮发病机制的研究提示痤疮的形成取决于下列因素:一、皮脂分泌的增加——雄激素的分泌增加和代谢异常。痤疮为发生于面,额、下颌和胸、背部等特定部     

强脉冲光联合胶原贴敷料治疗轻中度痤疮的临床疗效观察

目的探究分析观察强脉冲光联合胶原贴敷料治疗轻中度痤疮的临床疗效。方法 2019年1～12月皮肤科就诊的90例寻常性痤疮患者,分为对照组和治疗组各45例,对照组仅用强脉冲光治疗,治疗组采用强脉冲光联合胶原贴敷料治疗,比较两组的治疗效果。结果治疗组治疗有效率97.78%,明显高于对照组80.00%;治疗12周的炎性皮损评分明显小于对照组,差异均有统计学意义(P0.05)。结论强脉冲光联合胶原贴敷料治疗轻中度痤疮有效且可减少炎性皮损,值得推广应用。     

清肺凉血法对寻常痤疮患者皮脂溢出率和血清游离脂肪酸的影响

目的:系统观察清肺凉血法(清肺祛脂方)对寻常痤疮的临床疗效和机制。方法:将120例痤疮患者随机分成两组,治疗组(清肺凉血法)60例,对照组(异维A酸)60例,观察治疗前后的痤疮各种皮肤损害(白头粉刺、黑头粉刺、炎症丘疹、脓疱)、皮脂溢出率、血清游离脂肪酸以及临床疗效评价。结果:清肺凉血法对痤疮患者皮损有明显的改善(u=9.6,3.80,13.96,14.32,P<0.05),并减少皮脂溢出率(u=6.25,12,P<0.05)、降低血清游离脂肪酸(t=5.24,2.09,P<0.05),临床总有效率达90%,与阳性对照西药相近。结论:清肺凉血法(清肺祛脂方)对寻常痤疮临床疗效确切,皮脂溢出率及降低血清游离脂肪酸是其作用机制之一。     

刘瓦利教授治疗痤疮经验集萃舒涛

刘瓦利教授从事皮肤科工作20余年,擅长从肝、脾、痰瘀、湿热多角度论治痤疮,重视心理疏导,治疗痤疮用药如用兵,临床有较好的疗效。痤疮是皮肤科门诊的常见和多发病,因其病因复杂,病程慢性,治疗难以速效,又因其发病部位多在暴露部位,往往影响患者的心理和生活质量,因此痤疮患者对痤疮的治疗有更高的要求。刘瓦利教授擅长治疗痤疮,认为痤疮不仅仅是肺胃的事,治疗痤疮一定要辨证施治,既要考虑皮疹更要考虑整体。1谨守病机,从多角度论治1.1从肝论治痤疮患者的精神情绪表现出动则急躁,静则忧郁,究其内因,与肝的生理功能及病理机制密切相关。肝主…     

水氧仪器治疗面部囊肿型痤疮的疗效观察

目的观察水氧仪器治疗囊肿型痤疮的疗效。方法将120例囊肿型痤疮患者随机分为治疗组（60例）和对照组（60例）。治疗组采用水氧仪器,同时服用维胺酯胶囊及复合维生素B;对照组只服用维胺酯胶囊及复合维生素B0结果治疗组有效率为96．7％,对照组为90．0％,两组比较具有统计学意义（X^2=4．6660,P〈0．05）。结论水氧仪器治疗囊肿型痤疮疗效好。     

盐酸多西环素肠溶胶囊联合氯柳酊治疗寻常痤疮疗效观察

目的探讨盐酸多西环素联合氯柳酊治疗寻常痤疮的疗效。方法对治疗组96例寻常痤疮患者采用口服盐酸多西环素肠溶胶囊加氯柳酊外用治疗,并与对照组90例单服盐酸多西环素肠溶胶囊患者6周后进行疗效比较。结果治疗组总有效率明显优于对照组,两组比较差异有统计学意义(P<0.05)。结论盐酸多西环素肠溶胶囊口服与氯柳酊外用联合治疗,在消除痤疮的非炎症性损害和炎性损害方面有明显的协同作用,提高了临床治疗效果。     

兰州市在校大学生痤疮患病情况及认知情况调查分析

[目的]为进一步了解医学、非医学院校在校大学生痤疮的患病情况,评估痤疮病人信息主要来源、治疗方案以及影响因素。从而为大学生痤疮的防治及健康教育提供科学依据。[方法]采用随机抽样的方法,抽取兰州市3所高校的431名在校大学生,通过现场咨询、问卷调查的形式对痤疮患病情况及其对痤疮的认知情况进行调研分析。[结果]431名在校大学生中427名患痤疮,即患病率为99.1%,其中328名(76.1%)大学生不了解痤疮发病的病因。有425名(94.3%)大学生认为痤疮会影响到他们的就业、社交。[结论]兰州市在校大学生痤疮患病率较高,影响痤疮的发病因素较多,对痤疮的认识不够。痤疮较明显地影响了大学生的心理健康和生活质量。     

Pearls in the management of acne: an advanced approach

Acne is a common condition of the sebaceous follicle. The primary care physician can have a large impact on patients with acne by properly classifying the type of acne (obstructive versus inflammatory) and successfully treating the acne based on its severity. Reduction of acne lesions by appropriate topical and oral medications provides great psychological and physical benefits to these patients. By understanding how acne develops and its many manifestations and treatment options, the primary care physician can become an expert in acne diagnosis and treatment.     

Topical therapy for acne vulgaris. How do you choose the best drug for each patient?

Although management of acne is sometimes difficult, primary care physicians can offer a number of treatment plans to patients with this skin condition. Comedonal acne usually responds to topical keratolytics, such as salicylic acid, benzoyl peroxide, adapalene, and tretinoin. Inflammatory acne is usually treated with topical therapy plus a systemic antibiotic. Nodulocystic acne generally requires an 8-week course of systemic antibiotics. If the nodulocystic acne does not improve, minocycline or isotretinoin may be needed. Topical therapy is often helpful in the long-term management of nodulocystic acne. New products are available that deliver topical agents in novel ways that decrease skin irritation. With the proper tools and instructions in use, most patients have significant improvement in their acne.     

Update on acne

In summary, the therapy of acne has to be individualized according to the nature of the lesions. Noninflammatory acne requires a different therapeutic approach from that for inflammatory acne, and even among those with inflammatory acne, there can be a difference in the therapeutic approach, depending upon the extent of involvement. Attention to the principles of therapy will be a great aid in the success of the therapeutic program for acne.     

痤疮涂膜剂联合阿达帕林治疗女性青春期后痤疮临床研究

目的探讨痤疮涂膜剂联合阿达帕林治疗女性青春期后痤疮临床疗效及安全性,寻求有效的治疗方案。方法选择104例女性青春期后痤疮患者,随机开放分为验证组及对照组,验证组每天中午皮损处外用痤疮涂膜剂,同时每晚睡前患处涂沫0．1％阿达帕林凝胶一次;对照组仅单纯每晚外用阿达帕林凝胶患处一次。治疗8周,评定疗效,观察随访。结果验证组治愈率36．5％,有效率达96．2％;对照组治愈率15．4％,有效率82．7％。两组治愈率、有效率比较经χ^2检验P〈0．05,均有统计学差异。结论痤疮涂膜剂联合阿达帕林治疗女性青春期后痤疮疗效显著,且不良反应轻微,方法安全简便,患者易接受,值得临床推广应用。     

痤疮患者血清白介素4和干扰素γ水平与瘢痕形成相关性研究

目的通过检测中度痤疮患者血清白介素（IL）4和干扰素（IFN）γ水平,探讨痤疮患者瘢痕形成的免疫应答机制。方法采集中度痤疮瘢痕形成患者（瘢痕组）的血清,用双抗体夹心酶联免疫吸附试验（ELISA）方法检测受试者血清IL-4和IFN-γ水平,并以中度无瘢痕（无瘢痕组）、轻度痤疮以及健康人作为对照组。分析中度痤疮患者血清IL-4和IFN-γ水平以及IL-4/IFN-γ的比值与瘢痕形成的相关性。结果瘢痕组血清IL-4水平上升,与后三组比较差异有统计学意义（P值分别为0.00,0.002,0.017）;而瘢痕组IFN-γ水平下降,与后三组比较差异有统计学意义（P值分别为0.005,0.007,0.046）。瘢痕组IL-4/IFN-γ的比值高于其他三组,经比较差异有统计学意义值均（P〈0.001）。结论痤疮瘢痕形成患者机体存在免疫应答异答,体液免疫优势应答与瘢痕形成密切相关。     

Treatment of acne with topical antibiotics.

The introduction of topical antibiotics for acne vulgaris has ushered in a new era in the treatment of this troublesome disorder. Tetracycline, erythromycin, and clindamycin can now be prepared in lotion form in vehicles that are capable of carrying the antibiotic into the follicular canal, where the primary lesion of acne occurs. Topical antibiotics are practically as effective as oral antibiotics in treating acne and are particularly useful for mild papular acne of puberty and early adolescence and papular-pustular acne of adult women. Use of topical antibiotics avoids the possibility of the adverse effects of systemic therapy; the side effects from the formulations reported here are negligible. Above all, antibiotic lotions do not produce the dryness and scaling that occur with most other topical acne preparations.     

Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life

Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered.Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular.Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.     

穴位自血疗法联合痤疮散外敷对痤疮疗效及肿瘤坏死因子-a 、白细胞介素8的影响

目的：探讨采用穴位自血疗法联合痤疮散外敷治疗痤疮的作用机理及对肿瘤坏死因子-α（TNF-α）及患者血清中白细胞介素8（IL-8）的影响。方法将本院2012年11月～2013年10月皮肤科收治的180例面部痤疮患者随机分为观察组、对照1组、对照2组,每组60例;另选择健康体检者50例为对照3组。观察组患者采用穴位自血疗法及痤疮散面部外敷治疗痤疮;对照1组采用穴位自血疗法;对照2组给予罗红霉素胶囊口服及阿达帕林凝胶外用;对照3组未做任何治疗。观察痤疮治疗效果及治疗前、治疗后第4周、第8周、第12周三组患者皮损状态、皮损计数;TNF-α与IL-8指标。结果观察组痊愈率、总有效率明显优于对照组,差异有显著意义（P＜0．05）;观察组治疗前、治疗后第4周、第8周、第12周,平均皮损数量减少与对照组比较差异有显著意义（ P＜0．05）;观察组TNF-α与IL-8治疗前、治疗后第4周、第8周、第12周与对照组比较,差异有显著意义（P＜0．05）。结论采用穴位自血疗法结合痤疮散外敷治疗面部痤疮并实施专业护理,能有效促进痤疮恢复,且总有效率高。TNF-α和IL-8均参与了痤疮的发病过程,与痤疮的严重程度成正比,在痤疮皮损的形成中起着重要作用。随着用药时间的增长,TNF-α和IL-8明显降低,说明该联合治疗法对痤疮有明显疗效。     

Overview of the treatment of acne vulgaris with topical retinoids

Acne vulgaris is a common skin disease that is most effectively treated with a combination of topical products and, in some cases, systemic antibiotics. While it is important to treat papules, pustules, nodules, and cysts with topical or systemic antibiotics to suppress bacterial infection, all of these lesions develop from microcomedones. In fact, comedolytic agents enhance the effectiveness of antibiotics and limit the potential for recurrent acne lesions. Because of the superior comedolytic effects of topical retinoids, most patients with acne should be treated with a retinoid unless there is a specific contraindication. Interestingly, only 55% of patients with acne who are treated by dermatologists and 10% of patients with acne who are treated by primary care physicians receive a topical retinoid as a component of their acne regimen. Evidence is provided to buttress the contention that clinical outcomes will be improved if topical retinoids are utilized in patients with acne vulgaris.