湿润烧伤膏治疗褥疮14例临床观察

自1993年2月．作者应用MEBO外涂，配合红外线照射治疗护理褥疮14例，获得满意疗效。作者认为临床效果确切，创面愈合迅速。MEBO可改善微循环，自动清创，兼有止痛预防及控制感染的效果。与红外线照射并用，使疗效更加明显。     

湿润烧伤膏联合红外线照射治疗瓦斯烧伤的护理体会

目的　总结湿润烧伤膏（MEBO）联合红外线照射治疗瓦斯烧伤患者创面的方法、疗效及护理要点。方法　对15例瓦斯烧伤患者创面清创后采用MEBO换药联合红外线照射治疗,同时予以抗休克、抗感染、营养支持治疗及专科护理,观察治疗效果,总结护理要点。结果　15例瓦斯烧伤患者的痊愈时间最短为7d,最长为40d,治疗过程中未发生严重并发症,创面愈合效果满意。结论　MEBO联合红外线照射治疗瓦斯烧伤操作简便,疗效显著,创面愈合快,患者痛苦小,值得临床广泛推广。     

光疗联合中药面膜治疗寻常性痤疮的Meta分析

目的对比光疗联合中药面膜与单纯光疗治疗寻常性痤疮的临床疗效。方法检索Pubmed、Embase、Cochrane、中国知网数据库、万方数据库、维普数据库中收录的光疗联合中药面膜与单纯光疗对比治疗寻常性痤疮的文献,提取符合纳入与排除标准文献中的数据,采用Revman 5.0统计软件进行统计学分析,对比光疗联合中药面膜及单纯光疗治疗寻常性痤疮的临床疗效。结果符合纳入及排除标准的文献共5篇,包含382例试验组患者和325例对照组患者,经随机效应模型分析,光疗联合中药面膜治疗寻常性痤疮的疗效优于单纯光疗治疗(RR=1.25,95%CI为1.07~1.45,P0.05),差异具有统计学意义。结论光疗联合中药面膜治疗寻常性痤疮的临床疗效显著优于单纯光疗治疗。     

光动力疗法治疗重度痤疮1例

正目的:研究光动力疗法治疗重度痤疮的方法并观察疗效。为进一步治疗提供经验。方法:患者男性,24岁,面部重度痤疮,红斑、粉刺、丘疹、囊肿、结节,脓疱、皮下有窦道形成。一般情况好,无发热,无系统性疾病合并。外院曾予中药面膜外敷,局部皮损内注射糖皮质激素,清痘等治疗,皮损一度好转。后改用中药口服后病情渐加重,治疗效果不明显而来我院诊治。患者清洁面部后,采用5%~10%的5-ALA盐酸氨酮戊酸(上海     

双黄连(冻干)配伍利多卡因并红外线照射治疗溃疡期压疮疗效观察

目的 探讨采用利多卡因联合双黄连粉并红外线照射治疗溃疡期压疮效果观察.方法 将收治的40例溃疡期压疮患者,按照年龄、创面情况相当的原则随机分为观察组(20例)和对照组(20例),两组用药前创面均按常规清创、消毒后,用红外线照射30 min,观察组在创面上涂抹利多卡因与双黄连粉混合溶液,并盖上透气的无菌纱布,每天换药1～2次;对照组在创面涂抹紫花烧伤膏.结果 观察组治疗效果明显优于对照组,治愈时间少于对照组.结论 利用利多卡因联合双黄连粉并红外线照射治疗溃疡期压疮,可以提高治愈率,缩短创面的愈合时间.     

湿润烧伤膏联合红外线治疗压疮的疗效观察

目的:观察湿润烧伤膏(MEBO)联合红外线治疗对Ⅱ度、Ⅲ度压疮的疗效.方法:选取2006年1月至2009年12月收治的68例压疮患者,应用湿润烧伤膏联合红外线照射压疮创面治疗,每日2次,观察创面愈合情况及愈合时间.结果:MEBO联合红外线照射治疗压疮效果满意.Ⅱ度压疮平均愈合时间为(7±1.4)天,Ⅲ度压疮平均愈合时间为(11±2.1)天.结论:MEBO联合红外线治疗对Ⅱ度、Ⅲ度压疮效果满意,且费用低廉、易于操作.     

保留清创后应用MEBT/MEBO治疗手指粉碎性损伤6例体会

目的探讨治疗手指粉碎性损伤的有效方法,以期最大限度保留手指长度及其功能。方法 6例手指粉碎性损伤患者在全身治疗的同时,局部创面予以保留清创后应用原位再生医疗技术(MEBT/MEBO)结合红外线局部照射治疗,观察治疗效果。结果 6例患者的23只损伤手指的条索状组织均成活,损伤创面均康复,平均住院时间为14.5 d;半年后随访,手指创面无瘢痕形成,痛、温觉存在,功能良好。结论保留清创后,局部采用MEBT/MEBO结合红外线照射治疗手指粉碎性损伤,方法简便,成功率高,可有效保留手指长度及其功能,是无再植条件的手外伤患者的有效治疗方法,值得临床推广应用。     

清肺解毒消痤方加减联合红、蓝光治疗脓疱型痤疮临床研究

 目的 观察清肺解毒消痤方加减口服和面膜外用并联合红、蓝光照射治疗脓疱型痤疮的效果.方法 将88例脓疱型痤疮患者分为2组:治疗组46例,予以清肺解毒消痤方加减口服和面膜外用并联合红、蓝光照射;对照组42例,仅予以清肺解毒消痤方加减口服和面膜外用,6周后进行疗效评定与对比.结果 治疗组痊愈率80.43％,总有效率93.47％;对照组痊愈率和总有效率分别为59.52％,78.57％.二者比较差异均有统计学意义(x2 =4.61,P＜o.05;x2=4.14,P＜ 0.05).结论 清肺解毒消痤方加减口服和面膜外用并联合红、蓝光照射治疗脓疱型痤疮有较好疗效,且操作简便,不良反应少.     

中医药灸法治疗慢性皮肤溃疡疗效观察

目的：观察中药灸法治疗慢性皮肤溃疡的临床疗效。方法：选择慢性皮肤溃疡256例,随机分为观察组和对照组各128例。观察组采用中药灸法;对照采用清创包扎换药处理,全身及局部应用抗生素治疗。同时加强健康教育和心理疏导,观察两组治疗3周后溃疡创面的愈合情况。结果：两组患者均未发生不良反应,观察组总治愈率82.0%,对照组总治愈率21.9%。观察组治愈率非常显著高于对照组（P〈0.01）。结论：中药灸法治疗慢性皮肤溃疡,疗效显著优于常规局部清创消炎治疗。     

半导体激光穴位照射与针刺对痛经症治疗效果的比较

目的观察半导体激光穴位照射对痛经症的镇痛效果。方法依据循证医学／图样测评法（Design,Measurement and Evaluation,DME）原则,运用随机盲法,将痛经症患者120例随机分为两组。观察组60例,应用半导体激光照射不同三组穴位;对照组60例,应用针刺穴位治疗。比较两种方法治疗痛经症的有效性,并进行临床观察和评价。结果半导体激光穴位照射治疗痛经症的临床疗效明显优于针刺穴位法（I级镇痛率90％）。两组临床疗效比较差异有显著意义（P〈0．05）;两组治疗前后数字分级法（Numeric Rating Scales,NRS）评分比较差异有显著意义（P〈0．05）。结论半导体激光穴位照射治疗痛经症的方法更为安全,与单纯应用针刺法比较疗效更佳,患者依从性更好。     

Minimal spinal hyperostosis with low-dose isotretinoin therapy

Skeletal abnormalities have been reported on numerous occasions in patients who have received high doses of vitamin A and its derivatives. Recently, a new derivative, isotretinoin (Accutane, Hoffman-LaRoche, Inc.), has become available for the treatment of cystic acne. Ninety-six patients treated for a minimum of four months with low doses of this drug at two University centers have shown overall good to excellent clinical responses. However, ten of these patients have developed small pointed excrescences on the anterior margins of cervical, thoracic, or lumbar vertebral bodies. The findings are of unknown clinical significance but show some similarities to the spinal findings in DISH syndrome. Follow-up studies will be obtained, but, at the present time, the drug still can be recommended for patients who have severe cystic acne because of the excellent clinical response.     

Ultrasonic appearance of adenomatous and hyperplastic parathyroid glands

An investigation was made of the sonographic and histopathologic characteristics of 27 parathyroid adenomas and 11 primary and secondary hyperplastic parathyroid glands demonstrated by ultrasound before surgical confirmation. All the hyperplastic glands and 21 of the adenomas had a homogeneously sonolucent interior structure and a smooth periphery. The adenomas and hyperplastic glands were sonographically indistinguishable except for 5 large adenomas which had areas of varying echodensity and an irregularly nodulated periphery. The ultrasonically inhomogeneous adenomas were histopathologically more heterogeneous with asymmetric, nodular enlargement. One patient had a cystic adenoma. The results are discussed in relation to the ultrasonic appearance of thyroid noduli and lymph nodes being the main source of errors in parathyroid ultrasonography.     

强脉冲激光治疗寻常性痤疮的近期疗效观察

目的 观察420 nm脉冲强激光治疗Ⅰ～Ⅲ级寻常性痤疮的疗效.方法 Ⅰ～Ⅲ级痤疮患者118例,随机分为治疗组60例,对照组58例.治疗组使用420 nm强脉冲激光治疗,对照组外用甲硝唑凝胶治疗.分别记录治疗前及治疗后第1、2、4和8周时粉刺、丘疹及脓疱的数目变化,并对结果进行统计和评估.结果 治疗后1、2、4和8周有效率治疗组分别为33.3%、56.7%、75.0%和83.3%,对照组分别为17.4%、37.9%、58.6%和62.1%.两组疗效差异有显著意义(P＜0.05).结论 420nm强脉冲激光治疗Ⅰ～Ⅲ级痤疮,可以明显降低痤疮的炎性损害,有效消除粉刺、丘疹及脓疱等皮损,治疗后患者皮肤柔嫩、光滑、弹性增强.     

强脉冲光子嫩肤仪治疗炎性痤疮

目的 探讨强脉冲光子嫩肤仪治疗面部炎性痤疮的疗效.方法 炎性痤疮患者106例,皮损主要分布于面颈部.采用强脉冲光子嫩肤仪治疗,波长585nm,根据患者性别、年龄、肤色选择能量密度24～40 J/cm2,导光片垂直于病灶进行照射,光斑间重复10%～20%.4次为一个疗程,每次间隔4周.结果 治疗1疗程后,治愈16例,占15.1%;显效59,占55.7%;有效28,占26.4%;无效3例,占3.8%;总有效率97.1%.所有患者均无瘢痕及色素沉着发生.结论 强脉冲光子嫩肤仪治疗炎性痤疮效果好,见效快,无明显不良反应,患者医从性好.     

大黄(庶虫)虫丸治疗囊肿性痤疮的临床疗效评价

目的　观察大黄虫丸治疗囊肿性痤疮的临床疗效。　方法　选择囊肿性痤疮患者 33 例做为治疗组,给予口服大黄虫丸治疗,观察并记录结果。　结果　治疗的总有效率为 90 9%,对照组(P<0 05)。　结论　大黄虫丸对囊肿性痤疮有较好的临床疗效。     

A new LED device used for photodynamic therapy in treatment of moderate to severe acne vulgaris

ObjectiveThis study investigated the efficacy and safety of a newly designed LED device used in photodiagnosis and photodynamic therapy of moderate to severe acne vulgaris in Chinese patients.MethodsForty-six patients with moderate to severe facial acne showing high degrees of fluorescence by ultraviolet light examination were illuminated during ALA-PDT with two wavelengths of light (543–548 nm, and 630 ± 6 nm, respectively) after 2 h of incubation with ALA. Each patient received treatment once every 30 days for two or three sessions. Two independent investigators assigned an acne severity score at baseline, one week after each treatment, as well as 4, 8, and 12 weeks after the completion of treatment. Adverse effects were recorded during and after each treatment. All patients rated their satisfaction with the results of treatment at a 12-week follow up visit.ResultsThe ALA-PDL treatment regimen showed an overall effectiveness rate of 89.13% (41/46 patients). Some degree of clinical efficacy was seen in 71.42%, 86.67%, and 95.83% of patients with grades IV, V, and VI acne, respectively, and the rate of clinical effectiveness increased with increasing acne severity. When compared with baseline scores, significant reductions in acne scores were obtained at 8, and 12 weeks after completion of treatment. Maximum efficacy was shown at the 12 week follow up. No severe adverse events were observed.ConclusionALA-PDT administered with the newly designed LED device was an effective treatment for moderate to severe acne vulgaris, and side effects were mild and reversible.     

强脉冲光治疗寻常型痤疮的疗效

目的评价强脉冲光治疗寻常型痤疮的疗效及其安全性.方法寻常型痤疮患者50例,其中轻度患者16例,中度患者34例.以ClearTouchTM丝柔光子痤疮治疗仪行强脉冲光治疗,每周2次,8次为一个疗程.治疗前后对皮损拍照并计数各类皮损数目,严格记录每次治疗后皮损变化及不良反应.以治疗后炎性皮损减少百分率评价疗效,并观察其安全性.结果总有效率为72.0%,其中轻、中度患者的总有效率分别为93.8%和61.8%.除一过性红斑外,未发现其他不良反应.结论强脉冲光治疗轻、中度寻常型痤疮疗效显著,疗程短、无痛苦、安全性高.     

果酸、半导体激光、Aurora全功能E光、2940nm铒激光联合治疗寻常性痤疮156例

目的观察果酸、半导体激光、Aurora全功能E光、2 940 nm铒激光联合治疗面部寻常性痤疮的效果。方法面部寻常性痤疮患者156例,首先采用果酸、半导体激光、Aurora全功能E光联合治疗5次,之后行2 940 nm铒激光治疗2~3次,能量密度8~10 J/cm2。根据治疗前后的对比相片及临床表现评估治疗效果。结果治疗结束后随访3~6个月,显效97例,有效59例。主要并发症为短暂红斑、色素沉着。结论果酸、半导体激光、Aurora全功能E光、2 940 nm铒激光联合治疗面部寻常性痤疮操作准确、快捷、损伤小、术后恢复快,满意度高,副作用少。     

The assessment of psychology,quality of life in acne patients and evaluation of ALA-PDT for moderate to severe acne

ObjectiveTo evaluate the state of psychology and quality of life of patients effected by acne and also the efficacy and safety of photodynamic therapy with topical 5-aminolevulinic acid (ALA-PDT) for moderate to severe acne patients.MethodsIn the questionnaire part, a pre-designed form was filled out. The questionnaire was comprised of 2 sections related to acne including sociodemographic and disease information as well as Cardiff Acne Disability Index (CADI) and Self-Rating Anxiety Scale (SAS). In the trial part, the ALA-PDT was applied to moderate to severe acne patients. Fresh 5% ALA solution was topically applied to face or face & neck. After 1 h’s incubation, a LED device was illuminated. A power density of 60−100 mW/cm² was delivered for 20 min. All the patients finished 3–4 sessions of ALA-PDT at 7–10 days intervals. Non-invasive detections were taken for skin moisture, oil, and VISIA indexes. Adverse events were recorded during and after the treatment.ResultsA total of 247 acne patients finished questionnaires. Over 97 % patients were assessed as mild to severe impacts in CADI questionnaire and 37.6 % patients had various degrees of anxiety in SAS questionnaire. The higher the BMI was, the higher the CADI points were (G = 0.278, p = 0.005). The severity of acne was correlated with psychology and quality of life (CADI: G = 0.367, p = 0.000; SAS: G = 0.285, p = 0.003). A total of 116 patients with moderate or severe acne accepted ALA-PDT and completed at least 3 sessions (PDT3) or even PDT4. After 1 session of treatment (AT1) and AT2, the efficiencies of all patients were 5.2 % and 29.3 %. For patients with PDT3, the efficiencies at follow-up at 1st month after last session (FU1), FU2 and FU3 were 59.4 %, 66.7 % and 78.3 %, respectively. For patients with PDT4, the efficiencies at AT3 and FU1–3 were 51.3 %, 63.6 %, 76.5 % and 85.7 %, respectively. The efficacies of PDT4 patients showed an increasing trend from FU1 to FU3 (G = 0.480, p = 0.004). Acne lesions of mild to severe were correlated with the treatment efficacies (FU1: G = 0.354, p = 0.000; FU2: G = 0.474, p = 0.000; FU3: G = 0.397, p = 0.000). Nearly 15 % patients were followed up for 12 months and among them 52.9 % patients were able to maintain ≥90 % improvement rate. There were no statistically significant differences before and after treatment (p > 0.05) according to the skin moisture content, oil content, ultraviolet ray spots, brown spots, red areas, and purple textures measured. The adverse reactions of ALA-PDT, including local burning sensation, mild pain sensation, mild edema erythema, reactive acne, pigmentation, etc., were temporary and tolerable.ConclusionIn our study, 97.2 % patients were rated as impact in CADI questionnaire and 37.6 % patients had anxiety in SAS questionnaire. It is necessary to control weight and disease progression. The efficiencies of ALA-PDT for moderate and severe acne were 59.4%–85.7% at follow-ups of 1st, 2nd or 3rd month after last session. The adverse reactions of ALA-PDT were temporary and tolerable.     

复方木尼孜其对女性迟发性痤疮血清睾酮的影响及疗效观察

目的观察复方木尼孜其对女性迟发性痤疮血清睾酮的影响及疗效。方法将128名痤疮患者随机分为两组。治疗组(A组)65例口服复方木尼孜其颗粒。对照组(B组)63例口服一清胶囊和维生素B6,治疗时间为28 d。另设62例相应年龄段非痤疮患者作对照组(C组)。于治疗前后采用电化学发光免疫分析法检测其卵泡期血清睾酮水平,并进行疗效评价。结果 A组和B组的总有效率分别为89.2%和61.9%,差异有统计学意义(P<0.05)。A组治疗前血清睾酮水平较C组明显升高(P<0.05),而治疗后血清睾酮水平与C组相比差异无统计学意义(P>0.05)。结论女性迟发性痤疮发病的主要原因与雄激素分泌增多有关。复方木尼孜其颗粒具有抗雄激素作用,对女性迟发性痤疮的疗效确切,且无明显不良反应。