口服异维A酸联合ALA-PDT治疗中重度痤疮的临床疗效观察

目的观察口服异维A酸联合盐酸氨酮戊酸(5-aminolaevulinic acid,ALA)光动力治疗(photodynamic therapy,PDT)中重度痤疮的安全性及临床疗效。方法中重度痤疮患者75例,随机分为三组,分别为口服异维A酸联合ALA-PDT组(A组),在口服异维A酸基础上,进行ALAPDT治疗;ALA-PDT组(B组),仅采用ALA-PDT治疗,功率密度100～150 mW/cm2,时间20 min;异维A酸组(C组),患者仅口服异维A酸治疗,每组患者25例。共治疗4周,在治疗2、4、8周评价疗效,治疗后3个月随访观察疗效、不良反应发生率和复发情况。结果治疗后8周试验组有效率为92. 0%,ALA-PDT组有效率72. 0%,异维A酸组有效率40. 0%,试验组有效率明显高于对照组(P 0. 05)。试验组复发率明显低于对照组(P 0. 05)。结论口服异维A酸基础上,联合ALA-PDT治疗中重度痤疮安全性及有效率均较高,且复发率低,值得临床推广。     

异维A酸联合妈富隆治疗女性青春期后痤疮疗效观察

目的：观察异维A酸胶丸联合妈富隆治疗女性青春期后痤疮的疗效。方法：选择女性青春期后痤疮80例,随机分为观察组和对照组各40例。观察组给予异维A酸胶丸10 mg/次,3次/d,妈富隆1片/d;对照组给予异维A酸胶丸10 mg/次,3次/d,螺内酯20 mg/次,3次/d。比较两组总有效率。结果：观察组总有效率92.5%显著高于对照组75.0%（P〈0.05）。结论：异维A酸胶丸联合妈富隆治疗女性青春期后痤疮疗效优于异维A酸胶丸联合螺内酯。     

局部5-氨基酮戊酸-光动力疗法治疗中重度痤疮疗效分析

目的探讨局部5-氨基酮戊酸-光动力疗法治疗中重度痤疮的安全性及有效性。方法将60例中重度面部痤疮患者随机分为两组。治疗组30例,给予ALA-PDT治疗,每2周治疗1次,共治疗2～4次;对照组30例,单纯红光治疗,每周1次,共8次。在治疗后第2、4、6和8周对两组患者进行疗效判断和比较,同时观察治疗过程中出现的不良反应。结果治疗组和对照组治疗后第8周总有效率分别为96.7%和76.7%,治疗组疗效明显优于对照组(P0.05)。治疗组个别患者出现红斑、少许色素沉着,但无瘢痕形成。结论局部5-氨基酮戊酸-光动力疗法治疗中重度痤疮疗效高、复发率低,不良反应小,优于单纯红光治疗。     

异维A酸联合中药治疗痤疮疗效观察

目的：观察异维A酸联合中药治疗痤疮的疗效。方法：将痤疮62例随机分为观察组33例和对照组29例。观察组给予异维A酸联合中药治疗,对照组给予异维A酸单药治疗。治疗1个月后,比较两组的疗效及不良反应。结果：观察组治愈率和总有效率显著高于对照组（P〈0.01）,而不良反应发生率显著低于对照组（P〈0.01）。结论：异维A酸联合中药治疗痤疮疗效较好。     

痤疮合剂联合ALA-PDT治疗中重度寻常性痤疮疗效观察

目的观察痤疮合剂联合5-氨基酮戊酸光动力疗法(ALA-PDT)治疗中重度寻常性痤疮的临床疗效和安全性。方法采用随机数表法将2016年8月—2017年12月南通市第三人民医院皮肤科收治的96例中重度寻常性痤疮患者随机分为试验组(46例)与对照组(50例),其中试验组患者采用痤疮合剂联合ALA-PDT治疗,对照组患者采用盐酸米诺环素胶囊治疗,对比观察两组患者的皮损创面愈合情况、不良反应发生情况及复发情况等。结果治疗过程中,试验组患者中有8例患者发生局部不良反应,对照组患者中有5例患者发生局部不良反应,两组对比采用四格表资料的卡方检验,χ~2=1.118,P=0.290,P0.05,差异无统计学意义;治疗后两组患者皮损创面均逐渐好转,创面评分均逐渐降低,其中治疗2、4、6周后两组患者皮损创面评分对比采用t检验,t值分别为7.301、7.050及4.949,P均0.01,差异具有统计学意义;治疗6周后,两组患者临床疗效对比采用等级资料的秩和检验,mann-whitney U=807.000,Z=2.648,P=0.008,P0.01,差异具有统计学意义;3个月后随访,试验组患者中有1例患者复发,对照组患者中有8例患者复发,两组对比采用四格表资料的卡方检验,χ~2=3.886,P=0.021,P0.05,差异具有统计学意义。结论痤疮合剂联合ALA-PDT治疗中重度寻常性痤疮,可有效促进皮损创面痊愈,降低复发率,疗效显著,值得临床推广应用。     

消银颗粒联合阿维A胶囊治疗寻常性银屑病70例临床观察

目的:探讨消银颗粒联合阿维A胶囊治疗寻常性银屑病的临床疗效。方法:选择2010-03～2012-05治疗的寻常性银屑病患者140例,随机分为治疗组和对照组,治疗组口服阿维A胶囊30 mg,1次/d,一般病情控制后减到维持剂量20 mg,1次/d,逐渐减至停药共3个月,并用消银颗粒3.5 g,3次/d,疗程60 d。对照组单用阿维A胶囊,用法,疗程,均同治疗组。结果:治疗组总有效率明显优于对照组,差异有统计学意义(P<0.05)。结论:消银颗粒联合阿维A胶囊治疗寻常型银屑病疗效好,值得研究、推广。     

自制阿螺A微乳膏治疗痤疮的疗效观察

目的观察阿螺A微乳膏治疗痤疮的临床疗效。方法 256例患者随机分为:治疗组138例,外用阿螺A微乳膏;对照组118例,外用异维A酸凝胶,疗程8周。结果治疗组、对照组总有效率分别为90%、69%,两组差异有显著统计学意义(P<0.01)。结论阿螺A微乳膏治疗痤疮疗效显著、安全性高。     

果酸联合红蓝光治疗中重度痤疮的临床疗效和安全性分析

目的:对果酸联合红蓝光治疗中重度痤疮的临床疗效进行探究,并对该方法的安全性进行分析.方法:我院选取了时间段从2015年9月到2016年11月的240例中重度痤疮患者,将其随机分为两组,分别为对照组和实验组,每组120例.对照组患者采取果酸治疗,实验组患者在对照组的基础上采取果酸联合红蓝光治疗,对比观察两组患者治疗后的有效率以及不良反应的发生情况等相关指标.结果:经不同方法治疗后,实验组患者的治疗有效率明显高于对照组,实验组患者不良反应的发生情况明显降低,差异有统计学意义(P＜0.05).结论:实验组患者的治疗效果优于对照组.结果显示,果酸联合红蓝光治疗中重度痤疮疗效更好,安全性更高,值得临床推广应用.     

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。     

丁苯酞胶囊治疗急性脑梗死39例疗效观察

目的：观察丁苯酞胶囊治疗急性脑梗死的临床疗效。方法：选取78例急性脑梗死患者随机分为治疗组39例和对照组39例,两组在给予抗血小板聚集等常规治疗基础上,观察组再给予丁苯酞胶囊200 mg,3次/d。疗程为14 d。结果：治疗组总有效率,对照组总有效率,两组总有效率差异显著（P〈0.01）,观察组疗效明显优于对照组,且无明显不良反应。结论：丁苯酞胶囊对治疗急性脑梗死改善神经功能疗效确切。     

Successful treatment of refractory facial acne using repeat short-cycle ALA-PDT: Case study

Acne vulgaris is a common dermatological disorder. Topical photodynamic therapy (PDT)-mediated with aminolevulinic acid (ALA) or methyl aminolevulinic acid (MAL) has been successfully used in the treatment of moderate to severe acne. The purpose of this case report is to highlight the feasibility of using a repeat weekly short-cycle ALA-PDT to treat severe facial acne lesions refractory to systemic retinoid and antibiotics.     

The effects of ALA-PDT on microbiota in pilosebaceous units of patients with severe acne: A metagenomic study

Background5-aminolevulinic acid mediated photodynamic therapy (ALA-PDT) is increasingly used to control severe acne. However, its impact on skin microbiota remains uncertain.ObjectivesWe aimed to compare the makeup, diversity, and function of the microbiota in pilosebaceous units of patients with severe acne before and after ALA-PDT.MethodsA longitudinal cohort study was performed on 11 participants with severe facial acne. All patients were given 5%ALA-PDT every two weeks for three sessions in total. The contents of lesions were sampled for metagenomic sequencing at baseline and two weeks after the first ALA-PDT session.ResultsCutibacterium acnes was the most dominant species followed by Staphylococcus epidermidis and Pseudomonas fluorescens. Treatment with ALA-PDT led to clinical improvements in acne severity concurrent with a significant reduction in the relative abundance of C. acnes, while P. fluorescens increased significantly after ALA-PDT. No significant change was identified in other species. ALA-PDT administration was associated with an increased microbiota diversity and reductions in the relative abundance of the functional genes involved in energy metabolism and DNA replication.ConclusionsALA-PDT plays a therapeutic role by killing C. acnes, increasing P. fluorescens and the microbiome diversity, while inhibiting the function of microbiota in pilosebaceous units of severe acne.     

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.     

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.     

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.     

Efficacy and therapeutic reactions of tri-needle-pretreatment combined with painless ALA-PDT for the treatment of moderate-to-severe acne vulgaris: A randomized controlled trial

Background: Our clinical experience suggests that pretreatment of the original lesions may be crucial for enhancing the efficacy of 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) in moderate-to-severe acne vulgaris. We performed this randomized controlled trial (RCT) to validate this observation.Methods: Efficacy and therapeutic reactions between tri-needle-pretreatment with ALA-PDT (TP-PDT) and conventional ALA-PDT without pretreatment (NP-PDT) were compared. In TP-PDT group, tri-needle-pretreatment was performed using comedone extractors, fire needles, or plum-blossom needles, according to the lesion type. In the TP-PDT group, 5% ALA cream was applied to lesions 30 min before illumination (LED red light: 633±10 nm, 40 mW/cm², 150 J/cm²). In the NP-PDT group, 5% ALA cream was applied 1 h before illumination (60 mW/cm², 72 J/cm²). Patients underwent four sessions, at 1-week intervals. The efficacy was evaluated as the proportion of patients achieving a remarkable effective rate, based on the reduction in the number of lesions. A numeric rating scale was used to assess the severity of pain, erythema, and edema.Results: Forty-eight patients completed the trial. The proportion of remarkable effective rate was significantly greater and the pain score was significantly lower for the TP-PDT than NP-PDT group. The edema score was significantly higher for the TP-PDT than NP-PDT group. There was no difference in erythema scores between the two groups.Conclusion: The tri-needle-pretreatment can improve the efficacy of ALA-PDT, without an increase in pain, for the treatment of moderate-to-severe acne vulgaris. These qualities make the TP-PDT a promising gold standard pretreatment for ALA-PDT for acne vulgaris.     

类人胶原蛋白敷料联合超脉冲CO2点阵激光治疗凹陷性痤疮瘢痕的疗效和安全性

  目的 评价类人胶原蛋白敷料联合超脉冲CO₂点阵激光治疗面部凹陷性痤疮瘢痕的疗效和安全性。 方法 选择2015-05至2016-12就诊的面部痤疮凹陷性瘢痕患者76例,随机分为对照组和治疗组,各38例。对照组采用超脉冲CO₂点阵激光,间隔3个月治疗1次,共4次。治疗组在点阵激光术后给予类人胶原蛋白敷料外用。采用ECCA评估法评价皮损,对比两组患者的瘢痕评分、急性炎性反应红斑和疼痛持续时间、结痂时间、痂皮完全脱落时间、误工期、不良反应等。 结果 两组患者治疗后ECCA评分均比治疗前明显下降,治疗组比对照组下降更明显(P<0.05);治疗组术后红斑持续时间(1.25±0.62)d,疼痛持续时间(1.46±0.77)d,均明显短于对照组,差异有统计学意义(t=-2.483,P=0.015;t=-3.219,P=0.002);两组术后结痂时间对比,差异无统计学意义(t=-0.439,P=0.066),但治疗组痂皮完全脱落时间、误工期均短于对照组,差异有统计学意义(t=-3.049,P=0.003;t=-2.197,P=0.031);治疗组患者主观感受和舒适程度评价优于对照组,差异有统计学意义(Z=-2.197,P=0.028),治疗组患者满意率(68.42%)高于对照组(44.74%),差异有统计学意义(χ²=4.338,P=0.037);治疗组色素沉着发生率5.26%,低于对照组的21.05%,差异有统计学意义(χ²=4.145,P=0.042),两组患者均未出现水泡、感染和增生性瘢痕等不良反应。 结论 联合外用类人胶原蛋白敷料可明显提高超脉冲CO₂点阵激光术后痤疮凹陷性瘢痕患者的治疗效果,缩短急性期红斑持续时间和疼痛持续时间,促进愈合,缩短误工期,减少不良反应,改善患者术后不良感受,提高生活质量。     

口服米诺环素联合0.1%阿达帕林凝胶治疗痤疮疗效观察

目的探讨米诺环素联合0.1%阿达帕林凝胶治疗痤疮的疗效。方法将60名患者随机分为治疗组和对照组,治疗组接受米诺环素联合0.1%阿达帕林凝胶治疗,对照组接受米诺环素治疗,对治疗组和对照组用药8周后的治愈率进行比较并作出评价。结果治疗8周后,米诺环素联合0.1%阿达帕林凝胶治疗组的总有效率明显高于单独口服米诺环素组(P<0.05)。结论米诺环素联合0.1%阿达帕林凝胶较单独口服米诺环素能明显提高疗效,而且不会增加不良反应。