5-氨基酮戊酸光动力疗法治疗寻常痤疮的临床观察

目的观察5-氨基酮戊酸光动力疗法（ALA-PDT）治疗寻常痤疮的安全性及有效性。方法将90例中重度痤疮患者随机单盲分为两组：治疗组45例,给予ALA-PDT治疗,1次/10 d,共治疗2～4次;对照组45例,口服异维A酸胶囊,每次10 mg,2次/d,共治疗40 d。在治疗的第10、20、30及40天对两组患者进行疗效判断和比较,同时,记录治疗过程中出现的不良反应。结果治疗组患者经过2～4次治疗后,总有效率为97.8%;对照组治疗结束时总有效率为77.8%,治疗组疗效明显优于对照组（P〈0.01）。另外,治疗组复发程度明显低于对照组,且病情控制时间明显延长。治疗组的所有皮损,包括粉刺、丘疹、脓疱、囊肿、结节等均比对照组明显减少。结论 ALA-PDT治疗中重度痤疮的疗效明显优于口服异维A酸胶囊,是一种简单、高效、不良反应轻微的治疗中重度寻常痤疮的新方法。

Clinical observation of photodynamic therapy with 5-aminolevulinic acid in the treatment of acne vulgaris

Objective To observe the clinical efficacy and safety of photodynamic therapy using 5-aminolevulinic acid（ALA-PDT） in the treatment of acne vulgaris.Methods Ninety patients with moderate to severe facial acne were randomly divided into two groups with single-blind method,45 cases in treatment group were given ALA-PDT to the facial lesions for 2-4 times with an interval of 10 days,the other 45 cases in control group received oral isotretinoin,10mg twice daily for 40 days.The patients were evaluated for efficacy on days 10,20,30 and 40 after the initial treatment.The side-effects were also recorded during the treatment.Results The total effective rate was 97.8% in treatment group after 2-4 times of treatment,77.8% in the control group and the curative effect in treatment group was significantly better than that in control groups（P〈0.01）.The lesions tended to recur more slightly with a longer remission period in treatment group than in the control group.Every kind of lesions,including comedo,papules,pustules,cyst and nodules were significant reduced too.Conclusion The curative effect of ALA-PDT is better than that of oral isotretinoin.ALA-PDT is a simple,effective and optional treatment for moderate to severe acne with few adverse reactions.