果酸剥脱联合八白散治疗黄褐斑临床疗效观察

目的 评价果酸剥脱联合八白散治疗黄褐斑的临床疗效。方法 将72例确诊的黄褐斑患者随机分为联合组和果酸组。联合组采用果酸剥脱每2周治疗1次，共4次，每次治疗视患者耐受程度递增果酸浓度或停留时间（最高浓度为70%，最长停留时间为5 min），每次果酸剥脱治疗1周后，予以八白散外敷。果酸组单纯应用果酸剥脱治疗。两组于治疗8周后进行黄褐斑面积及严重程度（MASI）评分及皮肤特征定量评价。结果 治疗前，联合组MASI评分为19.16 ± 2.34，果酸组为20.27 ± 2.18，两组差异无统计学意义（P > 0.05）；治疗8周后，联合组为9.36 ± 1.44，果酸组为15.13 ± 1.78，均较治疗前降低（P < 0.05），且联合组MASI评分降低差值（9.56 ± 1.31）明显高于果酸组（4.78 ± 1.05），差异有统计学意义（P < 0.05）。联合组总有效率为83.3%，果酸组为58.3%，两组差异有统计学意义（P < 0.05）。VISIA皮肤图像分析数据显示，两组患者治疗后面部色素斑、皱纹、纹理、毛孔和紫质等得到明显改善，但与果酸组比较，联合组改善更显著（P < 0.05）。结论 果酸剥脱联合八白散治疗黄褐斑安全、有效，而且还能改善肤质，值得临床推广应用。

Efficacy of glycolic acid peeling combined with Babaisan for the treatment of melasma:a clinical observation

Tang Zhiming, Zhai Xiaoxiang, Li Jingguo, Shan Xiao, Jing Mengqing, Li Yongcong Department of Dermatology, Traditional Chinese Medicine Hospital of Xuzhou City, Xuzhou 221003, Jiangsu, China Corresponding author: Tang Zhiming, Email: 158914788@qq.com 【Abstract】 Objective To evaluate the clinical efficacy of glycolic acid peeling combined with Babaisan for the treatment of melasma. Methods Totally, 72 patients with melasma were randomly and equally divided into 2 groups to be treated with glycolic acid peeling alone （the glycolic acid group） or in combination with Babaisan （the combination group）. Glycolic acid peeling was performed once every two weeks for 4 sessions. The concentrations and residence time of glycolic acid were gradually increased according to the tolerance of patients, and should not exceed 70% and 5 minutes respectively. Babaisan was topically applied one week after each session of glycolic acid peeling. After 8?week treatment, melasma area and severity index （MASI） scores and skin conditions were assessed quantitatively. Results Before the treatment, there was no significant difference in MASI scores between the combination group and glycolic acid group （19.16 ± 2.34 vs. 20.27 ± 2.18, P > 0.05）. After 8?week treatment, MASI scores significantly decreased in both the combination group （9.36 ± 1.44, P < 0.05） and glycolic acid group （15.13 ± 1.78, P < 0.05）. Moreover, the degree of decline in MASI scores was significantly higher in the combination group than in the glycolic acid group （9.56 ± 1.31 vs. 4.78 ± 1.05, P < 0.05）, so was the total response rate （83.3% ［30/36］ vs. 58.3%［21/36］, P < 0.05）. VISIA skin analysis showed that facial pigmented spots, wrinkles, skin texture, pores and rhodopsin were all evidently improved in the two groups after treatment, and the improvement was significantly greater in the combination group than in the glycolic acid group （P < 0.05）. Conclusions Glycolic acid peeling combined with Babaisan is a safe and effective approach to the treatment of melasma and improvement of skin conditions. It is worthy of clinical promotion.