5-氨基酮戊酸光动力疗法联合冷冻治疗降低尖锐湿疣复发率

目的比较5-氨基酮戊酸光动力疗法（ALA-PDT）、冷冻和ALA-PDT联合冷冻3种方法治疗尖锐湿疣的疗效，探索一种能有效降低尖锐湿疣复发的方法。方法尖锐湿疣165例，随机分为3组，每组55例．冷冻组，每7～10d治疗一次，共2～6次。ALA-PDT组，皮损区涂20％ALA乳膏后3h，以激光发射器照射，照射距离40～80mm，照射时间为20min，能量95～102J／cm2，间隔7～10d治疗一次，共治疗3次。联合组冷冻1-5min后行光动力治疗。治疗后随访3～12个月。结果3组患者治疗后疣体完全清除，冷冻组复发率为58．2％，平均复发时间为（34．7±3．22）d。光动力治疗组复发率为16．4％，平均复发时间为（52．1±4．53）d，联合组复发率为7．3％，平均复发时间为（63．7±5．66）d。结论ALA-PDT联合冷冻治疗尖锐湿疣可明显降低复发率（P〈0．01），且安全、耐受性好，无明显不良反应。

Incorporating 5-aminolevulinic acid-photodynamic therapy with cryotherapy reducing the recurrence rate of condyloma acuminatum

Objective To evaluate the efficacy of combined therapy with both 5-aminolevuline acid- photodynamic therapy （ALA-PDT） and cryotherapy in the treatment of condyloma acuminatum（CA）. Methods One hundred and sixty-five patients with condyloma acuminatum were randomly divided into cryotherapy group, photodynamic therapy group, and cryotherapy-photodynamic therapy group （n = 55 ）. Patients were treated by cryotherapy once 7 - 10 days for 2 -6 times totally in cryotherapy group. In photodynamic therapy group, lesion area were coated with 20% ALA cream for 3 hours, laser irradiation were used by irradiation distance 40 - 80 mm, 95 - 102 J/cm2 for 20 minutes, every 7 to 10 days, 3 times totally . In cryotherapy-photodynamic therapy group, patients were treated by cryotherapy for 1 to 5 minutes and then by Photodynamic therapy. All the patients were follow-up for 3 to 12 months after treatment. Results The warts were all disappeared after treatment by three methods. The recurrence rates were 58.9%, 12.5% and 5.9% while the time of recurrence were 34.7, 52. 1 and 73. 7 days in cryotherapy group, photodynamic therapy group, and cryotherapy- photodynamic therapy group respectively. Conclusion The combination therapy of ALA-PDT with cryotherapy can significantly reduce the recurrence of CA, with good tolerance.