曲安奈德局部注射联合外用5%咪喹莫特治疗瘢痕疙瘩疗效观察(1)
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[摘要]目的:观察曲安奈德局部注射联合外用5%咪喹莫特乳膏治疗瘢痕疙瘩的临床疗效。方法:将患者随机分为两组,治疗组给予曲安奈德局部注射治疗,每10～15天注射1次,2～3次为1个疗程,最多不超过3个疗程。同时外用5%咪喹莫特每周3次,连续外用3个月;对照组单纯给予曲安奈德注射液局部注射治疗。治疗结束后随访1年,判断疗效并观察复发情况。结果:治疗组有效率96.4%,明显优于对照组(P<0.05),差异有显著性意义。治疗组复发率低于对照组。结论:曲安奈德局部注射联合外用5%咪喹莫特乳膏治疗瘢痕疙瘩治愈率高,疗效确切。
[关键词]曲安奈德;5%咪喹莫特;瘢痕疙瘩
[中图分类号]R619+.6 [文献标识码]A [文章编号]1008-6455(2010)07-1053-02
Treatment on keloid with triamcinolone combined with 5% imiquimod cream
ZHAO Jian-hua,QIAO Shao-hua,GENG Wen-jun,FU Ji-xing
(Department of Dermatology,Second People's Hospitol of Liaocheng,Linqing 252601,Shandong,China)
Abstract:Objective To observe the efficacy of triamcinolone combined with 5% imiquimod cream in the treatment on keloid.MethodsPatients were randomly divided into two groups. The treatment group orally took injection of triamcinolone one time every 10～15 days and 2～3 times a course for no more than 3 courses.The same time the treatment group took 5% imiquimod cream for three months.The control group only took injection of triamcinolone. one year after finishing the treatment, the evaluation of the efficacy and drug with drawal, follow-up recurrence of the situation was carried out.ResultsAfter one year,effective in the treatment(96.4%) was significantly higher than that in control group(P<0.05).The rate of relapse in control group was significantly higher than that in the treatment group.Conclusion Triamcinolone combined with 5% imiquimod cream in the treatment on keloid have a more satisfactory effect.
Key words:triamcinolone;5% imiquimod cream;keloid
瘢痕疙瘩是皮肤科常见病,患者常感觉有局部瘙痒、刺痛,并导致功能障碍和影响美观,其治疗是当前皮肤科所面临的一大难题。单一疗法往往疗效差、复发率高。2007年6月～2008年9月,我们应用曲安奈德局部注射联合外用5%咪喹莫特乳膏治疗瘢痕疙瘩取得了较满意的疗效,现报道如下。
1 临床资料和方法
1.1一般资料:96例瘢痕疙瘩患者,均来自我院皮肤科门诊。皮损形态符合瘢痕疙瘩诊断标准,为高出皮面的红色、坚实有一定弹性、表面光滑、略有光泽的多形性条块,横条多呈蟹足状或不规则状,自觉瘙痒、刺痛。皮损大部分位于胸前正中,少部分位于四肢、耳垂、外阴等处。皮损大小:0.5cm×0.5cm～4.0cm×5.0cm。其中26例曾经采用手术、激光、单纯药物注射等治疗,效果不佳,有严重系统性疾病者及近3月接受过其他方法治疗者不予入选。
将96例患者随机分为两组:治疗组56例,男26例,女30例,平均年龄30.5岁(18～48岁),平均病程8个月(3月～11年),其中单发40例,多发16例;对照组40例,男16例,女24例,平均年龄31.5岁(19～49岁),平均病程7个月(4月～10年),单发30例,多发10例。两组患者在性别、年龄、病程、皮损分布及大小方面具有可比性。
1.2 治疗方法:治疗组:56例,皮损区常规消毒后,将曲安奈德注射液1ml(含曲安奈德40mg)与2%利多卡因4ml充分混匀,在皮损基底呈放射状注入瘢痕组织,使其膨隆呈苍白色,至药液开始向周围组织浸润时为止。每10～15天注射1次,2～3次为1个疗程,最多不超过3个疗程。同时给予5%咪喹莫特乳膏,每周涂药3次,分别于周二、四、六晚给药。涂药前先清洗患处并擦干,用棉签涂于皮损,轻轻按摩患处2min,药物在患处保留6～8h后于第二天早晨洗净,连续外用3个月 ......
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