强脉冲光联合氨甲环酸治疗面部黄褐斑MASI评分观察(1)

http://www.100md.com 2018年3月1日 《中国美容医学》 2018年第5期

     [摘要]目的：使用强脉冲光(IPL)联合口服氨甲环酸治疗黄褐斑，并使用MASI评分系统进行疗效评价，观察联合治疗是否优于单一治疗。方法：124例黄褐斑患者，随机分为三组。治疗组：41例，口服氨甲環酸联合IPL治疗；对照A组：41例，仅口服氨甲环酸治疗；对照B组：42例，仅使用IPL治疗。所有患者治疗前后均进行MASI评分(黄褐斑面积及严重程度评分)，以MDR(治疗前后MASI分值下降率)作为有效性指标。结果：平均MDR治疗组(65.91±15.56)%，对照A组(56.53±21.25)%，对照B组(49.64±15.96)%，治疗组MDR高于对照A组及对照B组，均有显著性差异(P<0.001)。结论：IPL联合氨甲环酸口服治疗黄褐斑的效果良好，且联合治疗的疗效好于单一治疗。

    [关键词]黄褐斑；强脉冲光；氨甲环酸；MASI评分；联合治疗

    [中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455(2018)05-0036-03
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    Observation on MASI Score of Intense Pulsed Light IPL Combined with Oral Transamin in the Treatment of Chloasma

    SHI Ying-ying， CHEN Wei ，WANG Lu-ping， YU Pi-jun， LIU Yi

    (Department of Plastic Surgery，Shanghai Eighth People’s Hospital， Jiangsu University， Shanghai 200235，China)

    Abstract： Objective MASI scoring system is used to compare the curative effect of Intense Pulsed Light combined with oral Transamin， and to observe whether combined therapy is better than single therapy. Methods 124 patients were randomly divided into three groups. In the treatment group， 41 patients received Intense Pulsed Light combined with oral Transamin； in the control group A， 41 patients received oral Transamin alone； in control group B， 42 patients received intensive pulsed light alone. Before and after treatment， all patients had MASI score (melasma area and severity score)， and MDR (the decline rate of MASI score before and after treatment) as the validity index. Results The average MDR of the treatment group is (65.91±15.56)%. The average MDR of the control group A is (56.53±21.25)%. The average MDR of the control group B is (49.64±15.96)%.The MDR of the treatment group was higher than that of the control group A and the control group B， the difference was statistically significant (P<0.001). Conclusion The curative effect of Intense Pulsed Light IPL combined with oral Transamin is effective， and the combination therapy is more effective than single therapy.
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    Key words： chloasma； intense pulsed light； Transamin； MASI score； combination therapy

    黄褐斑是临床常见的色素增加性皮肤病，常见于中年女性。目前其病因尚不完全清楚，大多数学者认为其与遗传易感性、紫外线照射、内分泌因素等密切相关[1]，也有些学者认为其本质是由于皮肤屏障作用被破坏引起的慢性过度刺激性炎症性色素沉着，与过度搓揉造成的肉眼不可见的细微皮损有关[2]。2014年10月-2016年7月，笔者采用小剂量IPL联合氨甲环酸口服治疗，同时引入了MASI评分体系[3]对治疗效果进行更为客观的评价，现将结果报道如下。

    1 临床资料

    研究对象均为笔者科室就诊的女性黄褐斑患者，共124例。年龄35～50岁，平均42岁，已婚118例，未婚6例，将其随机分为三组。治疗组：41例，采用强脉冲光IPL联合氨甲环酸口服治疗；对照A组：41例，单纯采用氨甲环酸口服治疗；对照B组：42例，单纯采用IPL治疗。诊断标准：①面部淡褐色至深褐色、界限清楚的片状色斑；通常对称性分布，无炎症表现及鳞屑；②无明显自觉症状；③青春期后出现；④病情有季节性，常夏重冬轻；⑤排除其他疾病引起的色素沉着[4]。, 百拇医药(石莹莹 陈炜 王露萍 余丕军 柳逸)

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