果酸治疗黄褐斑30例临床分析(1)
[摘要]目的：观察果酸治疗黄褐斑的临床效果和安全性，掌握治疗的方法和适应证。明确果酸治疗黄褐斑的疗效、相关生物学指标的变化及患者的满意度评价。方法：本试验采取自身对照分析，共纳入30例行果酸治疗的黄褐斑患者。使用果酸(20%～70%)行剥脱治疗，每2周1次，共治疗4次。分别于治疗前、治疗后(第15天、30天、45天、60天)进行无创性皮肤测试仪检测皮肤黑色素及红色素，并评估术后MASI评分，收集患者主观感受及疗效。结果：随着治疗时间及次数的增加，果酸治疗黄褐斑患者皮损处黑色素、红色素数值降低，且较治疗前差异有统计学意义(P<0.05)；疗程结束时评估疗效，基本治愈10例，明显改善15例，轻度改善2例，改善不明显或加重3例，有效率90%；患者对果酸治疗满意度较高，且患者皮肤整体光泽度、肤色均匀性及黄褐斑皮损均改善，随着时间推移改善趋势越来越明显。结论：果酸治疗黄褐斑是一种安全、有效的治疗方式，可通过降低黑色素、红色素指标从而改善皮损处色斑。
[关键词]黄褐斑；果酸；化学剥脱；疗效；外用药
, 百拇医药
[中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455(2018)09-0021-04
Clinical Efficacy of Alpha-hydroxy Acid for Treatment of 30 Cases of Melasma
JIA Fei， WU Feng-qin， ZHANG Qian， LI Chun-ying， JIAN Zhe
(Department of Dermatology，Xijing Hospital，the Fourth Military Medical University，Xi’an 710032，Shaanxi，China)
Abstract： Objective To explore the clinical effect and safety of alpha-hydroxy acid in the treatment of melasma， and clarify the efficacy， related biological indicators and patient satisfaction were evaluated. Methods Self-control analysis was performed in this study.30 patients with melasma treated with alpha-hydroxy acid were included. More specifically， they received an exfoliation treatment with alpha-hydroxy acid (20% to 70%) once every two weeks for a total of four times. Skin melanin and red pigment were detected by non-invasive skin tester before and after treatment (15d， 30d， 45d， and 60d)， the MASI score after surgery was evaluated， and the patients’subjective feelings were also collected. Results The level of the melanin and red pigment in the skin lesions of melasma patients were decreased with the increase of time and frequency， and the difference was statistically significant before treatment (P<0.05). Assessment of the therapeutic efficacy at the end of treatment： basic cure (n=10)， significantly improved (n=15)， slightly improved (n=2)， insignificant or aggravated (n=3)， about 90% efficiency. Patients were more satisfied with their treatment. The skin gloss， color even and lesions of melasma patients had improved. The effect was getting better with the extension of treatment time. Conclusion Alpha-hydroxy acid was a safe and effective treatment for melasma. It did this through the reduction of melanin and red pigment levels and the improvement of skin lesions.
, 百拇医药
Key words： melasma； alpha-hydroxy acid； chemexfoliation； efficacy； external application drugs
黃褐斑是一种常见的色素增加性皮肤病，临床表现为面部黄褐色或深褐色斑片，对称分布，多见于Ⅲ～Ⅳ型皮肤类型人群，好发于颧颊部，也可累及眶周、前额、上唇及鼻部，在东南亚人群中发病率约占40%[1-2]。其发病及诱因与遗传易感、种族因素、日晒、激素、血管因素及其他系统疾病的伴发等相关[3]。黄褐斑临床治疗策略为抑制黑素细胞活性，减少黑素合成及转运，促进黑素降解破坏[4-5]。果酸(羟基乙酸)是一种弱酸，可通过加速表皮细胞的更新与脱落，促进黑素的代谢及降解破坏，治疗黄褐斑的临床疗效已有报道[6]，但尚缺乏治疗过程中客观指标的描述及肯定。本研究通过检测治疗过程中患者皮损处黑素、血红素等客观指标，联合主观评估明确果酸治疗黄褐斑的疗效及患者的满意度，现报道如下。, 百拇医药(贾菲 吴风琴 张倩 李春英 坚哲)
[关键词]黄褐斑；果酸；化学剥脱；疗效；外用药
, 百拇医药
[中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455(2018)09-0021-04
Clinical Efficacy of Alpha-hydroxy Acid for Treatment of 30 Cases of Melasma
JIA Fei， WU Feng-qin， ZHANG Qian， LI Chun-ying， JIAN Zhe
(Department of Dermatology，Xijing Hospital，the Fourth Military Medical University，Xi’an 710032，Shaanxi，China)
Abstract： Objective To explore the clinical effect and safety of alpha-hydroxy acid in the treatment of melasma， and clarify the efficacy， related biological indicators and patient satisfaction were evaluated. Methods Self-control analysis was performed in this study.30 patients with melasma treated with alpha-hydroxy acid were included. More specifically， they received an exfoliation treatment with alpha-hydroxy acid (20% to 70%) once every two weeks for a total of four times. Skin melanin and red pigment were detected by non-invasive skin tester before and after treatment (15d， 30d， 45d， and 60d)， the MASI score after surgery was evaluated， and the patients’subjective feelings were also collected. Results The level of the melanin and red pigment in the skin lesions of melasma patients were decreased with the increase of time and frequency， and the difference was statistically significant before treatment (P<0.05). Assessment of the therapeutic efficacy at the end of treatment： basic cure (n=10)， significantly improved (n=15)， slightly improved (n=2)， insignificant or aggravated (n=3)， about 90% efficiency. Patients were more satisfied with their treatment. The skin gloss， color even and lesions of melasma patients had improved. The effect was getting better with the extension of treatment time. Conclusion Alpha-hydroxy acid was a safe and effective treatment for melasma. It did this through the reduction of melanin and red pigment levels and the improvement of skin lesions.
, 百拇医药
Key words： melasma； alpha-hydroxy acid； chemexfoliation； efficacy； external application drugs
黃褐斑是一种常见的色素增加性皮肤病，临床表现为面部黄褐色或深褐色斑片，对称分布，多见于Ⅲ～Ⅳ型皮肤类型人群，好发于颧颊部，也可累及眶周、前额、上唇及鼻部，在东南亚人群中发病率约占40%[1-2]。其发病及诱因与遗传易感、种族因素、日晒、激素、血管因素及其他系统疾病的伴发等相关[3]。黄褐斑临床治疗策略为抑制黑素细胞活性，减少黑素合成及转运，促进黑素降解破坏[4-5]。果酸(羟基乙酸)是一种弱酸，可通过加速表皮细胞的更新与脱落，促进黑素的代谢及降解破坏，治疗黄褐斑的临床疗效已有报道[6]，但尚缺乏治疗过程中客观指标的描述及肯定。本研究通过检测治疗过程中患者皮损处黑素、血红素等客观指标，联合主观评估明确果酸治疗黄褐斑的疗效及患者的满意度，现报道如下。, 百拇医药(贾菲 吴风琴 张倩 李春英 坚哲)
参见：首页 > 医疗版 > 疾病专题 > 皮肤科 > 色素障碍性皮肤病(色素沉着) > 黄褐斑(肝斑)