5%氨甲环酸透皮给药治疗黄褐斑疗效分析(1)
[摘要]目的：觀察5%氨甲环酸透皮给药在治疗黄褐斑中的临床疗效和安全性。方法：选取就诊于笔者医院的36例面部黄褐斑患者，采用左右侧面部自身随机对照的研究方法，根据随机对照表，选择患者左侧或者右侧黄褐斑为实验侧，对侧即为对照侧，实验侧进行纳米晶体辅助5%氨甲环酸透皮给药治疗;对照侧仅涂抹5%氨甲环酸。每位患者分别于每次术前应用MASI评分(Melasma Area Severity Index， MASI)、VISIA、ANTERA 3D和治疗前后照片对比改善效果，效果评判用MASI评分、VISIA评分及黑色素分值变化等。结果：36例面部黄褐斑患者实验侧经纳米晶体辅助5%氨甲环酸透皮给药治疗5次后，黄褐斑均有不同程度改善，实验侧有7例(19.44%)达到60%以上的改善率，21例(58.33%)达到30%以上的改善率，总有效率达到77.78%，而对照侧的总改善率小于30.00%;实验侧有2例患者发生局部色素沉着，经修复治疗后色素沉着减退;36例黄褐斑患者无1例出现色素减退等其他不良反应。患者主观满意度高，且实验侧均有不同程度的皮肤光泽度及皮肤纹理改善。结论：5%氨甲环酸透皮给药在改善黄褐斑皮损中的疗效确切、安全性高，为临床治疗黄褐斑提供了一个新手段。
[关键词]5%氨甲环酸;透皮给药;黄褐斑;疗效;外用药
[中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455(2019)05-0011-04
Clinical Efficacy of 5% Tranexamic Acid Transdermal Administration for Treatment of Patients with Melasma
ZHANG Jin-e， JING Huan， WEI Jing-yi， JIAN Zhe
(Department of Dermatology， Xijing Hospital， Fourth Military Medical University， Xi’an 710032， Shaanxi， China)
Abstract： Objective To observe the clinical effect and safety of 5% tranexamic acid by transdermal administration in the treatment of melasma. Methods 36 patients with facial melasma admitted to our department were selected for a self-randomized control study. According to the random comparison table， the left or right side of the lesion was selected as the experimental side， and the opposite side as the control side. In the experimental side， nanocrystals were used to assist transdermal administration of 5% tranexamic acid. Only 5% tranexamic acid was applied on the control side. Each patient was provided with the Melasma Area Severity Index (MASI)， VISIA， and ANTERA 3D before and after treatment. MASI score， VISIA score and melanin variation were used to evaluate the effect. Results 36 patients with facial melasma by nanocrystals auxiliary 5% tranexamic acid transdermal administration in the experimental side after five times， contrasting photos， VISIA sorce， ANTERA 3D and MASI sore statistics analysis ，we found that the malasma were improved to varying degrees. There are 7 cases (19.44%) in the experimental side reached more than 60% ， 21 cases (58.33%) reached more than 30% of the period， the total effective rate reached 77.78%， and the control side is less than 30%. In the experimental side， 2 patients occurred local pigmentation， which decreased after the repair treatment. Among the 36 patients with melasma， no one with hypopigmentation or other adverse effects. At the same time， we found that 36 patients had a high subjective satisfaction after a course of 5 times of treatment， and all of them had different degrees of skin gloss and skin texture improvement on the experimental side. Conclusion Transdermal administration of 5% tranexamic acid is effective and safe in improving melasma，providing a new method for clinical treatment of melasma., 百拇医药(张金娥 景焕 卫静宜)
[关键词]5%氨甲环酸;透皮给药;黄褐斑;疗效;外用药
[中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455(2019)05-0011-04
Clinical Efficacy of 5% Tranexamic Acid Transdermal Administration for Treatment of Patients with Melasma
ZHANG Jin-e， JING Huan， WEI Jing-yi， JIAN Zhe
(Department of Dermatology， Xijing Hospital， Fourth Military Medical University， Xi’an 710032， Shaanxi， China)
Abstract： Objective To observe the clinical effect and safety of 5% tranexamic acid by transdermal administration in the treatment of melasma. Methods 36 patients with facial melasma admitted to our department were selected for a self-randomized control study. According to the random comparison table， the left or right side of the lesion was selected as the experimental side， and the opposite side as the control side. In the experimental side， nanocrystals were used to assist transdermal administration of 5% tranexamic acid. Only 5% tranexamic acid was applied on the control side. Each patient was provided with the Melasma Area Severity Index (MASI)， VISIA， and ANTERA 3D before and after treatment. MASI score， VISIA score and melanin variation were used to evaluate the effect. Results 36 patients with facial melasma by nanocrystals auxiliary 5% tranexamic acid transdermal administration in the experimental side after five times， contrasting photos， VISIA sorce， ANTERA 3D and MASI sore statistics analysis ，we found that the malasma were improved to varying degrees. There are 7 cases (19.44%) in the experimental side reached more than 60% ， 21 cases (58.33%) reached more than 30% of the period， the total effective rate reached 77.78%， and the control side is less than 30%. In the experimental side， 2 patients occurred local pigmentation， which decreased after the repair treatment. Among the 36 patients with melasma， no one with hypopigmentation or other adverse effects. At the same time， we found that 36 patients had a high subjective satisfaction after a course of 5 times of treatment， and all of them had different degrees of skin gloss and skin texture improvement on the experimental side. Conclusion Transdermal administration of 5% tranexamic acid is effective and safe in improving melasma，providing a new method for clinical treatment of melasma., 百拇医药(张金娥 景焕 卫静宜)