摘要目的:探讨异维A酸结合M22-ResurFx非剥脱点阵激光治疗重度痤疮的效果。方法:选取104例重度痤疮患者,随机分为对照组和观察组,每组52例,对照组给予M22-ResurFx非剥脱点阵激光治疗,观察组基于以上加予异维A酸。评估两组治疗5个月后的临床疗效,对比两组治疗前及治疗5个月后的皮肤生理指标(VISIA数字皮肤分析指标)和创面基底组织生化指标[血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)、转化生长因子-β激活激酶(TAK)]含量,记录两组不良反应发生情况和随访3个月内的复发率。结果:观察组治疗5个月后的总有效率高于对照组(96.15% vs 80.77%,P<0.05);治疗前,两组乳酸刺痛试验结果评分和皮肤VISIA各项评分对比差异无统计学意义(P>0.05),治疗5个月后,两组乳酸刺痛试验结果评分高于治疗前(P<0.05),两组关于红色区、紫质、斑点、纹理及毛孔共5项VISIA评分低于治疗前(P<0.05),其中观察组上述指标差值大于对照组(P<0.05);治疗前,两组创面基底组织中VEGF、TGF-β1、TAK含量对比差异无统计学意义(P>0.05),两组治疗后上述指标则有明显降低(P<0.05),其中观察组差值大于对照组(P<0.05);两组治疗期间不良反应总发生率对比差异无统计学意义(15.38% vs 17.31%,P>0.05);观察组的复发率显著低于对照组(1.92% vs 13.46%,P<0.05)。结论:异维A酸结合M22-ResurFx非剥脱点阵激光治疗重度痤疮的疗效显著,能明显改善痤疮严重程度和皮肤生理指标,并能对创面基底组织中VEGF、TGF-β1、TAK含量起到抑制作用,以减轻痤疮瘢痕再生,且并未增加不良反应,复发率低,安全性较佳。
Abstract：Objective: To explore the effects of isotretinoin combined with M22-ResurFx non-ablative fractional laser in the treatment of severe acne. Methods: A total of 104 patients with severe acne were selected and randomly divided into control group and observation group, with 52 cases in each group. The control group was given M22-ResurFx non-ablative fractional laser treatment, and the observation group was given isotretinoin on this basis. The clinical efficacy of the two groups was evaluated after 5 months of treatment. The skin physiological indexes (VISIA digital skin analysis indexes) and wound basal tissue biochemical indexes [vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), transforming growth factor-β activated kinase (TAK)] were compared between the two groups before treatment and after 5 months of treatment. The occurrence of adverse reactions and recurrence rate within 3 months of follow-up were recorded in both groups. Results: The total effective rate in observation group was higher than that in control group after 5 months of treatment (96.15% vs 80.77%, P<0.05). Before treatment, there were no statistical differences in the score of lactic acid sting test and scores of items of skin VISIA between the two groups (P>0.05). After 5 months of treatment, the score of lactic acid sting test in both groups was higher than that before treatment (P<0.05) while the five VISIA scores of redness zone, sclererythrin, spot, texture, and pore were lower compared with those before treatment (P<0.05), and the differences of the above indicators in observation group were greater than those in control group (P<0.05). There were no statistically significant differences in the levels of VEGF, TGF-β1 and TAK in wound basal tissue between both groups before treatment (P>0.05), and the above levels in the two groups after treatment were significantly decreased (P<0.05), and the differences in observation group were greater compared to control group (P<0.05). There was no statistical significance in the total incidence rate of adverse reactions between the two groups (15.38% vs 17.31%, P>0.05). The recurrence rate in observation group was significantly lower than that in control group (1.92% vs 13.46%, P<0.05). Conclusion: Isotretinoin combined with M22-ResurFx non-ablative fractional laser has significant efficacy in the treatment of severe acne, and it can significantly improve the acne severity and skin physiological indexes, and can inhibit the levels of VEGF, TGF-β1 and TAK in wound basal tissue to reduce the acne scar regeneration, and it does not increase adverse reactions, and it has low recurrence rate and good safety.
2023, Vol. 29 
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