长脉冲1064 nm激光与抗组胺药物治疗慢性湿疹的临床比较观察
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摘要
目的探讨长脉冲1064nm激光与抗组胺药物治疗慢性湿疹的疗效与安全性。方法选择2017年1—12月门诊收治的慢性湿疹患者226例,采用数字表随机法分为两组,每组各113例。对照组口服第2代抗组胺药物,外用1%氢化考的松乳膏。观察组采用长脉冲1064nm ND:YAG激光治疗,外用1%氢化考的松乳膏,1次/周,共治疗4周,疗程结束后,评价临床疗效及不良反应。治愈患者随访8周,记录复发情况。结果 4周疗程结束后,观察组症状积分为(2.97±0.14)分,明显低于对照组的(5.67±0.83)分,其差异有统计学意义(P<0.05)。观察组总有效率为78.76%,明显高于对照组的54.87%,其差异有统计学意义(P<0.05)。对照组复发率为37.93%,明显高于观察组的8.51%,其差异有统计学意义(χ~2=10.247,P<0.001)。观察组中无一例因激光照射发生色素沉着、紫癜、色素减退等。结论采用长脉冲1064nm ND∶YAG激光治疗慢性湿疹,疗效与安全性均优于抗组胺药物。
Objective To explore the efficacy and safety of long pulse 1064 nm laser and antihistamine in the treatment of chronic eczema. Methods From January to December 2017, 226 patients with chronic eczema in outpatient treatment were involved in the study. Patients were divided into two groups based on a random number table, with 113 cases in each group. The second generation of antihistamines was taken orally, and 1% hydrocortisone cream was applied for external use in the control group. Long pulse 1064 nm ND:YAG laser was performed, and 1% hydrocortisone cream was applied for external use in the observation group. The treatment course was once a week, for a total of 4 weeks. After treatment, the clinical efficacy and adverse reactions were evaluated. Treated patients were followed up for 8 weeks and recurrences were recorded. Results The score of symptoms in the observation group was(2.97±0.14), significantly lower than that of the control group(5.67±0.83). The difference was statistically significant(P<0.05). The total effectiveness rate of the observation group was 78.76%, significantly higher than that of the control group(54.87%). The difference was statistically significant(P<0.05). The recurrence rate in the control group was 37.93%, significantly higher than that of the observation group(8.51%). The difference was statistically significant(χ~2=10.247, P<0.001). No pigmentation, purpura, or hypopigmentation occurred in the observation group. Conclusion The efficacy and safety of long pulse 1064 nm ND: YAG laser in the treatment of chronic eczema was better than that of antihistamines.
Objective To explore the efficacy and safety of long pulse 1064 nm laser and antihistamine in the treatment of chronic eczema. Methods From January to December 2017, 226 patients with chronic eczema in outpatient treatment were involved in the study. Patients were divided into two groups based on a random number table, with 113 cases in each group. The second generation of antihistamines was taken orally, and 1% hydrocortisone cream was applied for external use in the control group. Long pulse 1064 nm ND:YAG laser was performed, and 1% hydrocortisone cream was applied for external use in the observation group. The treatment course was once a week, for a total of 4 weeks. After treatment, the clinical efficacy and adverse reactions were evaluated. Treated patients were followed up for 8 weeks and recurrences were recorded. Results The score of symptoms in the observation group was(2.97±0.14), significantly lower than that of the control group(5.67±0.83). The difference was statistically significant(P<0.05). The total effectiveness rate of the observation group was 78.76%, significantly higher than that of the control group(54.87%). The difference was statistically significant(P<0.05). The recurrence rate in the control group was 37.93%, significantly higher than that of the observation group(8.51%). The difference was statistically significant(χ~2=10.247, P<0.001). No pigmentation, purpura, or hypopigmentation occurred in the observation group. Conclusion The efficacy and safety of long pulse 1064 nm ND: YAG laser in the treatment of chronic eczema was better than that of antihistamines.
引文
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[10]李萍,章斌,王善纬,等.外涂大风子膏治疗成人慢性湿疹的疗效分析[J].中国临床医学,2015,22(5):624-627.
[11]王希香,张信江,朱月玲,等.他克莫司软膏联合氢化可的松乳膏治疗儿童慢性湿疹的疗效和安全性评价[J].中华实用儿科临床杂志,2017,32(17):1348-1350.
[12]金燕,郭永刚,李文志.长脉冲1 064 nm Nd:YAG激光治疗面部激素依赖性皮炎伴发的毛细血管扩张[J].中国美容医学,2011,20(1):103-105.
[13]张秀英,何焱玲,董洁.308 nm准分子激光治疗慢性湿疹28例[J].中国激光医学杂志,2010,19(3):180-183.
[14]袁玲玲,曲牟文,刘爱英,等.慢性湿疹患者生活质量分析研究[J].中国医药导刊,2009,11(10):1650,1652.
[15]刘涛,董秀芹,王红燕,等.点阵激光联合外用激素治疗神经性皮炎、慢性湿疹的临床研究[J].中国美容医学,2012,21(14):107-109.
[16]冯勇军,王明婧,吴湘明.低能量氦氖激光穴位照射结合川芎嗪治疗突发性耳聋疗效观察[J].现代中西医结合杂志,2015,24(24):2668-2670.
[2]中国中西医结合学会皮肤性病专业委员会环境与职业性皮肤病学组.外用中成药治疗湿疹皮炎的专家共识(2014)[J].中华皮肤科杂志,2014,47(6):440-441.
[3]邹晓辉,罗东,普雄明,等.点阵激光治疗慢性湿疹疗效评价[J].中国麻风皮肤病杂志,2014,30(5):297-299.
[4]LANDSMAN A S,ROBBINS A H.Treatment of mild,moderate,and severe onychomycosis using 870-and 930-nm light exposure:somefollow-up observations at 270 days[J].J Am Podiatr Med Assoc,2012,102(2):169-171.
[5]韩宇男,卢益萍.红光照射治疗慢性湿疹的临床疗效观察[J].中国中西医结合皮肤性病学杂志,2016,15(1):28-30.
[6]郭娟莉,李春鸟.红光照射对慢性湿疹的治疗效果研究[J].陕西医学杂志,2017,46(4):474-475.
[7]吴爱明,邓雪琴,程宝林.多磺酸黏多糖乳膏联合曲安奈德益康唑乳膏治疗成人慢性湿疹45例[J].安徽医药,2018,22(5):929-932.
[8]HEES H,RAULIN C,B魧UMLER W.Laser treatment ofonychomycosis:an in vitro pilot study[J].J Dtsch Dermatol Ges,2012,10(12):913-918.
[9]欧阳泠星,方鑫楷.毫火针配合灸法治疗慢性湿疹疗效观察[J].上海针灸杂志,2017,36(3):316-318.
[10]李萍,章斌,王善纬,等.外涂大风子膏治疗成人慢性湿疹的疗效分析[J].中国临床医学,2015,22(5):624-627.
[11]王希香,张信江,朱月玲,等.他克莫司软膏联合氢化可的松乳膏治疗儿童慢性湿疹的疗效和安全性评价[J].中华实用儿科临床杂志,2017,32(17):1348-1350.
[12]金燕,郭永刚,李文志.长脉冲1 064 nm Nd:YAG激光治疗面部激素依赖性皮炎伴发的毛细血管扩张[J].中国美容医学,2011,20(1):103-105.
[13]张秀英,何焱玲,董洁.308 nm准分子激光治疗慢性湿疹28例[J].中国激光医学杂志,2010,19(3):180-183.
[14]袁玲玲,曲牟文,刘爱英,等.慢性湿疹患者生活质量分析研究[J].中国医药导刊,2009,11(10):1650,1652.
[15]刘涛,董秀芹,王红燕,等.点阵激光联合外用激素治疗神经性皮炎、慢性湿疹的临床研究[J].中国美容医学,2012,21(14):107-109.
[16]冯勇军,王明婧,吴湘明.低能量氦氖激光穴位照射结合川芎嗪治疗突发性耳聋疗效观察[J].现代中西医结合杂志,2015,24(24):2668-2670.