摘要
目的 探讨富血小板血浆(PRP)、光疗联合用于雄激素性脱发(AGA)的临床观察及对转化生长因子-β(TGF-β)、血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)的影响.方法 前瞻性选取2022年7月至2023年1月资阳市中心医院皮肤科收治的AGA患者80例,按随机数字表法将其分为治疗组和对照组,每组各40例.对照组给予常规药物治疗,治疗组在对照组基础上联合PRP、光疗治疗.比较两组患者的临床疗效和不良反应发生情况,同时评估并比较两组患者治疗前、治疗后4个月的头皮症状评分,另外检测并比较两组患者治疗前、治疗后4个月的毛发镜指标(毛囊密度、被毛密度、顺发速率)及PRP中TGF-β、VEGF、PDGF水平.结果 治疗组整体效果优于对照组,总有效率为97.50％,高于对照组(85.00％),差异有统计学意义(P＜0.05).治疗后4个月,两组各头皮症状评分均较治疗前降低,且治疗组毛囊炎、油脂分泌、头屑、瘙痒等头皮症状评分分别为(0.49±0.14)、(0.52±0.16)、(0.59±0.16)、(0.39±0.11)分,均低于对照组[(0.73±0.16)、(0.84±0.15)、(0.81±0.19)、(0.61±0.12)分],差异均有统计学意义(P＜0.05).治疗后4个月,两组毛囊密度、被毛密度均较治疗前升高,顺发速率均较治疗前降低,且治疗组的毛囊密度、被毛密度分别为(101.45±6.68)、(132.42±8.56)cm2,均高于对照组[(84.56±8.35)、(121.62±10.56)cm2],顺发速率为(5.98±1.43)％,低于对照组[(8.82±1.86)％],差异均有统计学意义(P＜0.05).治疗后4个月,两组PRP中TGF-β、VEGF、PDGF水平均较治疗前升高,且治疗组PRP中TGF-β、VEGF、PDGF水平分别为(0.54±0.16)ng/mL、(0.58±0.11)ng/mL、(24.12±5.35)μg/mL,均高于对照组[(0.42±0.12)ng/mL、(0.47±0.15)ng/mL、(18.95±4.86)pg/mL],差异均有统计学意义(P＜0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论PRP联合光疗治疗AGA临床疗效显著,不仅能有效缓解患者头皮症状,还能改善其毛囊密度、被毛密度、顺发速率、TGF-β、VEGF、PDGF水平,且安全性高.
Abstract
Objective To explore the clinical observation of platelet rich plasma(PRP)combined with phototherapy for androgenetic alo-pecia(AGA)and its effects on transforming growth factor-β(TGF-β),vascular endothelial growth factor(VEGF),and platelet derived growth factor(PDGF).Methods A total of 80 patients with AGA admitted to the Department of Dermatology,Ziyang Central Hospital from July 2022 to January 2023 were prospectively selected and divided into the treatment group and the control group according to the random number table method,with 40 cases in each group.The control group received conventional drug treatment,while the treatment group received PRP and photo-therapy in addition to the control group.The clinical efficacy and the accurrence of adverse reactions between the two groups were compared.At the same time,the scalp symptom scores of the two groups of patients before treatment and 4 months after treatment were evaluated and compared.In addition,the hair mirror indexes(hair follicle density,hair density,hair rate)and the levels of TGF-β,VEGF and PDGF in PRP were de-tected and compared between the two groups before and 4 months after treatment.Results The overall effect of the treatment group was better than that of the control group,and the total effective rate was 97.50％,which was higher than that of the control group(85.00％),the difference was statistically significant(P＜0.05).At 4 months after treatment,the scores of scalp symptoms in the two groups were lower than those before treatment,and the scores of scalp symptoms such as folliculitis,grease secretion,dandruff and itching in the treatment group were(0.49±0.14),(0.52±0.16),(0.59±0.16)and(0.39±0.11)points,respectively,which were lower than those in the control group[(0.73±0.16),(0.84±0.15),(0.81±0.19)and(0.61±0.12)points],the differences were statistically significant(P＜0.05).At 4 months after treat-ment,the hair follicle density and hair coat density of the two groups were higher than those before treatment,and the hair growth rate was lower than that before treatment,the hair follicle density and hair coat density of the treatment group were(101.45±6.68)and(132.42±8.56)cm2,which were higher than those of the control group[(84.56±8.35)and(121.62±10.56)cm2],and the hair growth rate was(5.98±1.43)％,which was lower than that of the control group[(8.82±1.86)％],the differences were statistically significant(P＜0.05).At 4 months after treatment,the levels of TGF-β,VEGF and PDGF in PRP of the two groups were higher than those before treatment,and the levels of TGF-β,VEGF and PDGF in PRP of the treatment group were(0.54±0.16)ng/mL,(0.58±0.11)ng/mL and(24.12±5.35)pg/mL,respectively,which were higher than those of the control group[(0.42±0.12)ng/mL,(0.47±0.15)ng/mL,(18.95±4.86)pg/mL],the differences were statistically significant(P＜0.05).The incidence of adverse reactions in the two groups was basically equivalent(P＞0.05).Conclusion PRP combined with phototherapy has significant clinical efficacy in treating AGA.It can not only effectively alleviate patients'scalp symptoms,but also improve their hair follicle density,hair cover density,hair growth rate,TGF-β,VEGF,PDGF levels,and has high safety.
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