目的 探究精准脉冲光联合变方颠倒散治疗玫瑰痤疮难治性红斑的疗效.方法 选取自2020年5月至2022年5月,武汉市中医医院皮肤科、医疗美容科治疗的88例玫瑰痤疮难治性红斑患者,按随机数字表法分配为精准脉冲光组与联合组,44例/组.精准脉冲光组采用精准脉冲光治疗,联合组在精准脉冲光组基础上联合变方颠倒散治疗;采用皮肤病生活质量指数量表(dermatology life quality index,DLQI)对患者的生活质量进行评分,比较两组疗效、临床症状积分、皮肤屏障功能指标、临床症状缓解时间、DLQI评分、不良反应的发生情况.结果 联合组治疗总有效率显著优于精准脉冲光组(P＜0.05);联合组和精准脉冲光组的毛细血管扩张、灼热、红斑积分在治疗后均显著降低(P＜0.05);治疗后联合组的毛细血管扩张(0.49±0.13)分、灼热(0.73±0.18)分、红斑积分(0.36±0.11)分,均显著低于精准脉冲光组(0.93±0.28)分、(0.84±0.20)分、(0.84±0.23)分(P＜0.05);联合组毛细血管扩张(17.24±4.17)d、皮肤潮红(16.25±3.87)d、皮肤敏感(17.49±4.33)d、红斑的缓解时间(17.21±4.52)d,均显著低于精准脉冲光组(25.46±5.83)d、(23.72±5.39)d、(26.82±6.24)d、(28.16±6.37)d,差异有统计学意义(P＜0.05);联合组和精准脉冲光组的DLQI评分在治疗后均显著降低,差异有统计学意义(P＜0.05);治疗后联合组的DLQI评分(6.35±1.62)分显著低于精准脉冲光组(11.42±2.13)分,差异有统计学意义(P＜0.05);联合组和精准脉冲光组的皮肤红斑指数、经皮水分丢失在治疗后均显著降低,角质层含水量显著升高(P＜0.05);治疗后联合组的皮肤红斑指数(330.56±27.34)、经皮水分丢失(16.39±4.19)g/(h.m-2),显著低于精准脉冲光组(355.28±26.27)、(19.37±4.68)g/(h.m-2),角质层含水量(47.69±7.59)％显著高于精准脉冲光组(36.87±6.29)％,差异有统计学意义(P＜0.05).联合组治疗方式和治疗效果显著优于精准脉冲光组,差异有统计学意义(P＜0.05),术后护理比较,差异无统计学意义(P＞0.05);联合组不良反应发生率(13.64％,6/44)显著低于精准脉冲光组(34.09％,15/44;x2=5.066,P=0.024).结论 精准脉冲光联合变方颠倒散可有效改善玫瑰痤疮难治性红斑患者症状积分、生活质量,缩短症状缓解时间,效果显著.
Efficacy of delicate palsed light combined with variable inversion in the treatment of rosacea's refractory erythema
Objective To investigate the efficacy of delicate palsed light combined with variable inversion in the treatment of rosacea's refractory erythema.Methods From May 2020 to May 2022,88 patients with rosacea-refractory erythema who were treated in the outpatient clinic of our hospital were selected,and all patients were assigned to the delicate palsed light group(n=44)and joint group(n=44)according to the random number table method,and the delicate palsed light group was treated with delicate palsed light,and the joint group was combined with variable prescription upside down basis on the delicate palsed light group;the patients'quality of life was scored with Dermatology Life Quality Index(DLQI);the efficacy,clinical symptom score,score barrier function index,clinical symptom re-lief time,DLQI score,and occurrence of adverse conditions were compared between the two groups.Results The total effective rate of treatment in the combination group was significantly better than that of the delicate palsed light group(P＜0.05);the telangiectasias,burn-ing and erythema scores in the combined group and the delicate palsed light group were significantly lower(P＜0.05)after treatment,and the telangiectasias[(0.49±0.13)points],burning[(0.73±0.18)points]and erythema points[(0.36±0.11)points]in the combined group were significantly lower than those in the delicate palsed light group(0.93±0.28),(0.84±0.20)and(0.84±0.23)points](P＜0.05),telangiectasia[(17.24±4.17)d],skin flushing[(16.25±3.87)d],skin sensitivity[(17.49±4.33)d],and erythema relief time[(17.21±4.52)d]were significantly lower than those in the delicate palsed light group[(25.46±5.83)d,(23.72±5.39)d,(26.82±6.24)d,(28.16±6.37)d](P＜0.05).The DLQI scores of the combined group and the delicate palsed light group were significantly reduced after treatment(P＜0.05),and the DLQI score[(6.35±1.62)points]of the combined group after treatment was significantly lower than that of the delicate palsed light group[(11.42±2.13)points](P＜0.05),and the skin erythema index and percutaneous water loss in the combined group and the delicate palsed light group were significantly reduced after treatment.The water content of the stratum corneum was significantly increased(P＜0.05),the skin erythema index(330.56±27.34)and percutaneous water loss[(16.39±4.19)g/(h·m-2)]in the combined group were signifi-cantly lower than those in the delicate palsed light group(355.28±26.27),[(19.37±4.68)g/(h rr-2)],and the water content of the stratum corneum[(47.69±7.59)％]was significantly higher than that in the delicate palsed light group[(36.87±6.29)％](P＜0.05).the treatment methods and treatment effects of the combined group were significantly better than those in the delicate palsed light group(P＜0.05),and the incidence of adverse reactions in the combination group(13.64％,6/44)was significantly lower than that in the delicate palsed light group(34.09％,15/44)(x2=5.066,P=0.024).Conclusion Delicate palsed light combined with variable square reversal can effectively im-prove the symptom score and quality of life of patients with rosacea-refractory erythema,shorten the symptom relief time,and have signifi-cant effects.
Refractory erythema of rosaceaDelicate palsed light(DPL)Diandao powderCurative effect
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