目的:探究2 940 nm铒像素激光联合重组人表皮生长因子(Recombinant human epidermal growth factor,rhEGF)凝胶外敷对痤疮凹陷性瘢痕患者皮肤生理参数、屏障功能和瘢痕权重得分的影响.方法:选取2020年2月-2023年2月笔者医院收治的78例痤疮凹陷性瘢痕患者,随机分为实验组(39例)和对照组(39例).对照组给予点阵CO2激光联合rhEGF凝胶进行治疗,实验组给予2 940 nm铒像素激光联合rhEGF凝胶进行治疗,观察两组治疗后的疗效和不良反应以及治疗前后美学评分、皮肤生理参数(角质层含水量、油脂量和丝氨酸蛋白酶活性)、屏障功能[(经皮水分丢失(Transepidermal water loss,TEWL)、pH值、皮肤红斑指数(Erythema index,EI)和角质层完整性(粘脱蛋白质含量)]、瘢痕权重得分(Echelle d'evaluation clinique des cicatrices d'acne,ECCA)和治疗期间不良反应发生情况.结果:治疗后,实验组总有效率明显高于对照组(P＜0.05);实验组主观和客观美学评分均高于对照组(P＜0.05);实验组角质层含水量明显高于对照组,油脂量和丝氨酸蛋白酶活性明显低于对照组(P＜0.05);实验组TEWL、pH值、EI和粘脱蛋白质含量均明显低于对照组(P＜0.05).治疗2、3次后,实验组的ECCA评分明显低于对照组(P＜0.05).两组不良反应发生率差异无统计学意义(P＞0.05).结论:将2 940 nm铒像素激光和rhEGF凝胶联合应用于痤疮凹陷性瘢痕患者的临床治疗中,其疗效良好,能提高患者面部皮肤的美学评分,调控皮肤生理参数,改善屏障功能,减轻瘢痕程度,且安全性良好.
Curative Effect of 2 940 nm Erbium Pixel Laser Combined with rhEGF Gel for External Application on Atrophic Acne Scars
Objective To explore the effects of 2 940 nm erbium pixel laser combined with recombinant human epidermal growth factor(rhEGF)gel for external application on skin components,barrier function and score of echelle d'evaluation clinique des cicatrices d'acne(ECCA)in patients with atrophic acne scars.Methods A total of 78 patients with atrophic acne scars admitted to Linfen People's Hospital were enrolled and randomly divided into an experimental group(39 cases)and a control group(39 cases)between February 2020 and February 2023.On the basis of rhEGF gel for external application,the control group was treated with a fractional CO2 laser,while the experimental group was treated with a 2 940 erbium pixel laser.The curative effect and adverse reactions after treatment,aesthetic scores,skin physiological indicators(cuticle water content,fat content,activity of serine protease),barrier function[transepidermal water loss(TEWL),pH,erythema index(EI),cuticle integrity(content of adhesion protein)],and ECCA scores before and after treatment,as well as the occurrence of adverse reactions during treatment in the two groups,were observed.Results After treatment,total response rate of experimental group was significantly higher than that of control group(P＜0.05).The scores of subjective and objective aesthetics in experimental group were higher than those in the control group(P＜0.05).The cuticle water content in experimental group was significantly more than that in control group,while fat content and activity of serine protease were significantly lower than those in control group(P＜0.05).TEWL,pH,EI and content of adhesion protein in experimental group were significantly lower than those in control group(P＜0.05).After two or three treatments,ECCA scores in experimental group were significantly lower than those in control group(P＜0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P＞0.05).Conclusion The clinical curative effect of the 2 940 erbium pixel laser combined with rhEGF gel is good in patients with atrophic acne scars.This treatment can increase the aesthetic score of facial skin,regulate skin physiological indicators,improve barrier function,and relieve scars with good safety.
2 940 nm erbium pixel laserrecombinant human epidermal growth factoratrophic acne scarbarrier function
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