A型肉毒毒素联合红蓝光改善面部外伤后色素沉着的临床研究

doi:10.11958/20253270

摘要/Abstract

摘要：

目的探究A型肉毒毒素联合红蓝光改善面部外伤后色素沉着的临床效果。方法选取面部外伤后色素沉着的120例患者为研究对象，按随机数字表法分为红蓝光组（60例）和联合治疗组（60例），其中红蓝光组采用红蓝光治疗仪治疗6周，联合治疗组在红蓝光组的基础上给予A型肉毒毒素注射。比较2组患者疗效、治疗前后的皮肤性质评分、面部图像评分，血清氧化应激指标丙二醛（MDA）、脂质过氧化物（LPO）、超氧化物歧化酶（SOD）变化及不良反应发生情况。结果联合治疗组的总有效率显著高于红蓝光组（78.33% vs. 60.00%，P<0.05）；治疗后，2组皮肤水分、弹性评分、色素沉着评分、血清SOD水平均上升，且联合治疗组高于红蓝光组（P<0.05）；2组色素沉着面积评分、血清MDA、LPO水平均下降，且联合治疗组低于红蓝光组（P<0.05）；红蓝光组、联合治疗组不良反应总发生率差异无统计学意义（20.00% vs. 16.67%，P>0.05）。结论 A型肉毒毒素联合红蓝光治疗面部外伤后色素沉着有较好的临床疗效且安全性高。

关键词: 色素沉着, 外伤, 肉毒杆菌毒素类, A型, 超氧化物歧化酶, 红蓝光, 面部图像评分

Abstract:

Objective To explore the clinical effect of botulinum toxin type A combined with red and blue light in improving post-traumatic facial pigmentation. Methods A total of 120 patients with post-traumatic facial pigmentation were selected as the research subjects and randomly divided into the red and blue light group (60 cases) and the combined treatment group (60 cases) according to the random number table method. The red and blue light group was treated with a red and blue light therapy device for 6 weeks, and the combined treatment group was given botulinum toxin type A injection on the basis of the red and blue light group. The therapeutic effects, skin property scores before and after treatment, facial image scores, changes in serum oxidative stress indicators such as malondialdehyde (MDA), lipid peroxides (LPO) and superoxide dismutase (SOD), as well as the occurrence of adverse reactions were compared between the two groups. Results The total effective rate was significantly higher in the combined treatment group than that of the red and blue light group (78.33% vs. 60.00%, P<0.05). After treatment, the skin moisture, elasticity scores, pigmentation scores and serum SOD levels were increased in both groups, and those in the combined treatment group were higher than those in the red and blue light group (P<0.05). After treatment, the serum MDA, LPO levels and pigmentation area scores were decreased in both groups, and those in the combined treatment group were lower than those in the red and blue light group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the red and blue light group and the combined treatment group (20.00% vs. 16.67%, P > 0.05). Conclusion Botulinum toxin type A combined with red and blue light therapy has a good clinical efficacy and high safety in the treatment of post-traumatic facial pigmentation.

Key words: pigmentation, external injury, botulinum toxins, type A, superoxide dismutase, red and blue light, facial image scores

中图分类号:

R751.05

图/表 7

参考文献 27

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组别		性别				年龄/岁
组别		男		女		年龄/岁
红蓝光组		25（41.67）		35（58.33）		32.34±4.21
联合治疗组		21（35.00）		39（65.00）		33.75±4.16
t或χ²		0.564				1.845
组别	病程/月		色素沉着程度
组别	病程/月		轻度		中度		重度
红蓝光组	3.86±0.92		17（28.33）		29（48.33）		14（23.33）
联合治疗组	4.21±1.05		19（31.67）		26（43.33）		15（25.00）
t或χ²	1.387		0.309

组别		性别				年龄/岁
组别		男		女		年龄/岁
红蓝光组		25（41.67）		35（58.33）		32.34±4.21
联合治疗组		21（35.00）		39（65.00）		33.75±4.16
t或χ²		0.564				1.845
组别	病程/月		色素沉着程度
组别	病程/月		轻度		中度		重度
红蓝光组	3.86±0.92		17（28.33）		29（48.33）		14（23.33）
联合治疗组	4.21±1.05		19（31.67）		26（43.33）		15（25.00）
t或χ²	1.387		0.309

组别	痊愈	显效	好转	无效	总有效
红蓝光组	14（23.33）	22（36.67）	15（25.00）	9（15.00）	36（60.00）
联合治疗组	20（33.33）	27（45.00）	11（18.33）	2（3.33）	47（78.33）
χ²					4.728^＊

组别	痊愈	显效	好转	无效	总有效
红蓝光组	14（23.33）	22（36.67）	15（25.00）	9（15.00）	36（60.00）
联合治疗组	20（33.33）	27（45.00）	11（18.33）	2（3.33）	47（78.33）
χ²					4.728^＊

组别	水分
组别	治疗前	治疗后	t
红蓝光组	41.26±5.03	74.26±7.61	28.818^＊＊
联合治疗组	42.13±5.11	87.54±8.92	37.307^＊＊
t	0.940	8.773^＊＊
组别	弹性
组别	治疗前	治疗后	t
红蓝光组	10.12±1.03	14.34±1.52	16.831^＊＊
联合治疗组	10.25±1.06	17.45±1.83	26.486^＊＊
t	0.681	10.126^＊＊