张雪梅 陈俊芳 姚战非

[摘要]目的：探讨强的松龙皮损内注射联合5-氨基酮戊酸光动力疗法治疗重度痤疮的临床疗效及安全性。方法：将140例重度痤疮患者随机分成两组。治疗组：70例，给予强的松龙囊肿及结节内注射，同时配合ALA-PDT治疗，每7d治疗1次，共治疗4次；对照组：70例，仅给予ALA-PDT治疗，每7d治疗1次，共治疗4次。治疗第2、4、6周对两组患者进行疗效判断及不良反应对比，并且判定安全性及治疗后3个月的复发状况。结果：所有患者经过1～4次治疗后，治疗组总有效率为97.1%，对照组总有效率为87.1 %，治疗组疗效明显优于对照组，差异具有统计学意义（P<0.05）。结论：强的松龙皮损内注射联合光动力疗法治疗重度痤疮安全、有效，不良反应发生少。

[关键词]重度痤疮；ALA-PDT；强的松龙；临床疗效；不良反应

[中图分类号]R758.73+3 [文献标志码]A [文献编号]1008-6455（2018）06-0068-03

Abstract： Objective To discuss the clinical efficacy and safety of prednisolone injection with 5-aminolevulinic acid photodynamic therapy（ALA-PDT） in the treatment of severe acne. Methods 140 cases of severe acne were randomly divided into two groups，including 70 cases in the experimental group，and 70 cases in the control group.The control group was given prednisolone injection with ALA-PDT，1 time per 7 days， total 4 times；The experimental group was only given ALA-PDT，1 time per 7 days， total 4 times. The patients were evaluated for efficacy and adverse effects on week 2，4 and 6 after the initial treatment. Safety and recurrence in each group after 3 months treatment were also recorded at each vist. Results The total effective rate was 97.1% in ALA-PDT group after 1-4 sessions of treatment，87.1% in the control group and the difference was significant between the two groups（P<0.05）. Conclusion The clinical efficacy of prednisolone injection with 5-aminolevulinic acid photodynamic therapy in the treatment of severe acne is safe，effective and minimal adverse reactions.

Key words：severe acne； photodynamic therapy； prednisolone； clinical efficacy； adverse effects

痤瘡是一种好发于皮脂溢出部位的慢性炎症性皮肤病，发病率为70%～87%，相比哮喘、癫痫等，痤疮对青少年情绪和社交的影响更为显著[1]。根据临床皮损表现分为轻、中及重度痤疮[2]，重度痤疮以男性多见，不易消退，愈后经常遗留瘢痕，严重影响患者容貌。以往治疗方案中外用药物效果欠佳，系统用药不良反应大，所以寻找一种有效、不良反应小的新方法对痤疮的治疗尤为重要[3]。5-氨基酮戊酸光动力疗法（5-aminolevulinicacid photodynamic therapy，ALA-PDT）作为一个前景广阔的新型疗法，正被越来越多地应用于痤疮治疗[4]。2015年1月-2017年1月，笔者采用强的松龙皮损内注射联合5-氨基酮戊酸光动力疗法治疗重度痤疮患者，取得了满意疗效，现报道如下。

1 资料和方法

1.1 一般资料：选择笔者科室门诊就诊的140例重度痤疮患者为研究对象。……