黄朝卫 解翠林 石年

[摘要]目的：探究女性黃褐斑患者的临床特点、易感因素及点阵激光治疗的美容效果。方法：选取2015年1月-2016年12月于笔者科室门诊确诊的女性黄褐斑患者130例，分析其年龄、职业、皮损情况等一般临床特点及易感因素，随机分为两组。观察组：68例，给予点阵激光治疗；对照组：62例，给予强脉冲光治疗，对比两组患者的治疗前后临床疗效及不良反应发生。结果：女性黄褐斑好发于中青年，皮损多位于面颊部呈蝶形分布，易感因素包括：阳性家族史，合并妇科疾病，口服避孕药，日晒及光辐射，精神紧张，不正当使用化妆品。观察组患者治疗时间为（59.4±11.7）min，愈合时间为（3.2±1.5）d；对照组患者治疗时间为（38.2±9.1）min，愈合时间为（2.2±0.8）d，差异有统计学意义（P<0.05）。观察组和对照组总有效率分别为92.6%和82.3%，差异有统计学意义（χ2=6.143，P<0.05）；观察组和对照组患者满意度分别为95.6%和79.0%，差异有统计学意义（χ2=6.895，P<0.05）；观察组不良反应发生率为4.4%，显著低于对照组的22.6%，差异有统计学意义（χ2=22.834，P<0.05）。观察组半年后的复发率为2.94%，显著低于对照组的16.13%，差异具有统计学意义（χ2=6.732，P<0.05）。结论：该病好发于中青年女性，发病与遗传、内分泌、物理及精神等多种因素有关，点阵激光治疗效果确切，不良反应少，值得临床推广应用。

[关键词]女性；黄褐斑；点阵激光技术；强脉冲光；不良反应

[中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455（2018）06-0085-03

Abstract： Objective To explore the clinical characteristics， predisposing factors and fractional laser cosmetic effect of female chloasma patients. Methods From January 2015 to December 2016， 130 female patients with melasma were selected as the research objects， and the general clinical characteristics and predisposing factors of their age， occupation， skin lesions were analyzed. According to the patients' wishes， 68 cases were treated with fractional laser therapy （observation group）， 62 cases were given strong pulse light treatment （control group）， and the efficacy and adverse reactions of the two groups were compared. Results Female chloasma occurs in the youth and the lesions were located in the cheek is butterfly distribution， predisposing factors include： positive family history， associated with gynecological diseases， oral contraceptives， and sun radiation， mental stress， improper use of cosmetics. The patients in the observation group were treated for min （59.4±11.7）， healing time was （3.2±1.5） d， the control group of patients treated with time （38.2±9.1） min （2.2±0.8）， healing time was D， the difference was statistically significant （P<0.05）； the observation group and the control group total effective rate were 92.6% and 82.3%， the difference was statistically significant （χ2=6.143， P<0.05）； the observation group and the control group of patients satisfaction were 95.6% and 79%， the difference was statistically significant （χ2=6.895， P<0.05）； the incidence of adverse reactions was 4.4%， significantly lower than the control group 22.6%， the difference was statistically significant （χ2=22.834，P<0.05）. The recurrence rate in the observation group after six months was 2.94%， which was significantly lower than that in the control group （16.13%） （χ2=6.732， P<0.05）. Conclusion The disease is prevalent in young and middle-aged women， and its pathogenesis is related to many factors， such as heredity， endocrine， physical and mental factors. Dot matrix laser treatment effect is accurate， less adverse reactions， worthy of clinical promotion.

Key words： female； chloasma； dot matrix laser technique； pulsed light therapy； adverse reaction

黄褐斑为面部常见的色素增加性皮肤病，多见于女性，发病原因尚不清楚。有研究表明，其发病与雌激素水平密切相关，且存在一些明确的易感因素，如日光照射、内分泌紊乱、精神紧张等[1]。传统的抗氧化劑药物及强脉冲光局部治疗是最简单和常用的方法，治疗后均有不同程度的疗效，但存在治疗不彻底、易复发等不足[2]。近年来，笔者科室采用点阵激光治疗女性黄褐斑，取得了一定的疗效，本研究旨在分析女性黄褐斑患者的临床特点及易感因素并探究点阵激光的临床疗效，现报道如下。

1 资料和方法

1.1 一般资料：选取2015年1月-2016年12月于笔者科室门诊确诊的130例女性黄褐斑患者为研究对象。……