李俊仪　李巧玲　熊梓汀

[摘要]目的：探讨点阵激光治疗痤疮后萎缩性瘢痕的疗效和安全性。方法：计算机检索中英文数据库，手工检索相关杂志及学术会议论文集。收集所有点阵激光治疗痤疮后萎缩性瘢痕的随机对照试验，采用Cochrane协作网推荐的方法作系统综述。结果：共纳入11个研究。结果显示，点阵激光治疗痤疮后萎缩性瘢痕有效，与点阵射频相比，差异无统计学意义，但点阵射频的不良反应较轻。点阵激光的疗效与安全性均优于化学换肤。与传统激光和微针治疗相比，点阵激光疗效较优，但安全性较差。结论：点阵激光是治疗痤疮后萎缩性瘢痕的有效方法，但临床应用的确切有效性和安全性尚需更多的随机对照试验证实。

[关键词]痤疮；瘢痕；点阵激光；点阵射频；随机对照试验

[中图分类号]R619+.6 [文献标志码]A [文章编号]1008-6455（2019）01-0085-04

Efficacy and Safety of Fractional Laser in the Treatment of Atrophic Acne Scar： a Meta-analysis

LI Jun-yi1， LI Qiao-ling2， XIONG Zi-ting2， YANG Hong2

（1.Sichuan Hamilton Aesthetic Hospital， Chengdu 610000，Sichuan，China； 2.Chengdu University of Traditional Chinese Medicine，Chengdu 610075，Sichuan，China）

Abstract： Objective To assess the efficacy and safety of fractional laser in the treatment of atrophic acne scar. Methods We searched the Chinese and English databases. Relevant journals and conference proceedings were manually searched. The randomized controlled trials （RCT） were evaluated and analyzed according to the method recommended by Cochrane network. Results Eleven trials were included and assessed. The systematic review indicated that fractional laser was effective for atrophic acne scar. The difference in efficacy was not statistically significant compared with the radiofrequency， but the adverse reaction of radiofrequency was relatively mild. Fractional laser was superior to chemical reconstruction of skin scar. Compared with traditional laser and microneedling， fractional laser had obvious advantage in efficacy but disadvantage in safety. Conclusion Fractional laser is an effective treatment for atrophic acne scar. More RCTs with high methodological quality should be performed to confirm the accurate efficacy and tolerability of fractional laser.

Key words：acne； scar； fractional laser； radiofrequency； randomized controlled trial

尋常性痤疮是一种发生于毛囊皮脂腺的慢性炎症性疾病，愈后遗留的萎缩性瘢痕影响患者容貌，造成生活、心理上的影响[1]。目前，临床上治疗萎缩性瘢痕的手段包括化学换肤（chemical reconstruction of skin scar，CROSS）、手术治疗、射频治疗和激光治疗。传统激光包括剥脱性激光和非剥脱性激光，剥脱性激光代表为CO2激光和掺铒钇铝石榴石激光（Er：YAG），非剥脱性激光代表是钇铝石榴石激光（Nd：YAG）和半导体激光。点阵激光是以点阵式光热分解作用为理论，在一定深度内均匀地创建微热损伤区，激发一连串的皮肤重建反应，达到紧肤、淡斑及改善瘢痕的效果[1]。点阵激光也分成两大类：非剥脱性点阵激光主要包括铒玻璃激光（Er：G）或Er：YAG等；……