陈永国 崔静 杨慧

[摘要]目的：探讨5-氨基酮戊酸光动力（ALA-PDT）疗法联合常规方法治疗玫瑰痤疮的疗效。方法：选择2015年1月-2017年10月在笔者科室进行治疗的78例玫瑰痤疮患者为研究对象，按照随机数字表法将其分为对照组与观察组，每组39例。对照组使用他克莫司软膏联合盐酸米诺环素治疗，观察组在对照组治疗的基础上使用ALA-PDT治疗，对比两组的治疗效果。结果：两组患者经过治疗后，脓疱、红斑、丘疹及毛细血管扩张程度评分均降低，观察组降低幅度大于对照组，数据差异均具有统计学意义（P<0.05），观察组的疗效优于对照组，数据比较具有统计学意义（z=-2.215，P<0.05），治疗过程中，两组患者的各类不良反应发生情况比较，差异均不具有统计学意义（χ2=0.214、0.347、2.053、1.054，P>0.05）。结论：使用ALA-PDT联合常规治疗方法对玫瑰痤疮进行干预，可以提高各类症状的改善程度，提升治疗效果，值得在临床推广应用。

[关键词]玫瑰痤疮;丘疹;感染;他克莫司;米诺环素

[中图分类号]R758.73+4    [文献标志码]A    [文章编号]1008-6455（2019）02-0066-04

Abstract：Objective  To investigate the effect of aminolevulinic acid photodynamic therapy （ALA-PDT） combined with routine treatment of rosacea. Methods  78 patients with rosacea treated in our hospital from January 2015 to October 2017 were selected. According to the random number method， the patients were divided into the control group and the observation group， each group of 39 patients. The patients in the control group were treated with Tacrolimus Ointment combined with minocycline. The patients in the observation group were treated with ALA-PDT on the basis of the treatment methods in the control group， and the effect was compared. Results  After treatment， the scores of pustules， erythema， papules and capillary dilatation were all decreased after treatment in the two groups. The decrease of the patients in the observation group was greater than that of the control group， and the difference of the data was statistically significant （P<0.05）. The treatment effect of the observation group was better than that of the control group， and the difference was statistically significant （z=-2.215， P<0.05）. During treatment， there was no statistically significant difference in the incidence of adverse reactions between the two groups （χ2=0.214，0.347， 2.053，1.054， P>0.05）. Conclusion  The treatment of rosacea with the method of ALA-PDT combined with conventional therapy can improve the improvement of all kinds of symptoms and improve the effect of treatment.It is worth promoting in the clinical scope.

Key words： rosacea; papules; infection; tacrolimus; minocycline

玫瑰痤瘡是一种主要累及面中部的慢性炎症性皮肤病，临床表现为面中部阵发性潮红、持久性红斑、丘疹、脓疱等，少数患者可发展成鼻赘[1]，俗称“酒渣鼻”。流行病学调查结果显示，女性发病率略高于男性，发病年龄30～50岁[2]。本病的病因及发病机制尚十分不清楚，目前研究认为是多种因素共同作用的结果[3]，包括微生物感染、皮肤免疫异常和血管异常、皮脂溢出等。长期的吸烟、饮酒和刺激性饮食的摄入可能也是危险因素[4-6]。患者往往自觉面部瘙痒和灼热感，出现一过性或持久性红斑及鼻赘[7]，严重影响患者的面部外观和生活质量。玫瑰痤疮的治疗一般以药物为主[8]，但治疗效果有限。……