杨力 林新瑜 罗霞 肖媛媛

[摘要]目的：評价30%超分子水杨酸联合抗菌凝胶治疗轻中度寻常痤疮的临床疗效和安全性。方法：选取2018年7月-2019年7月笔者科室就诊的60例轻中度寻常痤疮患者作为研究对象，采用随机数字法分为两组。实验组：30例，予以30%超分子水杨酸联合抗菌凝胶治疗;对照组：30例，单用抗菌凝胶治疗，记录治疗前与治疗8周后两组患者总皮损、非炎性皮损及炎性皮损GAGS评分，评估临床疗效，同时记录治疗期间不良反应发生情况，治疗结束1个月后随访复发情况。结果：治疗8周后，实验组有效率为93.33%，对照组为70.00%。治疗前，实验组总皮损、非炎性皮损、炎性皮损GAGS评分分别为14.83±3.715、3.00（3.00，4.25）、12.00（9.00，13.00）;对照组分别为13.07±3.713、2.00（2.00，3.25）、9.00（8.00，14.50）。治疗后，实验组总皮损、非炎性皮损、炎性皮损GAGS评分分别为2.43±1.406、1.00（0.75，2.00）、1.00（0.75，2.00）;对照组分别为4.23±1.906、2.00（1.00，2.00）、2.00（1.00，4.00）。组内比较，两组治疗前后总皮损、非炎性皮损及炎性皮损GAGS评分差异均具有统计学意义（P<0.05）;组间比较，两组治疗前后有效率、总皮损、非炎性皮损ΔGAGS评分差异均具有统计学意义（P<0.05）;炎性皮损ΔGAGS评分差异无统计学意义（P>0.05）。实验组不良反应发生率为6.67%，对照组为3.33%，差异无统计学意义（P>0.05）。治疗结束1个月后，实验组复发率为23.33%，对照组为27.27%，差异有统计学意义（P<0.05）。结论：30%超分子水杨酸联合抗菌凝胶治疗轻中度寻常痤疮（尤其针对非炎性皮损）疗效显著，安全性高，复发率低。

[关键词]30%超分子水杨酸;抗菌凝胶;轻中度寻常痤疮;疗效;不良反应;复发率

[中图分类号]R758.73+3    [文献标志码]A    [文章编号]1008-6455（2021）06-0064-05

Evaluation of Therapeutic Effect of 30% Supramolecular Salicylic Acid Combined with Anti-bacterial Gel for Facial Mild to Moderate Acne Vulgaris

YANG Li1，LIN Xin-yu1，2，LUO Xia1，XIAO Yuan-yuan1

（1.Department of Dermatology，the Affiliated Hospital of Southwest Medical University，Luzhou 646000，Sichuan，China;

2.Department of Dermatology， Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital，Chengdu 610072，Sichuan，China）

Abstact： Objective  To evaluate the efficacy and safety of 30% supramolecular salicylic acid combined with anti-bacterial gel for facial mild to moderate acne vulgaris. Methods  From July 2018 to July 2019， a total of 60 patients with mild to moderate acne vulgaris were enrolled in this study. Patients were randomly divided into groups A and B， 30 patients per group. Patients in group A were treated with 30% supramolecular salicylic acid combined with anti-bacterial gel， while patients in group B were treated with anti-bacterial gel alone. The patient's total GAGS scores，GAGS scores of comedo and inflammatory papules were recorded separately.And the clinical efficacy was evaluated，the adverse reactions occurred during the treatment were recorded. Follow-up was performed to check the recurrence 1 month after treatment. Results  After 8 weeks of treatment， the total effective rates in groups A and B were 93.33% and 70.00% respectively.Before treatment，group A： total GAGS scores，GAGS scores of comedo，GAGS scores of inflammatory papules are 14.83±3.715，3.00（3.00，4.25），12.00（9.00，13.00），group B： 13.07±3.713， 2.00（2.00，3.25）， 9.00（8.00，14.50）.After treatment，group A： total GAGS scores，GAGS scores of comedo，GAGS scores of inflammatory papules are 2.43±1.406，1.00（0.75，2.00），1.00（0.75，2.00），group B： 4.23±1.906， 2.00（1.00，2.00）， 2.00（1.00，4.00）. There was significant difference in the total GAGS score、GAGS scores of comedo and inflammatory papules within each group （P<0.05），There were significant differences in effective rate， total ΔGAGS score and ΔGAGS scores of comedo（P<0.05）， while no significant differences in inflammatory papules between two groups （P>0.05）.There was no significant difference in the rate of adverse reactions in group A 6.67% and B 3.33%（P>0.05）.There was significant difference in the rate of recurrence in group A 23.33% and B 27.27%（P<0.05）. Conclusion  30% Supramolecular salicylic acid combined with anti-bacterial gel is effective for facial mild to moderate acne vulgaris（especially for comedo），with small adverse reactions and low recurrence rate.

Key words： 30% supramolecular salicylic acid; anti-bacterial gel; mild to moderate acne vulgaris;efficacy;the adverse reactions;recurrence rate

寻常痤疮是皮肤科最常见的慢性炎症性毛囊皮脂腺疾病，好发于面部及胸背部，临床表现为粉刺、丘疹、脓疱、囊肿或结节，反复发作可遗留色素沉着或瘢痕。发病机制包括皮脂分泌过多、毛囊皮脂腺导管角化异常、微生物（特别是痤疮丙酸杆菌）的感染及炎症反应等。主要治疗方案为口服和/或外用异维A酸、抗生素等。由于……