[摘要]目的：观察放血疗法与序贯脉冲染料激光治疗红斑毛细血管扩张型玫瑰痤疮的临床疗效。方法：选取在遂宁市中心医院皮肤科门诊就诊的80例红斑毛细血管扩张型玫瑰痤疮患者，纳入时间为2021年1月-2023年12月，通过抽签法随机分为两组，对照组（n=40）口服盐酸多西环素和硫酸羟氯喹片，治疗组（n=40）在对照组治疗基础上予以放血疗法与序贯脉冲染料激光治疗，两组均治疗8周，比较其临床疗效、症状评分、皮损情况、不良反应及随访情况。结果：治疗组治疗显效率高于对照组（P＜0.05）。治疗后，两组红斑、灼热、毛细血管扩张、瘙痒评分与治疗前相比均下降（P＜0.05），且治疗组上述症状评分均低于对照组（P＜0.05）。治疗4周和8周时，两组皮损PGA评分均较治疗前升高（P＜0.05），且治疗组皮损PGA评分高于对照组（P＜0.05）。两组不良反应发生率差异无统计学意义（P＞0.05）。随访结果显示，两组患者治疗后3个月均无复发。结论：对红斑毛细血管扩张型玫瑰痤疮患者采用放血疗法与序贯脉冲染料激光治疗，效果更显著，且安全性较佳。

[关键词]玫瑰痤疮；红斑毛细血管扩张型；放血疗法；序贯脉冲染料激光

[中图分类号]R758.73+4" " [文献标志码]A" " [文章编号]1008-6455（2025）08-0113-04

Clinical Efficacy of Bloodletting Therapy and Sequential Pulsed Dye Laser on Erythematotelangiectatic Rosacea

OUYANG Fei， YU Chunshui， ZHOU Jianqiong， ZENG Hui， LIU Tingting， LU Qinglian， LIU Linli，

DENG Lingli， FANG Hui

（ Department of Dermatology， Suining Central Hospital， Suining 629000， Sichuan， China ）

Abstract： Objective" To observe the clinical efficacy on erythematotelangiectatic rosacea treated by bloodletting therapy and sequential pulsed dye laser. Methods 80 patients with rosacea of erythematotelangiectatic type in dermatology clinic of Suining Central Hospital were selected from January 2021 to December 2023， and were randomly divided into two groups by lottery method. The control group （n=40） took doxycycline hydrochloride and hydroxychloroquine sulfate tablets orally， while the treatment group （n=40） received bloodletting therapy and sequential pulsed dye laser on the basis of the treatment in the control group. Both groups were treated for 8 weeks. The clinical efficacy， symptoms scores， skin lesions， adverse reactions and follow-up were compared. Results" The treatment group had higher markedly effective rate of treatment than the control group （P＜0.05）. After treatment， the scores of erythema， scorching hot， telangiectasia， and pruritus were reduced in both groups compared to before treatment （P＜0.05）， and the above scores were lower in the treatment group （P＜0.05）. The PGA score of skin lesions in both groups was risen at 4 and 8 weeks of treatment， than that before treatment （P＜0.05）， and the treatment group had higher PGA score （P＜0.05）. No obvious differences were shown in the incidence rates of adverse reactions between both groups （P＞0.05）. Follow-up results showed no recurrence in both groups in 3 months after treatment. Conclusion" Combined therapy with bloodletting therapy and sequential pulsed dye laser therapy has significant effect and good safety on patients with erythematotelangiectatic rosacea.

Key words： rosacea; erythematotelangiectatic; bloodletting therapy; sequential pulsed dye laser

玫瑰痤疮为皮肤科常见慢性炎症性皮肤病，好发于面颊部[1]。根据玫瑰痤疮的部位、皮损特点等情况，通常将其分为四型，其中红斑毛细血管扩张型最为常见，该类型早期主要表现为面部阵发性潮红，随着病情发展，表现出持续性红斑和毛细血管扩张，可引起面部瘙痒、灼热感等不适，对患者身心均产生不良影响[2-3]。……