目的 探讨CO2点阵激光“双层”治疗模式以及针刺疗法联合 CO2点阵激光治疗痤疮凹陷性瘢痕的临床疗效和安全性。方法 应用split-face方 法对20例痤疮凹陷性瘢痕患者进行治疗,患者的左/右侧面颊分别随机接受CO2点 阵激光治疗或针刺疗法联合CO2点阵激光治疗,治疗间隔3个月,连续治疗3次,并进 行医生视觉评估、ECCA权重评分、VAS评分以及满意度评价,记录治疗中、治疗后的不良反应 。结果 两种方法治疗后ECCA评分均明显降低(P〈0.01),医师视觉评分均显著提高 (P〈0.01); 其中联合治疗侧治疗前后ECCA权重评分较CO2点阵激光治 疗侧下降明显(P〈0.05)、医师视觉评分较高(P〈0.05)、且对V型及U型 瘢痕疗效更好(P〈0.05),患者满意度更高(P〈0.05)。所有患者均未出现 水疱、感染、增生性瘢痕等严重不良反应。结论 两种方法均能有效、安全治疗痤疮凹陷性瘢 痕,针刺疗法联合CO2点阵激光疗效更好且显著改善V型及U型瘢痕。
Objective To evaluate the clinical efficacy and safety of a“double- layer”modality of fractional CO2 laser,and pinprick therapy combined with fractional CO2 laser for atrophic acne scars. Methods A split- face, self-controlled study was employed to evaluate the efficacy and safety.A total of 20 patients with atrophic acne scars were randomly treated with fractional CO2 laser on one side of the face and pinprick therapy plus fractional CO2 laser on the other side of the face for 3 times at a 3 -month interval. Investigator's visual assessment,ECCA and VAS scores,patient's satisfaction and adverse reactions were evaluated before and after the treatment.Results Although both regimens significantly improved ECCA scores and investigator's visual assessment(P〈0.01),the efficacy of pinprick therapy plus fractional CO2 laser was superior to fractional CO2 laser alone in respect of the improvement of ECCA scores, investigator's visual assessment and patients' satisfactory rates (P〈0.05). Moreover, pinprick therapy plus fractional CO2 laser was more effective for V-shaped and U-shaped scars(P〈0.05). All patients had no severe adverse reactions such as blister,infection or hypertrophic scar. Conclusion Both regimens are effective and safe for atrophic acne scars. The combination therapy is more effective, particularly for V-shaped and U-shaped scars.