红蓝光联合治疗面部痤疮与单纯蓝光治疗面部痤疮的疗效对比观察
摘要
目的:比较红光(630nm)和蓝光(415nm)联合治疗面部痤疮与单纯蓝光(415nm)治疗面部痤疮的临床疗效。
方法:将61例面部痤疮患者随机分为红蓝光联合治疗组与单纯蓝光治疗组,分别进行8周治疗,于实验第2.4.6.8周对疗效进行比较分析。
结果:59例患者完成了实验,红蓝光联合治疗组对脓疱、结节/囊肿的疗效(皮损总数的减少率)较单纯蓝光治疗组好,而单纯蓝光治疗组对丘疹的疗效较好,所得结果均有统计学意义(P<0.05)。8周治疗结束后,两组皮损总有效率无差异性(P>0.05)。
结论:红蓝光联合治疗及单纯蓝光治疗均对面部痤疮有一定的疗效,虽然二者总体疗效无差别,但对不同类型皮疹的疗效不同,且所得结果有统计学意义。
Objective:To compare the clinical effects of facial acne treated by combined blue (415nm) and red (630nm) light and blue(415nm) light.
Methods:A total of 61 cases were recruited for the study and randomly divided into the combination group and the blue light group .Subjects were treated in 8 weeks.Acne was assessed at baseline and at weeks 2,4,6,8.
Results:59 patients completed the trial. The combination therapy is better to pustule, cyst/nodule(P<0.05),while blue light is better to papule(P<0.05).There was no significant difference on total efficacy between the two group after 8 weeks’treatment.
Conclusion:The combination therapy is more effective to facial acne in the reduction of lesions total number.varies lesions have different response to each therapy.
方法:将61例面部痤疮患者随机分为红蓝光联合治疗组与单纯蓝光治疗组,分别进行8周治疗,于实验第2.4.6.8周对疗效进行比较分析。
结果:59例患者完成了实验,红蓝光联合治疗组对脓疱、结节/囊肿的疗效(皮损总数的减少率)较单纯蓝光治疗组好,而单纯蓝光治疗组对丘疹的疗效较好,所得结果均有统计学意义(P<0.05)。8周治疗结束后,两组皮损总有效率无差异性(P>0.05)。
结论:红蓝光联合治疗及单纯蓝光治疗均对面部痤疮有一定的疗效,虽然二者总体疗效无差别,但对不同类型皮疹的疗效不同,且所得结果有统计学意义。
Objective:To compare the clinical effects of facial acne treated by combined blue (415nm) and red (630nm) light and blue(415nm) light.
Methods:A total of 61 cases were recruited for the study and randomly divided into the combination group and the blue light group .Subjects were treated in 8 weeks.Acne was assessed at baseline and at weeks 2,4,6,8.
Results:59 patients completed the trial. The combination therapy is better to pustule, cyst/nodule(P<0.05),while blue light is better to papule(P<0.05).There was no significant difference on total efficacy between the two group after 8 weeks’treatment.
Conclusion:The combination therapy is more effective to facial acne in the reduction of lesions total number.varies lesions have different response to each therapy.
引文
[1]. Cynthia E, Brad AYentzer,Steven R.A Review of Adapalene in the Treatment of Acne Vulgaris [J].Journal of Adolescent Health.2008, 43(5): 421~424.
[2]. Webster CF.Acne vulgaris [J].Br Med J, 2002,325:475~479
[3]. Velicer CM., Heckbert SR, Lampe JW et al.Antibiotic use in relation to the risk of breast cancer [J]. Dermatol Surg,2004,291: 827~835
[4]. Mills OH, Kligman AM.Ultraviolet phototherapy and photochemotherapy of acne vulgaris [J].Arch Dermatol.1978,114 (2) :221~223
[5]. Shalita AR, Harth Y, Elman M,et al.Acne phototherapy using UV-free high-intensity narrow-band blue light: a three-center clinical study [J].Proc SPIE , 2001,4244:61~73
[6]. Elman M, Lebzelter J.Light therapy in the treatment of acne vulgaris [J].Dermatol Surg,2004,30 (2 Pt 1):139~146
[7]. Elman M, Slatkine Mand,Harth Y.The effective treatment of acne vulgaris by a high-intensity, narrow band 405–420 nm light source [J].J Cosmetic Laser Ther ,2003,5 (2):111~117
[8]. Kawada A, Aragane Y, Kameyama H, et al.Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation [J].J Dermatol Sci,2002,30 (2):129~135
[9]. Tzung TY, Wu KH, Huang ML.Blue light phototherapy in the treatment of acne [J].Photodermatol Photoimmunol Photomed, 2004,20 (5):266~269
[10]. Charakida A,Seaton ED, Charakida M,et al.Phototherapy in the treatment of acne vulgaris:what is its role? [J].Am J Clin Dermatol , 2004,5(4):211~216
[11]. Shnitkind E,Yaping E,Geen S,et al.Anti-inflammatory properties of narrow-band blue light [J]. J Drugs Dermatol,2006,5(7):605~610
[12]. Chang SE, Ahn SJ, Rhee DY,et al.Treatment of facial acne papules and pustules in Korean patients using an intense pulsed light device equipped with a 530- to 750-nm filter [J].Dermatol Surg ,2007,33 (6),676~679
[13]. Rivera AE.Acne scarring:A review and current treatment modalities[J].J Am Acad Dermatol.2008,59(4):659~76
[14]. Elman M,Lask G..The role of pulsed light and heat energy(LHE) in acne clearanced [J].J Cosmet Laser Ther,2004,6(2):91~95
[15]. (Fukao M,Kawada A,Aragane Y,et al.An open study and in vitro investigation of acne phototherapy with a high-intensity,enhanced,narrowband,blue light source[J].J Am Acad Dermatol,2005,52(3 Suppl ):14
[16]. Thiboutot D,Gollnick H,Bettoli V,et al.New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group[J].J Am Acad Dermatol,2009,60(5 Suppl):S1-50
[17].刘清.中药联合红蓝光照射治疗痤疮49例疗效观察[J].北京中医,2006笫25(l0):607~608
[18]. Konig K,Teschke M,Sigusch B,et al .Red light kills bacteria via photodynamic action [J].Cell Mol Biol(Noisy—le—grand),2000,46(7):l297~l303.
[19]. Gupta A K,Ryder JE.Photodynamie therapy and topical aminolevulinic acid:an overview [J].Am J Clin Dermatol,2003,4:699~708
[20]. Papageorgiou P,Katsambas A,Chu A.Phototherapy with blue(415nm)and red(660 nm)light in the treatment of aene vulgaris[J].Br J Dermatol,2000,l42(5):973~978
[21]. Goldberg DJ, Russell BA .Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris[J]. J Cosmet Laser Ther,2006,8(2):71~75
[22].丁慧琳,项蕾红,郑志中.窄谱蓝光疗法治疗寻常痤疮.中国皮肤科杂志[J],2006,39(2):112
[23]. Lee SY, You CE, Park MY.Lasers Surg Med. Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV[J],2007,39(2):180~188
[24].钟建桥,先德海,陈德宇.窄谱蓝光治疗寻常型痤疮临床疗效.临床皮肤科杂志[J],2007, 39(2):112
[25]. Campos V, Ferreira C.The Brazilian experience in the treatment of mild to moderate acne using blue light from a new device[J]. J Am Acad Dermatol,2007,56(2 Suppl ): AB200
[1]. Fukao M,Kawada A,Aragane Y,et al.An open study and in vitro investigation of acne phototherapy with a high-intensity,enhanced,narrowband,blue light source[J].J Am Acad Dermatol,2005,52(3 Suppl ):14
[2]. Shnitkind E,Yaping E,Geen S ,et al.Anti-inflammatory properties of narrow-band blue light [J]. J Drugs Dermatol,2006,5(7):605~10.
[3]. Goldberg DJ, Russell BA .Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris[J]. J Cosmet Laser Ther,2006,8(2):71~75
[4]. Wong W R,Shyu WL,Tsai JW,et al.Intense pulsed light effects on the expression of extracellular matrix proteins and transforming growth factor beta-1 in skin dermal fibroblasts cultured within contracted collagen lattices[J].Dermatol Surg,2009,35(5):816-825
[5]. Wanitphakdeedecha R,Tanzi EL,Alster TS.Photopneumatic therapy for the treatment of acne[J]. J Drugs Dermatol,2009,8(3):239~241
[6]. Rivera AE.Acne scarring:A review and current treatment modalities[J].J Am Acad Dermatol,2008,59(4):659~676
[7]. Harto A,García-Morales I,Belmar P,et al.Pulsed dye laser treatment of acne. Study of clinical efficacy and mechanism of action [J].Actas Dermosifiliogr,2007,98(6):415~419
[8]. Lee DH,Choi YS,Min SU,et al.Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd:YAG laser for the treatment of acne scars: A randomized split-face clinical study[J]. J Am Acad Dermatol,2009,60(5):801~807.
[9]. Jih MH,Friedman PM,Goldberg LH,et al.The 1450-nm diode laser for facial inflammatory acne vulgaris: Dose-response and 12-month follow-up study[J].J Am Acad Dermatol,2006,55(1):80~87.
[10]. Alster TS,Tanzi EL and Lazarus M.The use of fractional laser phothothermolysis for the treatment of atrophic scars[J].Dermatol Surg,2007,33(3):295-299
[11]. Niwa AB,Mello AP,Torezan LA,Osório N.Fractional photothermolysis for the treatment of hypertrophic scars: clinical experience of eight cases[J].Dermatol Surg,2009,35(5):773-7; discussion 777~778
[12]. Srivastava D,Mahmoud B,Ozog D,et al.The safety and efficacy of fractional laser treatments for acne scars in Fitzpatrick skin types IV to VI[J].J Am Acad Dermatol. 2009,60(3 Suppl ):AB197
[13]. Hwang EJ,Chang SH,Kim BS,et al .Treatment of acne vulgaris by photodynamic therapy with aminolevulinic acid: Clinical and histopathologic findings[J].J Am Acad Dermatol,2008,58(2 Suppl ):AB17
[14]. Taub AF.A comparison of intense pulsed light, combination radiofrequency and intense pulsed light, and blue light in photodynamic therapy for acne vulgaris[J].J Drugs Dermatol,2007,6(10):1010~1016
[15]. Wiegell SR,Wulf HC.Photodynamic therapy of acne vulgaris using 5-aminolevulinic acid versus methyl aminolevulinate[J].J Am Acad Dermatol,2006,54(4):647~651
[16].吴志刚,联合药物治疗痤疮疗效观察,重庆医学[J].2004,33(6):816.
[17]. Bhardwaj SS,Rohrer TE,Arndt K.Lasers and light therapy for acne vulgaris[J].Semin Cutan Med Surg,2005,24(2):107~112
[18]. Thiboutot D,Gollnick H,Bettoli V,et al.New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group[J].J Am Acad Dermatol,2009,60(5 Suppl):S1-50
[19]. Ruiz-Esparza J,Gomez JB.Nonablative radiofrequency for active acne vulgaris: the use of deep dermal heat in the treatment of moderate to severe active acne vulgaris (thermotherapy): a report of 22 patients[J]. Dermatol Surg,2003,29(4):333-9; discussion 339
[20]. Prieto VG.,Zhang PS,Sadick NS.Evaluation of pulsed light and radiofrequency combined for the treatment of acne vulgaris with histologic analysis of facial skin biopsies[J].J Cosmet Laser Ther,2005,7(2):63-8
[21]. Gold M,Biron J.Bipolar radiofrequency with vacuum apparatus in the treatmentof acne scars[J]. J Am Acad Dermatol,2007,56(2 Suppl ):AB206
[22]. Alster TS,Lupton JR.Nonablative cutaneous remodeling using radiofrequency devices (M).Clin Dermatol,2007,25(5):487-91
[2]. Webster CF.Acne vulgaris [J].Br Med J, 2002,325:475~479
[3]. Velicer CM., Heckbert SR, Lampe JW et al.Antibiotic use in relation to the risk of breast cancer [J]. Dermatol Surg,2004,291: 827~835
[4]. Mills OH, Kligman AM.Ultraviolet phototherapy and photochemotherapy of acne vulgaris [J].Arch Dermatol.1978,114 (2) :221~223
[5]. Shalita AR, Harth Y, Elman M,et al.Acne phototherapy using UV-free high-intensity narrow-band blue light: a three-center clinical study [J].Proc SPIE , 2001,4244:61~73
[6]. Elman M, Lebzelter J.Light therapy in the treatment of acne vulgaris [J].Dermatol Surg,2004,30 (2 Pt 1):139~146
[7]. Elman M, Slatkine Mand,Harth Y.The effective treatment of acne vulgaris by a high-intensity, narrow band 405–420 nm light source [J].J Cosmetic Laser Ther ,2003,5 (2):111~117
[8]. Kawada A, Aragane Y, Kameyama H, et al.Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation [J].J Dermatol Sci,2002,30 (2):129~135
[9]. Tzung TY, Wu KH, Huang ML.Blue light phototherapy in the treatment of acne [J].Photodermatol Photoimmunol Photomed, 2004,20 (5):266~269
[10]. Charakida A,Seaton ED, Charakida M,et al.Phototherapy in the treatment of acne vulgaris:what is its role? [J].Am J Clin Dermatol , 2004,5(4):211~216
[11]. Shnitkind E,Yaping E,Geen S,et al.Anti-inflammatory properties of narrow-band blue light [J]. J Drugs Dermatol,2006,5(7):605~610
[12]. Chang SE, Ahn SJ, Rhee DY,et al.Treatment of facial acne papules and pustules in Korean patients using an intense pulsed light device equipped with a 530- to 750-nm filter [J].Dermatol Surg ,2007,33 (6),676~679
[13]. Rivera AE.Acne scarring:A review and current treatment modalities[J].J Am Acad Dermatol.2008,59(4):659~76
[14]. Elman M,Lask G..The role of pulsed light and heat energy(LHE) in acne clearanced [J].J Cosmet Laser Ther,2004,6(2):91~95
[15]. (Fukao M,Kawada A,Aragane Y,et al.An open study and in vitro investigation of acne phototherapy with a high-intensity,enhanced,narrowband,blue light source[J].J Am Acad Dermatol,2005,52(3 Suppl ):14
[16]. Thiboutot D,Gollnick H,Bettoli V,et al.New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group[J].J Am Acad Dermatol,2009,60(5 Suppl):S1-50
[17].刘清.中药联合红蓝光照射治疗痤疮49例疗效观察[J].北京中医,2006笫25(l0):607~608
[18]. Konig K,Teschke M,Sigusch B,et al .Red light kills bacteria via photodynamic action [J].Cell Mol Biol(Noisy—le—grand),2000,46(7):l297~l303.
[19]. Gupta A K,Ryder JE.Photodynamie therapy and topical aminolevulinic acid:an overview [J].Am J Clin Dermatol,2003,4:699~708
[20]. Papageorgiou P,Katsambas A,Chu A.Phototherapy with blue(415nm)and red(660 nm)light in the treatment of aene vulgaris[J].Br J Dermatol,2000,l42(5):973~978
[21]. Goldberg DJ, Russell BA .Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris[J]. J Cosmet Laser Ther,2006,8(2):71~75
[22].丁慧琳,项蕾红,郑志中.窄谱蓝光疗法治疗寻常痤疮.中国皮肤科杂志[J],2006,39(2):112
[23]. Lee SY, You CE, Park MY.Lasers Surg Med. Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV[J],2007,39(2):180~188
[24].钟建桥,先德海,陈德宇.窄谱蓝光治疗寻常型痤疮临床疗效.临床皮肤科杂志[J],2007, 39(2):112
[25]. Campos V, Ferreira C.The Brazilian experience in the treatment of mild to moderate acne using blue light from a new device[J]. J Am Acad Dermatol,2007,56(2 Suppl ): AB200
[1]. Fukao M,Kawada A,Aragane Y,et al.An open study and in vitro investigation of acne phototherapy with a high-intensity,enhanced,narrowband,blue light source[J].J Am Acad Dermatol,2005,52(3 Suppl ):14
[2]. Shnitkind E,Yaping E,Geen S ,et al.Anti-inflammatory properties of narrow-band blue light [J]. J Drugs Dermatol,2006,5(7):605~10.
[3]. Goldberg DJ, Russell BA .Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris[J]. J Cosmet Laser Ther,2006,8(2):71~75
[4]. Wong W R,Shyu WL,Tsai JW,et al.Intense pulsed light effects on the expression of extracellular matrix proteins and transforming growth factor beta-1 in skin dermal fibroblasts cultured within contracted collagen lattices[J].Dermatol Surg,2009,35(5):816-825
[5]. Wanitphakdeedecha R,Tanzi EL,Alster TS.Photopneumatic therapy for the treatment of acne[J]. J Drugs Dermatol,2009,8(3):239~241
[6]. Rivera AE.Acne scarring:A review and current treatment modalities[J].J Am Acad Dermatol,2008,59(4):659~676
[7]. Harto A,García-Morales I,Belmar P,et al.Pulsed dye laser treatment of acne. Study of clinical efficacy and mechanism of action [J].Actas Dermosifiliogr,2007,98(6):415~419
[8]. Lee DH,Choi YS,Min SU,et al.Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd:YAG laser for the treatment of acne scars: A randomized split-face clinical study[J]. J Am Acad Dermatol,2009,60(5):801~807.
[9]. Jih MH,Friedman PM,Goldberg LH,et al.The 1450-nm diode laser for facial inflammatory acne vulgaris: Dose-response and 12-month follow-up study[J].J Am Acad Dermatol,2006,55(1):80~87.
[10]. Alster TS,Tanzi EL and Lazarus M.The use of fractional laser phothothermolysis for the treatment of atrophic scars[J].Dermatol Surg,2007,33(3):295-299
[11]. Niwa AB,Mello AP,Torezan LA,Osório N.Fractional photothermolysis for the treatment of hypertrophic scars: clinical experience of eight cases[J].Dermatol Surg,2009,35(5):773-7; discussion 777~778
[12]. Srivastava D,Mahmoud B,Ozog D,et al.The safety and efficacy of fractional laser treatments for acne scars in Fitzpatrick skin types IV to VI[J].J Am Acad Dermatol. 2009,60(3 Suppl ):AB197
[13]. Hwang EJ,Chang SH,Kim BS,et al .Treatment of acne vulgaris by photodynamic therapy with aminolevulinic acid: Clinical and histopathologic findings[J].J Am Acad Dermatol,2008,58(2 Suppl ):AB17
[14]. Taub AF.A comparison of intense pulsed light, combination radiofrequency and intense pulsed light, and blue light in photodynamic therapy for acne vulgaris[J].J Drugs Dermatol,2007,6(10):1010~1016
[15]. Wiegell SR,Wulf HC.Photodynamic therapy of acne vulgaris using 5-aminolevulinic acid versus methyl aminolevulinate[J].J Am Acad Dermatol,2006,54(4):647~651
[16].吴志刚,联合药物治疗痤疮疗效观察,重庆医学[J].2004,33(6):816.
[17]. Bhardwaj SS,Rohrer TE,Arndt K.Lasers and light therapy for acne vulgaris[J].Semin Cutan Med Surg,2005,24(2):107~112
[18]. Thiboutot D,Gollnick H,Bettoli V,et al.New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group[J].J Am Acad Dermatol,2009,60(5 Suppl):S1-50
[19]. Ruiz-Esparza J,Gomez JB.Nonablative radiofrequency for active acne vulgaris: the use of deep dermal heat in the treatment of moderate to severe active acne vulgaris (thermotherapy): a report of 22 patients[J]. Dermatol Surg,2003,29(4):333-9; discussion 339
[20]. Prieto VG.,Zhang PS,Sadick NS.Evaluation of pulsed light and radiofrequency combined for the treatment of acne vulgaris with histologic analysis of facial skin biopsies[J].J Cosmet Laser Ther,2005,7(2):63-8
[21]. Gold M,Biron J.Bipolar radiofrequency with vacuum apparatus in the treatmentof acne scars[J]. J Am Acad Dermatol,2007,56(2 Suppl ):AB206
[22]. Alster TS,Lupton JR.Nonablative cutaneous remodeling using radiofrequency devices (M).Clin Dermatol,2007,25(5):487-91