|
|
光动力治疗II型玫瑰痤疮临床疗效观察
|
Abstract:
目的：观察光动力治疗II型玫瑰痤疮的临床治疗效果，比较光动力治疗与常规多西环素治疗II型玫瑰痤疮的临床疗效，进一步探讨光动力治疗对II型玫瑰痤疮患者血清中LL-37表达水平的影响，旨为临床上光动力治疗II型玫瑰痤疮提供一定的理论依据。方法：从2019年11月至2022年10月，青海大学附属医院对60例均在入选标准内的II型玫瑰痤疮患者，使用随机数字表法分为治疗组(光动力组) 30例，予以光动力治疗，每2周1次，共3次；对照组(多西环素组) 30例，予以口服盐酸多西环素片，每天1次，每次0.1 g，连用6周。在治疗前后，提取所有研究对象各2 ml的外周静脉血，检测血清LL-37的表达水平。结果：治疗组经光动力治疗后总有效率为93.33%，高于对照组多西环素治疗的83.33%，两组比较有显著性差异(P < 0.05)；经过数据对比分析，两组患者治疗前血清LL-37表达水平，无统计学差异(P > 0.05)；两组患者治疗后血清LL-37表达水平比治疗前均降低(P < 0.001)；光动力治疗后与治疗前血清LL-37表达水平下降幅度较多西环素大(P < 0.05)。结论：光动力治疗II型玫瑰痤疮的临床疗效确切；且比多西环素效果明显；光动力疗法通过抑制血清LL-37的表达水平对II型玫瑰痤疮起治疗作用。
Objective: To observe the clinical effect of photodynamic therapy on type II rose acne, compare the clinical effect of photodynamic therapy with routine doxycycline in the treatment of type II rose ac-ne, and further explore the effect of photodynamic therapy on the serum LL-37 expression level of type II rose acne patients. Methods: From November 2019 to October 2020, 60 patients with type II rose acne in the Affiliated Hospital of Qinghai University were randomly divided into the treatment group and the control group. 30 patients in the treatment group (PDT group) were given photody-namic therapy once every two weeks for three times; 30 cases in the control group (Doxycycline group) were given doxycycline hydrochloride tablets orally, once a day, 0.1 g each time for 6 weeks. Before and after treatment, 2 ml peripheral venous blood was extracted from all research objects for testing the expression level of serum LL-37. Results: Total efficiency after photodynamic therapy was 93.33%, higher than 83.33% of doxycyclin therapy in the control group, with significant dif-ferences between the two groups (P < 0.05). There was no significant difference in serum LL-37 ex-pression between the two groups before treatment (P > 0.05). The level of serum LL-37 expression in both groups decreased after treatment (P < 0.001). Compared with doxycycline treatment, pho-todynamic therapy significantly decreased the expression of LL-37 in serum (P < 0.05). Conclusion: Photodynamic therapy is effective in the treatment of type II rose acne, and is more effective than doxycycline. Photodynamic therapy can inhibit the expression of serum LL-37 in the treatment of type II rose acne.
| [1] | 陈永国, 崔静, 杨慧. 5-氨基酮戊酸光动力疗法联合常规方法治疗玫瑰痤疮疗效观察[J]. 中国美容医学, 2019, 28(2): 66-69. |
| [2] | Holmes, A.D., Spoendlin, J., Chien, A.L., et al. (2018) Evidence-Based Update on Rosacea Comor-bidities and Their Common Physiologic Pathways. Journal of the American Academy of Dermatology, 78, 156-166.
https://doi.org/10.1016/j.jaad.2017.07.055 |
| [3] | Pindado-Ortega, C., Saceda-Corralo, D., Buendia-Castano, D., et al. (2018) Frontal Fibrosing Alopecia and Cutaneous Comorbidities: A Potential Relationship with Rosacea. Journal of the American Academy of Dermatology, 78, 596-597.
https://doi.org/10.1016/j.jaad.2017.09.004 |
| [4] | Tan, J., Schofer, H., Araviiskaia, E., et al. (2016) Prevalence of Rosacea in the General Population of Germany and Russia—The RISE Study. Journal of the European Academy of Dermatology and Venereology, 30, 428-434.
https://doi.org/10.1111/jdv.13556 |
| [5] | Gether, L., Overgaard, L.K., Egeberg, A., et al. (2018) Incidence and Prev-alence of Rosacea: A Systematic Review and Meta-Analysis. British Journal of Dermatology, 179, 282-289. https://doi.org/10.1111/bjd.16481 |
| [6] | Rainer, B.M., Fischer, A.H., Luz, F., et al. (2015) Rosacea Is Associated with Chronic Systemic Diseases in a Skin Severity-Dependent Manner: Results of a Case-Control Study. Journal of the American Academy of Dermatology, 73, 604-608. https://doi.org/10.1016/j.jaad.2015.07.009 |
| [7] | 李健, 袁超. 玫瑰痤疮的病因及流行病学[J]. 皮肤病与性病, 2017, 39(2): 90-91. |
| [8] | 王莲, 张自辉, 蒋献. 玫瑰痤疮发病机制的研究进展[J]. 实用皮肤病学杂志, 2019, 12(3): 171-174. |
| [9] | Tan, J. and Berg, M. (2013) Rosacea: Current State of Epidemiology. Journal of the American Academy of Dermatology, 69, S27-S35. https://doi.org/10.1016/j.jaad.2013.04.043 |
| [10] | Steinhoff, M., Buddenkotte, J., Aubert, J., et al. (2011) Clinical, Cellular, and Molecular Aspects in the Pathophysiology of Rosacea. Journal of Investigative Dermatology Symposium Proceedings, 15, 2-11.
https://doi.org/10.1038/jidsymp.2011.7 |
| [11] | Steinhoff, M., Schauber, J. and Leyden, J.J. (2013) New Insights into Rosacea Pathophysiology: A Review of Recent Findings. Journal of the American Academy of Dermatology, 69, S15-S26. https://doi.org/10.1016/j.jaad.2013.04.045 |
| [12] | Forton, F.M. (2012) Papulopustular Rosacea, Skin Im-munity and Demodex: Pityriasis Folliculorum as a Missing Link. Journal of the European Academy of Dermatology and Venereology, 26, 19-28.
https://doi.org/10.1111/j.1468-3083.2011.04310.x |
| [13] | Steinhoff, M., Schmelz, M. and Schauber, J. (2016) Facial Erythema of Rosacea—Aetiology, Different Pathophysiologies and Treatment Options. Acta Dermato-Venereologica, 96, 579-586. https://doi.org/10.2340/00015555-2335 |
| [14] | 许丽君, 张瑞, 董春明. 抗菌肽LL-37研究进展[J]. 军事医学, 2022, 46(7): 551-557. |
| [15] | Yang, B., Good, D., Mosaiab, T., et al. (2020) Significance of LL-37 on Immuno-modulation and Disease Outcome. BioMed Research International, 2020, Article ID: 8349712. https://doi.org/10.1155/2020/8349712 |
| [16] | Reinholz, M., Ruzicka, T. and Schauber, J. (2012) Cathelicidin LL-37: An Antimicrobial Peptide with a Role in Inflammatory Skin Disease. Annals of Dermatology, 24, 126-135. https://doi.org/10.5021/ad.2012.24.2.126 |
| [17] | Gokcinar, N.B., Karabulut, A.A., Onaran, Z., et al. (2019) Elevated Tear Human Neutrophil Peptides 1-3, Human Beta Defensin-2 Levels and Conjunctival Cathelicidin LL-37 Gene Expres-sion in Ocular Rosacea. Ocular Immunology and Inflammation, 27, 1174-1183. https://doi.org/10.1080/09273948.2018.1504971 |
| [18] | Lee, J., Jung, Y., Jeong, S.W., et al. (2021) Inhibition of Hippo Signaling Improves Skin Lesions in a Rosacea-Like Mouse Model. International Journal of Molecular Sciences, 22, Article No. 931. https://doi.org/10.3390/ijms22020931 |
| [19] | Chen, Y., Moore, C.D., Zhang, J.Y., et al. (2017) TRPV4 Moves toward Center-Fold in Rosacea Pathogenesis. Journal of Investigative Dermatology, 137, 801-804. https://doi.org/10.1016/j.jid.2016.12.013 |
| [20] | Kim, M., Kim, K.E., Jung, H.Y., et al. (2015) Recombinant Erythroid Differentiation Regulator 1 Inhibits Both Inflammation and Angiogenesis in a Mouse Model of Rosacea. Experimental Dermatology, 24, 680-685.
https://doi.org/10.1111/exd.12745 |
| [21] | Wang, Z., Wu, C., Mascarenhas, N., et al. (2017) 372 Anabotulinum Toxin Reduces LL-37 Induced Rosacea Inflammation by Blocking Mast Cell Degranulation. Journal of Investigative Derma-tology, 137, S256.
https://doi.org/10.1016/j.jid.2017.07.567 |
| [22] | Gerber, P.A., Buhren, B.A., Steinhoff, M., et al. (2011) Rosacea: The Cytokine and Chemokine Network. Journal of Investigative Dermatology Symposium Proceedings, 15, 40-47. https://doi.org/10.1038/jidsymp.2011.9 |
| [23] | 李卉, 罗桃, 章杰梅. 三种方法治疗酒糟鼻临床疗效分析[J]. 医药前沿, 2016, 6(11): 83-84. |
| [24] | 褚娜, 温小美. 皮肤病血毒片联合多西环素治疗痤疮的临床研究[J]. 现代药物与临床, 2018, 33(4): 938-941. |
| [25] | Schaller, M., Almeida, L.M., Bewley, A., et al. (2017) Rosacea Treatment Update: Recommendations from the Global ROSacea COnsensus (ROSCO) Panel. British Journal of Dermatology, 176, 465-471.
https://doi.org/10.1111/bjd.15173 |
| [26] | Fan, L., Yin, R., Lan, T., et al. (2018) Photodynamic Therapy for Rosacea in Chinese Patients. Photodiagnosis and Photodynamic Therapy, 24, 82-87. https://doi.org/10.1016/j.pdpdt.2018.08.005 |
| [27] | Friedmann, D.P., Goldman, M.P., Fabi, S.G., et al. (2016) Multi-ple Sequential Light and Laser Sources to Activate Aminolevulinic Acid for Rosacea. Journal of Cosmetic Dermatology, 15, 407-412. https://doi.org/10.1111/jocd.12231 |
| [28] | Kim, M., Jung, H.Y. and Park, H.J. (2015) Topical PDT in the Treatment of Benign Skin Diseases: Principles and New Applications. International Journal of Molecular Sciences, 16, 23259-23278. https://doi.org/10.3390/ijms161023259 |
