Abstract:

Objective　To investigate the clinical effect of photodynamic therapy combined with tacrolimus ointment in the treatment of facial rosacea and its influence on the levels of serum inflammatory factors. Methods　A total of 78 patients with facial rosacea admitted to the Department of Dermatology and Plastic Surgery, the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from May 2020 to January 2023 were prospectively selected as research objects, and were divided into a control group and an observation group with 39 cases in each group by the random number table method. In the control group, there were 24 males and 15 females, the age was (34.51±3.17) years old, and the course of disease was (2.13±0.39) years. In the observation group, there were 27 males and 12 females, the age was (33.38±3.25) years old, and the course of disease was (2.19±0.37) years. The control group received photodynamic therapy. The observation group received photodynamic therapy combined with tacrolimus ointment (2 times/day, respectively in the morning and evening, for 1 month). Both groups were treated for 1 month. The clinical efficacy (improvement time of skin flushing, telangiectasia, and erythema), levels of serum inflammatory factors [interleukin 1α (IL-1α), IL-8, and tumor necrosis factor α (TNF-α)], skin lesion scores, and Echelle d'Evaluation Clinique des Cicatrices d'acné (ECCA) scores before and after treatment, and adverse reactions were compared between the two groups. Statistical methods used were t test and χ² test. Results　The improvement time of skin flushing, telangiectasia, and erythema in the observation group were shorter than those in the control group [(10.82±1.05) d vs. (14.39±1.70) d, (12.68±1.66) d vs. (15.11±1.00) d, (16.77±1.53) d vs. (19.84±2.81) d], with statistically significant differences (t=11.16, 7.83, and 5.99, all P<0.05). After treatment, the levels of IL-1α, IL-8, and TNF-α, skin lesion score, and ECCA score in the observation group were lower than those in the control group [(4.74±1.11) ng/L vs. (6.43±1.26) ng/L, (23.94±3.11) ng/L vs. (31.30±4.31) ng/L, (27.95±3.45) ng/L vs. (53.13±6.88) ng/L, (3.44±1.04) points vs. (7.50±1.64) points, (26.46±3.08) points vs. (39.92±4.27) points], with statistically significant differences (t=6.29, 8.65, 20.43, 13.06, and 15.97, all P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group [7.69% (3/39) vs. 25.64% (10/39)], with a statistically significant difference (χ²=4.52, P<0.05). Conclusion　The combined treatment of facial rosacea with photodynamic therapy and tacrolimus ointment effectively improves the skin flushing, telangiectasia, erythema, serum inflammatory factor levels, skin lesions and scar evaluation, and reduces the occurrence of adverse reactions, so as to enhance the clinical efficacy.

Key words:

Photodynamic therapy, Tacrolimus, Facial rosacea, Clinical efficacy, Serum inflammatory factors

摘要：

目的　探讨光动力疗法与他克莫司软膏联合应用治疗丘疹脓疱型玫瑰痤疮患者的临床效果及对血清炎症因子水平的影响。方法　前瞻性选取2020年5月至2023年1月在陕西中医药大学第二附属医院皮肤整形科收治的78例丘疹脓疱型玫瑰痤疮患者作为研究对象，通过随机数字表法分为对照组和观察组各39例。对照组男24例，女15例，年龄（34.51±3.17）岁，病程（2.13±0.39）年，接受光动力疗法治疗；观察组男27例，女12例，年龄（33.38±3.25）岁，病程（2.19±0.37）年，接受光动力疗法联合他克莫司软膏治疗（2次/d，分别在早晨和晚上进行，持续治疗1个月）。两组均治疗1个月。比较两组患者临床疗效（皮肤潮红改善时间、毛细血管扩张改善时间、红斑改善时间），治疗前后血清炎症因子水平［白细胞介素（IL）-1α、IL-8、肿瘤坏死因子α（TNF-α）］、皮损积分、痤疮瘢痕评估量表（ECCA）评分与不良反应。统计学方法采用t检验、χ²检验。结果　观察组患者皮肤潮红、毛细血管扩张、红斑改善时间均短于对照组［（10.82±1.05）d比（14.39±1.70）d、（12.68±1.66）d比（15.11±1.00）d、（16.77±1.53）d比（19.84±2.81）d］，差异均有统计学意义（t=11.16、7.83、5.99，均P<0.05）；治疗后，观察组患者IL-1α、IL-8、TNF-α、皮损积分、ECCA评分均低于对照组［（4.74±1.11）ng/L比（6.43±1.26）ng/L、（23.94±3.11）ng/L比（31.30±4.31）ng/L、（27.95±3.45）ng/L比（53.13±6.88）ng/L、（3.44±1.04）分比（7.50±1.64）分、（26.46±3.08）分比（39.92±4.27）分］，差异均有统计学意义（t=6.29、8.65、20.43、13.06、15.97，均P<0.05）；观察组不良反应发生率低于对照组［7.69%（3/39）比25.64%（10/39）］，差异有统计学意义（χ²=4.52，P<0.05）。结论　光动力疗法联合他克莫司软膏治疗面部玫瑰痤疮患者，能够有效改善其皮肤潮红、毛细血管扩张、红斑、血清炎症因子水平、皮损及瘢痕评价，降低不良反应的发生，从而提高临床疗效。

关键词:

光动力疗法, 他克莫司, 玫瑰痤疮, 临床效果, 血清炎症因子