Abstract:

Objective　To evaluate the clinical effect of intense pulsed light (IPL) combined with recombinant human type Ⅲ collagen dressing in the treatment of patients with rosacea. Methods　One hundred and twenty-two patients with rosacea treated at Department of Dermatology, Yan'an People's Hospital from April 2020 to April 2023 were selected for the randomized controlled trial, and were divided into an IPL group and a treatment group by the random number table method, with 61 cases in each group. There were 31 males and 30 females in the IPL group; they were (31.63±5.57) years old; their disease course was (3.49±1.31) years; they were treated by IPL. There were 34 males and 27 females in the treatment group; they were (30.18±5.14) years old; their disease course was (3.36±1.27) years; they were treated by IPL and recombinant human type Ⅲ collagen dressing. The clinical efficacies, rosacea researchers' general assessment (IGA) scores, VISIA red zone measurements, skin physiological indicators, physicians' global assessment (PGA), Acne-specific quality of life (Acne-QOL), and treatment-related adverse events were compared between the two groups. t and χ² tests were applied. Results　Four weeks after the treatment, the total effective rate in the treatment group was higher than that in the IPL group [91.80% (56/61) vs. 73.77% (45/61)], with a statistical difference (χ²=6.960; P=0.008). Before the treatment, there were no statistical differences in the score of IGA, facial VISIA red zone measurement value, transepidermal water loss (TEWL), skin grease, water in cuticle, skin injury degree, and life quality score between the two groups (all P>0.05). Four weeks after the treatment, the score of IGA, TEWL, and skin grease in the treatment group were lower than those in the IPL group [(2.27±0.83) vs. (3.83±0.86), (12.29±2.91)% vs. (16.45±2.17)%, and (70.31±11.92) μg/cm² vs. (83.64±13.83) μg/cm²]; the facial VISIA red zone measurement value, water in cuticle, and scores of PGA, self-perception, emotion function, rosacea symptoms, and social function in the treatment group were higher than those in the IPL group [(56.82±12.56) vs. (42.31±10.97), (67.91±11.24)% vs. (56.26±10.39)%, (2.82±0.87) vs. (2.25±0.81), (22.52±2.71) vs. (18.73±2.52), (16.83±2.74) vs. (14.32±2.18), (20.52±2.46) vs. (17.93±2.38), and (19.74±2.85) vs. (15.83±2.14)], with statistical differences (t=10.194, 8.951, 5.702, 6.796, 5.944, 3.745, 7.999, 5.599, 5.910, and 8.568; all P<0.05). There was no statistical difference in the incidence of adverse events between the treatment group and the IPL group [6.56% (4/61) vs. 11.48% (7/61); χ²=0.899; P=0.343]. Conclusion　IPL combined with recombinant human type Ⅲ collagen dressing for patients with rosacea is effective and safe, and can improve their overall skin conditions and quality of life, so it is worth being clinically generalized.

Key words:

Intense pulsed light, Rosacea, Recombinant human type Ⅲ , collagen dressing, Treatment efficacy, Safety

摘要：

目的　评估强脉冲光结合重组人源Ⅲ型胶原蛋白贴敷料在玫瑰痤疮治疗中的临床效果。方法　前瞻性研究，选取2020年4月至2023年4月在延安市人民医院皮肤科治疗的122例玫瑰痤疮患者作为研究对象，依据随机数字表法将患者分为强脉冲光组和治疗组，各61例。强脉冲光组男31例、女30例，年龄（31.63±5.57）岁，病程（3.49±1.31）年，接受强脉冲光治疗；治疗组男34例、女27例，年龄（30.18±5.14）岁，病程（3.36±1.27）年，在强脉冲光组基础上采用重组人源Ⅲ型胶原蛋白贴敷料治疗。对比两组患者临床疗效、玫瑰痤疮研究者整体评估（IGA）评分、VISIA红区情况、皮肤生理指标、医生整体评价法（PGA）、痤疮特异性生活质量调查表（Acne-QOL）及治疗相关不良事件。统计学方法采用t检验、χ²检验。结果　治疗组治疗后4周的总有效率为91.80%（56/61），高于强脉冲光组的73.77%（45/61），差异有统计学意义（χ²=6.960，P=0.008）。治疗前，两组患者IGA评分、面部VISIA红区检测情况、经皮水分散失值（TEWL）、皮肤油脂、角质层含水量、皮肤损伤程度及生活质量评分比较，差异均无统计学意义（均P>0.05）。治疗后4周，治疗组IGA评分、TEWL、皮肤油脂均低于强脉冲光组［（2.27±0.83）分比（3.83±0.86）分、（12.29±2.91）%比（16.45±2.17）%、（70.31±11.92）μg/cm²比（83.64±13.83）μg/cm²］，面部VISIA红区检测情况、角质层含水量、皮肤损伤程度、自我感知、情感功能、痤疮症状、社会功能评分均高于强脉冲光组［（56.82±12.56）分比（42.31±10.97）分、（67.91±11.24）%比（56.26±10.39）%、（2.82±0.87）分比（2.25±0.81）分、（22.52±2.71）分比（18.73±2.52）分、（16.83±2.74）分比（14.32±2.18）分、（20.52±2.46）分比（17.93±2.38）分、（19.74±2.85）分比（15.83±2.14）分］，差异均有统计学意义（t=10.194、8.951、5.702、6.796、5.944、3.745、7.999、5.599、5.910、8.568，均P<0.05）。治疗组不良事件发生率为6.56%（4/61），与强脉冲光组［11.48%（7/61）］比较，差异无统计学意义（χ²=0.899，P=0.343）。结论　强脉冲光联合重组人源Ⅲ型胶原蛋白贴敷料在治疗玫瑰痤疮应用中显示出良好的临床效果，可有效改善皮肤整体状况和生活质量，同时表现出较高的安全性，适宜在临床上推广应用。

关键词:

强脉冲光, 玫瑰痤疮, 重组人源Ⅲ型胶原蛋白贴敷料, 治疗效果, 安全性