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 参见附件。

  [摘要]目的：探讨红蓝混合光联合倒模治疗不同级别痤疮的临床疗效。方法：将629例痤疮患者按照病情程度分为Ⅱ、Ⅲ、Ⅳ三级，每级患者随机分为两组。Ⅱ级患者治疗组采用红蓝混合光联合倒模及外用药物治疗，对照组单纯采用外用药物治疗；Ⅲ、Ⅳ级患者治疗组采用红蓝混合光联合倒模及异维A酸治疗，对照组口服异维A酸，两组均使用相同的外用药物。12周后评价疗效。结果：第12周进行随访，三级患者治疗组总有效率分别为96.8%、94.4%、83.3%，对照组总有效率分别为81.1%、83.1%、68.8%。结论：红蓝混合光联合倒模治疗中重度痤疮较常规药物起效快，疗程缩短，效果显著，复发率低。

 [关键词]痤疮；红蓝光；倒模；维A酸

 [中图分类号]R758.73+3 [文献标识码]A [文章编号]1008-6455(2012)05-0796-03

 Combination of red/blue light phototherapy and Chinese medicinal liniment pourmask in the treatment of acne

 QIN Xiao-lei,CHEN Zhi-ying,YU Zhen,YANG Fan

 (Department of Dermatology, Shenzhen Chronic Diseases Control Center,Shenzhen 518020,Guangdong,China)

 Abstract: Objective To investigate the clinical effect of red/blue light phototherapy combining with Chinese medicinal liniment pourmask in the treatment of acne. Methods 629 patients of acne were divided into three groups (Degree Ⅱ,Ⅲ，Ⅳ) according to their pathogenetic condition. Each group divided into two teams: treatment team and control team. The treatment team of Degree Ⅱwas treated with red/blue light and external drug, but the control team was treated only with topical drug. The patients left of Degree Ⅲ,Ⅳ were trearted with the same way but both the treatment team and control team add oral isotretinoin. 12 weeks later evaluate the effects. Results At 12th week the total effective rate in the treatment group were 96.8%,94.4%,83.3% and control group were 81.1%,83.1%,68.8% respectively. Conclusion Red/blue light phototherapy combining with Chinese medicinal liniment pourmask Isotretinoin is more quickly and effective, lower the relapse rate.

 Key words:Acne;Red and blue light;Chinese medicinal liniment;ratinoic acid

 痤疮是青春期常见的一种毛囊皮脂腺的慢性炎症,其发病率较高,主要发生在面部及胸背部等处,形成粉刺、丘疹、脓疮、结节、囊肿等损害。其病因与雄激素、皮脂分泌增加及毛囊皮脂腺腺管的过度角化、腺管内痤疮丙酸杆菌移生、炎性介质及炎症有关[1]。目前用于痤疮治疗的药物众多,其中维A酸类药物作为中、重度痤疮的主要用药，但由于其较大的不良反应及较长的疗程限制了其广泛应用。光疗法是最近几年广泛应用于临床的治疗痤疮的常见物理治疗，笔者在临床上用红蓝混合光联合倒模治疗痤疮患者,其疗效显著优于常规治疗,能够使疗程缩短、复发率降低，现报道如下。

 1 资料和方法

 1.1 研究对象:629例痤疮患者均来自本科门诊，痤疮诊断标准见参考文献[2]。痤疮分度：参考四级国际改良分型法。Ⅰ级：主要皮损为粉刺，损害数目不超过30个；Ⅱ级：主要皮损为粉刺加潜在性脓疱，皮损总数在31～50个；Ⅲ级：丘疹和脓疱较多，皮损数在51～100个，并可见结节,但数目少于3个；Ⅳ级：皮损数大于100个，并可见结节、囊肿数在3个以上。658例患者均为Ⅱ、Ⅲ、Ⅳ级患者。排除标准：①妊娠和哺乳期妇女；②有光敏感或光敏感疾病者；③4周内系统使用过抗炎或抗生素药物者；④有肝、肾及血液等疾病者；⑤因其他疾病接受过对痤疮有影响的药物治疗者。

 1.2 一般资料:629例痤疮患者按照病情分级分为三组，每组随机分为治疗组与对照组。Ⅱ级患者231例，其中男102例 ......