目的: 探讨点阵超脉冲 CO2激光联合表皮生长因子凝胶治疗痤疮瘢痕的临床疗效。方法: 96例痤疮瘢痕患者随机分为C组(n＝48)和L组(n＝48)。C组采用点阵超脉冲 CO2激光治疗,L组在点阵超脉冲 CO2激光治疗基础上加用 rhEGF 凝胶治疗。比较两组临床疗效及治疗前后ECCA权重得分,治疗后结痂时间和红斑持续时间,患者满意度及治疗前后角质层含水量、经皮水分丢失量(TEWL)、乳酸刺激实验评分、角质层蛋白质含量。记录两组患者的治疗不良反应。结果: L组治疗总有效率为91.67%,明显高于C组的72.92%,差异比较具有统计学意义(χ2＝5.79,P＜0.05)。两组治疗后ECCA权重得分较治疗前均有下降(P＜0.05),但L组改善幅度高于C组(P＜0.05)。L组结痂时间、红斑持续时间短于C组(P＜0.05),患者满意度高于C组(P＜0.05)。与治疗前比较,L组治疗后角质层水含量、TEWL、乳酸刺激实验评分、角质层蛋白质等指标均有明显改善(P＜0.05),且改善幅度高于C组(P＜0.05)。而C组治疗后以上指标均无明显变化(P＞0.05)。两组未发现严重不良反应。结论: 点阵超脉冲CO2激光联合rhEGF凝胶治疗痤疮瘢痕的效果显著,且明显优于点阵超脉冲CO2激光单用。

Objective: To investigate the clinical effect of ultrapulsed lattice CO2 laser combined with recombinant human epidermal growth factor (rhEGF) on acne scar. Methods: 96 patients with acne scar were randomly divided into group C (n=48) and group L (n=48). Group C was treated with ultrapulsed lattice CO2 laser, and group L was treated with ultrapulsed lattice CO2 laser combined with rhEGF. Clinical efficacy, ECCA score before and after treatment, scabbing time and erythema duration time after treatment, patient satisfaction and cuticle moisture content, transepidermal water loss (TEWL), lactic acid stimulation test score, cuticle protein content before and after treatment were compared between the two groups. The adverse reactions of the two groups were recorded. Results: The total effective rate of treatment in group L was 91.67%, significantly higher than 72.92% in group C, the difference was statistically significant (χ2＝5.79,P＜0.05). Compared with those before treatment, ECCA scores in both groups decreased after treatment (P<0.05), but the improvement of group L was higher than that of group C (P<0.05). The scab time and erythema duration time of group L were shorter than those of group C (P<0.05), and the patient satisfaction in group L was higher than that in group C (P<0.05). Compared with those before treatment, cuticle moisture content, TEWL, lactic acid stimulation test score, cuticle protein content of group L showed significant improvement after treatment (P<0.05), and the improvement was higher than those of group C (P<0.05).There were no significant change in the above indexes after treatment in group C (P>0.05). No serious adverse reactions were found in either groups. Conclusion: The effect of ultrapulsed lattice CO2 laser combined with recombinant human epidermal growth factor on acne scar is better than that of ultrapulsed lattice CO2 laser alone.