激光在斑秃联合治疗中的应用进展

王月莹; 李婵婵; 宋继权; 谢君

doi:doi:10.3969/j.issn.1007-7146.2021.01.004

激光生物学报, 2021, 30 (1): 30, 网络出版: 2021-08-23

激光在斑秃联合治疗中的应用进展

The?Application?of?Laser?in?the?Combined?Treatment?for?Alopecia Areata

论文大纲

王月莹李婵婵宋继权 ^*谢君

作者单位

武汉大学中南医院皮肤科, 武汉 430071

激光疗法斑秃点阵激光低能量激光准分子激光 laser therapy alopecia areata fractional laser low-level laser excimer laser

摘要

斑秃(AA)是一种临床上常见的无瘢痕性脱发, 多数患者会有病症复发的经历。现有的治疗方法包括使用糖皮质激素、免疫抑制剂等药物、光动力疗法、富血小板血浆(PRP)局部注射、补骨脂素联合长波紫外线(PUVA)等, 但均存在治疗方法所需时间长、药物不良反应多、患者依从性差等问题。激光疗法因治疗周期短、疗效确切、不良反应少已成为安全有效的替代方法。本文对近年来使用的各种类型的激光或激光联合其他方法治疗斑秃的作用机制、临床应用及疗效做了相关综述。提出激光联合其他方法治疗斑秃是确切有效的, 具有很好的发展前景, 但未来仍需进行大样本的临床试验, 同时结合研究斑秃发病机制与治疗机制, 进一步评估其治疗斑秃的疗效与安全, 使其有望发展成为临床治疗斑秃的一种最有效的技术。

Abstract

Alopecia areata (AA) is one of the most common and often recurring type of non-scarring alopecia. The existing treatment methods include the use of glucocorticoids, immunosuppressive drugs, photodynamic therapy, PRP injection, PUVA, etc. However, these methods have many limitations, such as requirement of long treatment cycles, adverse drug reactions, poor patient compliance etc. On the other hand, laser therapy has become one of the most commonly used methods in clinical treatment of alopecia areata due to its short treatment cycle, definite curative effect and few adverse reactions. In this article, the mechanism, clinical application and efficacy of various kinds of laser in the combined treatment of alopecia areata are reviewed. We proposed that laser or laser combined with other methods are effective and prospective treatments of alopecia areata, but there still need to be large amounts of samples of clinical trials. It is noted that therapeutic mechanism can be combined with pathogenesis to further evaluate the efficacy and safety for the disease. In brief, laser therapy is expected to become one of the most effective technology in the clinical treatment of alopecia areata.

参考文献

[1] MESSENGER A G, MCKILLOP J, FARRANT P, et al. British Association of Dermatologists’ guidelines for the management of alopecia areata［J］. British Journal of Dermatology, 2012, 166(5): 916-926.

[2] 中华医学会皮肤性病学分会毛发学组. 中国斑秃诊疗指南(2019)［J］. 临床皮肤科杂志, 2020, 49(2): 69-72.

[3] MIRZOYEV S A, SCHRUM A G, DAVIS M D P, et al. Lifetime incidence risk of alopecia areata?estimated?at?2.1% by?Rochester?Epidemiology?Project, 1990-2009［J］. Journal of Investigative Dermatology, 2014, 134 (4) : 1141-1142.

[4] 郑莉琴, 王瑜华, 陈小钢, 等. 低强度激光疗法作用机制的新进展［J］. 中国激光医学杂志, 2014, 23(5): 233-241.

[5] LOLIS M S, MARMUR E S. Paradoxical effects of hair removal systems: a review［J］. Journal of Cosmetic Dermatology, 2006, 5(4): 274-276.

[6] KIM H, CHOI J W, KIM J Y, et al. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device–controlled multicenter trial［J］. Dermatologic Surgery, 2013, 39(8): 1177-1183.

[7] 别爱桂, 许卫平, 王汉荣. 中西医结合治疗斑秃疗效观察［J］. 湖北中医杂志, 2003, 25(9): 32.

[8] WAIZ M, SAIEH A Z, HAYANI R, et al. Use of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata［J］. Journal of Cosmetic and Laser Therapy, 2006, 8(1): 27-30.

[9] YOO K H, KIM M N, KIM B J, et al. Treatment of alopecia areata with fractional photother-molysis laser［J］. International Journal of Dermatology, 2010, 49(7): 845-847.

[10] ISSA M C, PIRES M, SILVEIRA P, et al. Transepidermal drug delivery: a new treatment option for areata alopecia?［J］. Journal of Cosmetic and Laser Therapy, 2015, 17(1): 37-41.

[11] BAE J M, JUNG H M, GOO B, et al. Hair regrowth through wound healing process after ablative fractional laser treatment in a murine model［J］. Lasers in Surgery and Medicine, 2015, 47(5): 433-440.

[12] MAJID I, JEELANI S, IMRAN S. Fractional carbon dioxide laser in combination with topical corticosteroid application in resistant alopecia areata: a case series［J］. Journal of Cutaneous and Aesthetic Surgery, 2018, 11(4): 217-221.

[13] 谭帅, 吴树毅, 李凤春, 等. CO2点阵激光联合0.1%他克莫司软膏治疗斑秃临床疗效观察［J］. 中国现代药物应用, 2018, 12(11): 103-105.

[14] 刘辉峰, 肖汉龙, 安湘杰, 等. 1 550 nm非剥脱点阵激光治疗斑秃的临床随机对照试验［J］. 激光生物学报, 2016, 25(2): 185-188.

[15] MUHSIN A A, MURTADHA H A, HUSSEIN R A A. The use of a 1 540 nm fractional erbium-glass laser in treatment of alopecia areata［J］. Lasers in Surgery and Medicine, 2019, 51(10): 859-865.

[16] 金蝉, 房秀萍. 1 565 nm非剥脱点阵激光联合米诺地尔治疗斑秃的效果［J］. 临床医学研究与实践, 2019(31) : 60-61, 64.

[17] SPENCER J M, HADI S M. The excimer lasers［J］. Journal of Drugs in Dermatology, 2004, 3(5): 522-525.

[18] MEHRABAN S, FELLY A. 308 nm?excimer laser?in?dermatology［J］. Journal of Lasers in Medical Sciences, 2014, 5(1): 8-12.

[19] OHTSUKI A, HASEGAWA T, IKEDA S. Treatment of alopecia areata with 308-nm excimer lamp［J］. Journal of Dermatology, 2010, 37: 1032-1035.

[20] 杨慧兰, 黄小晏. 308 nm准分子激光诱导T淋巴细胞凋亡的研究［J］. 临床皮肤科杂志, 2008, 37(10): 639-641.

[21] 李雪梅, 杨慧兰. 308 nm准分子激光治疗对白癜风患者外周血Th1/Th2细胞因子的影响［J］. 中国美容医学杂志, 2010, 19(11): 79-80.

[22] 刘琴, 杨春俊, 张学军, 等. 308 nm准分子激光治疗斑秃进展［J］. 国际皮肤性病学杂志, 2006, 32(4): 216-218.

[23] AL-MUTAIRI N. 308-nm excimer laser for the treatment of alopecia areata［J］. Dermatologic Surgery, 2007, 33(12): 1483-1487.

[24] OHTSUKI A, HASEGAWA T, KOMIYAMA E, et al. 308-nm excimer lamp for the treatment of alopecia areata: clinical trial on 16 cases［J］. Indian Journal of Dermatology, 2013, 58(4): 326.

[25] LI A Q, MENG X F, XING X J, et al. Efficacy?and?influence?factors?of?308-nm?excimer?lamp with minoxidil?in the?treatment?of?alopecia?areata［J］. Lasers in Surgery and Medicine, 2020, 52(8): 761-767.

[26] GUNDOGAN C, GREVE B, RAULIN C. Treatment of alopecia areata with the 308-nm xenon chloride excimer laser: case report of two successful treatments with the excimer laser［J］. Lasers in Surgery and Medicine, 2004, 34(2): 86-90.

[27] 谭欢, 兰雪梅, 周村建, 等. 斑秃患者生活质量评估及皮肤病生活质量指数的信度分析及因子分析［J］. 临床皮肤科杂志, 2015, 44(6): 356-360.

[28] KRANZ D, NADAREVIC L, ERDFELDER E. Bald and bad?［J］. Experimental Psychology, 2019, 66(5): 331-345.

[29] WU Y F, WANG S H, WU P S, et al. Enhancing hair follicle regeneration by nonablative fractional laser: assessment of irradiation parameters and tissue response ［J］. Lasers in Surgery and Medicine, 2015, 47(4): 331-341.

[30] 李艳锦. 探讨综合护理干预在皮肤激光美容治疗中的应用效果［J］. 中国医疗美容, 2017, 7(12): 93-95.

王月莹, 李婵婵, 宋继权, 谢君. 激光在斑秃联合治疗中的应用进展[J]. 激光生物学报, 2021, 30(1): 30. WANG Yueying, LI Chanchan, SONG Jiquan, XIE Jun. The?Application?of?Laser?in?the?Combined?Treatment?for?Alopecia Areata[J]. Acta Laser Biology Sinica, 2021, 30(1): 30.

激光在斑秃联合治疗中的应用进展

关于本站 Cookie 的使用提示

全站搜索

激光在斑秃联合治疗中的应用进展

相关论文

相关资讯

关于本站 Cookie 的使用提示

全站搜索