盐酸氨酮戊酸光动力治疗外阴硬化性苔藓的 疗效观察

Clinical efficacy of 5-aminolevulinic acid hydrochloride in photodynamic therapy for lichen sclerosus vulva

摘要:

目的 探讨盐酸氨酮戊酸光动力（ALA-PDT）治疗外阴硬化性苔藓（LS）的疗效及安全性。方法 选取40 例经病理检查确诊为外阴硬化性苔藓的患者，随机分为实验组和对照组，每组各20 例，实验组采用20% ALA-PDT，每2 周治疗1 次，治疗6 次。对照组局部外用0.1% 他克莫司软膏，2 次/d，治疗3 个月，观察两组 治疗效果和不良反应。结果 两组均完成19 例，治疗后，实验组总有效率为89.47%（17/19），对照组总有效率为 78.95%（15/19），两组疗效比较差异有统计学意义（P <0.05）。实验组的皮损面积（2.89±3.25）cm2、白斑（1.67± 1.21）、瘙痒（0.87±1.32）、症状/ 体征总分（7.64±5.63）分与对照组皮损面积（4.15±3.04）cm2、白斑（2.98±1.05）、 瘙痒（1.45±1.24）、症状/ 体征总分（9.72±6.47）分，组间比较差异有统计学意义（P <0.05）。两组均未见 明显的不良反应发生。结论 ALA-PDL 治疗LS 疗效高且安全性好。

Abstract:

Objective To explore the efficacy and safety of 5-aminolevulinic acid hydrochloride photodynamic therapy (ALA-PDT) in the treatment of lichen sclerosus vulva (LS). Methods Forty patients diagnosed with lichen sclerosus vulva were randomly divided into an experimental group and a control group with 20 patients in each group. The patients in the experimental group were treated with 20% ALA-PDT every 2 weeks for 6 times. The patients in the control group were treated with 0.1% Tacrolimus ointment in any on-spot treatment, twice per day for 3 months. The treatment effect and adverse reactions were observed in both groups. Results In each group, 19 patients completed the treatment. The total effective rate was 89.47% (17/19) in the experimental group and 78.95% (15/19) in the control group, there was a significant difference in therapeutic effect between the two groups (P < 0.05). In the experimental group, the lesion area was (2.89 ± 3.25) cm2, white spot score was (1.67 ± 1.21), pruritus score was (0.87 ± 1.32), symptoms/signs score was (7.64 ± 5.63); while in the control group the lesion area was (4.15 ± 3.04) cm2, white spot score was (2.98 ± 1.05), pruritus score was (1.45 ± 1.24), symptoms/signs score was (9.72 ± 6.47), the differences between the two groups were statistically significant (P < 0.05). There was no obvious adverse reaction in either group. Conclusions ALA-PDL is an effective and safe method for the treatment of LS.