不同剂量异维A酸联合超分子水杨酸治疗对中重度痤疮患者治疗安全性和负性情绪的影响

Effects of different doses of isotretinoin combined with supramolecular salicylic acid on treatment efficacy, safety, and negative emotions in patients with moderate to severe acne

摘要:

目的 探讨不同剂量异维A酸联合超分子水杨酸治疗对中重度痤疮患者的疗效、安全性和对负面情绪的影响。方法 选取2019年8月—2023年8月江南大学附属无锡五院皮肤科和无锡市康复医院皮肤科接收的中重度痤疮患者93例。根据不同治疗方式将患者分为对照组、联合A组和联合B组，每组31例。对照组仅接受30%超分子水杨酸治疗，联合A组在对照组的基础上口服0.2 mg/（kg·d）的低剂量异维A酸，联合B组在对照组的基础上口服0.5 mg/（kg·d）的常规剂量异维A酸；3组均治疗8周。比较3组患者治疗8周后的临床疗效，以及治疗前、治疗1、4、8周后的皮损数量，通过VISIA数字皮肤分析仪评估患者治疗前后的皮肤生理指标，通过一般自我效能感量表（GSES）和积极情感消极情感量表（PANAS）评估患者治疗前后的心理状态，比较两组患者的不良反应。结果 3组治疗前、治疗1、4、8周后皮损数量比较，结果 ①不同时间点的皮损数量比较，差异有统计学意义（F =2 539.401，P =0.000）；②3组的皮损数量比较，差异有统计学意义（F =50.171，P =0.000），联合A组、联合B组的皮损数量少于对照组；③3组皮损数量的变化趋势比较，差异有统计学意义（F =4.986，P =0.000）。与对照组比较，联合A组和联合B组的治疗总有效率均更高（P <0.05）。联合A组和联合B组治疗前、治疗8周后皮肤生理指标（红色区、紫质、斑点、毛孔、纹理）评分的差值均高于对照组（P <0.05）。联合A组治疗前、治疗8周后心理状态评分（GSES、积极情绪评分、消极情绪评分）的差值高于对照组和联合B组（P <0.05）。与联合B组比较，对照组和联合A组的不良反应总发生率均更低（P <0.05）。结论 低剂量异维A酸联合超分子水杨酸有助于提高中重度痤疮患者的治疗效果，并降低患者的负性情绪。

Abstract:

Objective To explore the efficacy, safety, and impact on negative emotions of different doses of isotretinoin combined with supramolecular salicylic acid in the treatment of moderate to severe acne.Methods A total of 93 patients with moderate to severe acne who were treated at the Dermatology Departments of Wuxi Fifth Hospital Affiliated to Jiangnan University and Wuxi Rehabilitation Hospital from August 2019 to August 2023 were selected. Patients were randomly assigned to three groups: the control group, the combined A group, and the combined B group, with 31 patients in each group. The control group received 30% supramolecular salicylic acid treatment only. The combined A group received 0.2 mg/(kg·d) of low-dose isotretinoin in addition to the control treatment. The combined B group received 0.5 mg/(kg·d) of standard-dose isotretinoin in addition to the control treatment. All treatments lasted 8 weeks. Clinical efficacy, number of skin lesions before and after treatment at 1, 4, and 8 weeks, skin physiological indicators before and after treatment using the VISIA digital skin analyzer, and psychological status using the General Self-Efficacy Scale (GSES) and Positive and Negative Affect Schedule (PANAS) were compared among the three groups. Adverse reactions were also recorded.Results Significant differences were observed in the number of skin lesions at different time points (F = 2,539.401, P = 0.000). The number of lesions in the combined A and B groups was significantly lower than in the control group (F = 50.171, P = 0.000). There were also significant differences in the trend of changes in lesion numbers among the groups (F = 4.986, P = 0.000). The total effective rate was higher in the combined A and B groups compared to the control group (P < 0.05). The combined A and B groups showed greater improvements in skin physiological indicators (redness, pigmentation, spots, pores, texture) compared to the control group (P < 0.05). The combined A group had better psychological status scores (GSES, positive and negative emotion scores) before and after treatment compared to the control and combined B groups (P < 0.05). The incidence of adverse reactions was lower in the combined A and control groups compared to the combined B group (P < 0.05).Conclusion Low-dose isotretinoin combined with supramolecular salicylic acid improves the treatment outcomes for moderate to severe acne and reduces negative emotions in patients.