作　　者： (李静）; (吴晓琰）; (陈晓栋）;

机构地区： 南通大学研究生院,江苏南通226001 常熟市第五人民医院皮肤性病科,江苏常熟215500

出　　处： 《临床皮肤科杂志》 2017年第9期629-632,共4页

摘　　要： 目的:探索瘢痕疙瘩皮损内注射药物的联合治疗方案。方法:共选取瘢痕疙瘩患者35例(90个皮损),采用随机表单盲法,将皮损分为3组(A、B、C组),分别进行皮损内注射复方倍他米松+A型肉毒素、复方倍他米松+氟尿嘧啶、单独复方倍他米松。以瘢痕体积、硬度、痒痛感觉及外观自我评价4项观察指标进行分析,运用统计学方法比较3种方法的疗效差异。结果:共32例患者的85个皮损完成试验(A组29个,B组28个,C组28个)。体积、硬度、外观自我评价各组间及组内配对比较P>0.05,差异无统计学意义;而在痒痛评分疼痛值上A组和C组疗程结束后,差异有统计学意义(P≤0.05),A组和B组、B组和C组差异无统计学意义(P>0.05)。结论:糖皮质激素联合A型肉毒素皮损内注射对于缓解瘢痕疙瘩痒痛有明显的疗效。 Objective： Exploring a better drug combination therapy to intralesional injection for keloid. Method： 90 skin lesions of 35 cases with keloid were selected and divided into 3 groups （A, B and C） with randomized single-blind method. The three groups were respectively injected intralesionally with compound betamethasone injection＋botulinum toxin type A, compound betamethasone injection＋fluorouracil and compound betamethasone injection alone. Four outcome measures were used for analysis which including the volume, hardness, itching sensation, and appearance self-evaluation. And statistical analysis was used to compare the efficacy of the three therapys. Results： The experiment was done in 85 lesions of 32 patients（group A 29, group B 28, group C 28）. The difference was not statistically significant on the clinical efficacy among and within three groups on improving keloid volume, hardness and appearance evaluation（P〉0.05）. However, the difference was statistically significant between group A and group C at the end of treatment concerning the pain threshold in tickle pain score（P〈0.05）. There was no statistical significance among group A and group B, group B and group C（P〉0.05）. Conclusion： Intralesional injection of glucocorticoid combined with botulinum toxin type A has an obvious curative effect on releasing itching sensation of keloid.

关 键 词： 瘢痕疙瘩 糖皮质激素 型肉毒素 疗效观察