摘要
目的 旨在研究聚焦超声联合“消痤汤”对皮脂成分中角鲨烯、亚油酸的影响，观察聚焦超声治疗痤疮后临床疗效。方法 选取 2021年10月至 2022年12月期间就诊于贵州中医药大 学第一附属医院皮肤科门诊的脾胃湿热型粉刺患者为研究对象，纳入符合要求的40名患者，脱落2名，剩余38名采取自身半脸对照，在内服“消痤汤”基础上，观察组（左侧脸）予聚焦超声治疗，1次/月，对照组（右侧脸）予颠倒散外敷，隔日一次，1月后通过治疗前后主观指标及客观指标，评估超声刀联合“消痤汤”临床疗效。客观指标包括：通过高效液相色谱分析检测法（high-perfromance liquid chromagraphy，HPLC）测定皮脂中角鲨烯及亚油酸含量、VISIA红斑区及紫质区评分比较、皮脂前后重量比较；主观指标包括全球痤疮综合分级系统(Global Acne Integrated Grading System GAGS）观察评分比较。结果 通过GAGS评分，治疗后患者两侧面部皮损区均有改善((观察组：Z＝-4.825，对照组：-4.346，P＜0.001),有统计学差异；但治疗后两侧面部组间GAGS评分无统计学意义（Z＝-0.117，P＞0.05）；观察组、对照组治疗后VISIA紫质、红斑均具有显著的统计学意义(P＜0．001)，紫质区域组间比较发现，观察组增幅明显高于对照组（Z＝-2.346，P＜0.05）；观察组治疗后角鲨烯含量含量明显降低，差异具有统计学意义（Z＝-4.837，P＜0.001），亚油酸含量有降低趋势，但无统计学意义（Z＝-1.647，P＞0.05）；聚焦超声治疗后同颠倒散外敷一样，具有临床疗效性。结论 聚焦超声联合“消痤汤”治疗对痤疮具有临床疗效；聚焦超声能有效改善面部炎症及油脂分泌；聚焦超声能降低皮脂成分中角鲨烯，但对亚油酸无明显影响作用。
关键词： 消痤汤；痤疮；皮脂；角鲨烯；亚油酸
Abstract
Objective To study the effect of focused ultrasound combined with Xiaocuo Decoction on squalene and linoleic acid in sebum, and to observe the clinical effect of focused ultrasound in the treatment of acne. Methods A total of 40 patients with dampness-heat acne of the spleen and stomach admitted to the Dermatology Department of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from October 2021 to December 2022 were selected as the study subjects. Two of them fell off, and the remaining 38 were treated with half-face control. On the basis of taking Xiaocuo Decoction internally, Observation group (left face) was given focused ultrasound treatment once a month, while control group (right face) was given reversed scattered external application once every other day. One month later, the clinical efficacy of ultrasonic knife combined with "Xiaocuo decoction" was evaluated by subjective and objective indicators before and after treatment. Objective indicators included: determination of squalene and linoleic acid content in sebum by high performance liquid chromatography (HPLC), comparison of scores in VISIA erythema region and violet region, weight before and after sebum; Subjective indicators included the Global Acne Integrated Grading System GAGS observation score comparison. Results According to GAGS score, both sides of the facial lesions were improved after treatment (observation group: Z = -4.825, control group: -4.346, P < 0.001), with statistical difference. However, there was no statistical significance in GAGS scores between the two facial groups after treatment (Z = -0.117, P > 0.05). After treatment, VISIA violet and erythema in the observation group and the control group were statistically significant (P < 0.001), and the increase rate of violet region in the observation group was significantly higher than that in the control group (Z = -2.346, P < 0.05). After treatment, the content of squalene in the observation group was significantly decreased, the difference was statistically significant (Z = -4.837, P < 0.001), and the content of linoleic acid had a trend of decrease, but there was no statistical significance (Z = -1.647, P > 0.05). The focused ultrasound treatment is as effective as external application of reverse powder. Conclusion Focused ultrasound combined with "Xiaocuo Decoction" has clinical effect on acne. Focused ultrasound can effectively improve facial inflammation and oil secretion. Focused ultrasound can reduce the content of squalene in sebum, but has no obvious effect on linoleic acid, which may reduce the secretion of oil and change the composition of oil.
Key words： Xiaocuo Decoction; Acne; Sebum; Squalene; Linoleic acid
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