【摘要】 目的：评估小能量、低密度新型1 927 nm铥激光联合妥塞敏治疗黄褐斑的临床疗效及安全性。方法：选取30例黄褐斑患者(Fitzpatrick皮肤Ⅲ～Ⅳ型)，随机分为1 927 nm+妥塞敏组和妥塞敏组。1 927 nm+妥塞敏组采用新型1 927 nm铥激光联合妥塞敏治疗，1 927 nm铥激光治疗重复次数1或2次，治疗间隔4～8周，接受3～5次治疗；妥塞敏口服250毫克/次，早晚各一次，口服3个月；妥塞敏组口服妥塞敏，用法同1 927 nm+妥塞敏组。由两位研究者评估治疗前、治疗后1个月、3个月和6个月改良的黄褐斑面积及严重程度指数(mMASI)评分、医生整体评价法(Physician global assessment,PGA)、患者自评以及不良反应。结果：与治疗前相比，两组治疗后1个月、3个月及6个月mMASI评分下降，差异有统计学意义(P=0.000)；1 927 nm+妥塞敏组治疗后1个月、3个月的mMASI评分下降大于妥塞敏组，差异均有统计学意义(P=0.001，P=0.005)；同时，1 927 nm+妥塞敏组治疗后1个月、3个月的PGA评分优于妥塞敏组，差异有统计学意义(χ~2=5.932，P=0.035；χ~2=7.897，P=0.016)；1 927 nm+妥塞敏组治疗后无明显红斑、水肿、色素沉着以及疼痛等不良反应。结论：新型1 927 nm铥激光联合妥塞敏治疗黄褐斑安全有效，值得临床推广应用。更多还原

【Abstract】 Objective To evaluate the clinical efficacy and safety of a novel 1 927 nm thulium laser combined with Transamin in the treatment of Melasma.Methods A total of 30 subjects(Fitzpatrick Ⅲ skin-Ⅳ type) were randomly divided into 1 927 nm+Transamin group and Transamin group.The experimental group was treated with a novel 1 927 nm thulium laser combined with Transamin.The number of 1 927 thulium laser repeats was 1 or 2.Treatment interval was 3 to 5 sessions,and 4 to 8 weeks.Transamin was taken orally 250 mg/time,once in the morning and once in the evening,for 3 months.The control group was given Transamin orally,the same as the experimental group.Modified melasma area and severity index (mMASI) score,Physician Global Assessment(PGA),patient self-assessment,and adverse events were assessed by two investigators before treatment,1,3,and 6 months after treatment.Results Compared with previous treatment,the mMASI scores in both groups improved to varying degrees 1,3 and 6 months after treatment,with statistical significance(P=0.000).In the experimental group,mMASI scores descends greater than the control group to varying degrees 1 and 6 months after treatment,with statistical significance (P=0.001,P=0.001).Meawhile,the PGA scores in 1 and 3 months after treatment were better than the control group,with statistical significance(χ~2=5.932,P=0.035,χ~2=7.897,P=0.016).There were no adverse reactions of erythema,edema,chromatism and pain in the treatment group.Conclusion The new 1 927 nm thulium laser combined with Transamin is safe and effective in the treatment of melasma,which is worthy of clinical application.更多还原