【摘要】 目的 评估复合中层酸联合30%超分子水杨酸对黄褐斑的治疗效果。方法 选取中山大学附属第三医院2022年5—12月收治的5例女性黄褐斑患者，采用自身平行对照研究。试验侧在第0周与第4周使用复合中层酸，第8周使用30%超分子水杨酸。对照侧在第0周与第4周使用30%超分子水杨酸，第8周使用复合中层酸。评估患者面部皮损面积、颜色、油脂、含水量的情况及患者心理影响程度，综合评估联合方法的疗效。结果 治疗后，试验侧额部、颊部及下颌黄褐斑的面积评分分别由4.00降至3.40、4.60降至4.20、2.20降至2.00(均P<0.05),对照侧仅额部评分下降；试验侧及对照侧额部、颊部、下颌皮损颜色评分均下降，且试验侧额部、颊部皮损颜色的降幅均显著高于对照侧(P<0.05);试验侧及对照侧的皮肤油脂均显著升高，试验侧的提升高于对照组(P<0.05);两侧皮肤含水量均呈升高趋势，试验侧由60.32%升高至70.21%,对照侧由55.63%升高至68.47%,但两侧升高程度无明显差异(P>0.10)。治疗后患者的SAS评分为20.86±6.44,较治疗前(21.62±5.99)下降(P<0.05);SDS评分为23.33±5.12,较治疗前(25.05±4.21)亦显著降低(P=0.024)。结论 复合中层酸联合30%超分子水杨酸治疗黄褐斑，能显著改善患者的面部皮损情况及心理状态；先使用复合中层酸，再使用30%超分子水杨酸可取得更好效果。更多还原

【Abstract】 Objective To evaluate the therapeutic efficacy of a combination of compound middle-layer acid and 30% supramolecular salicylic acid for melasma. Methods Five female patients with melasma who were admitted to our hospital from May 2022 to December 2022 were enrolled in this study. A self-parallel controlled study was carried out. The patients′ treated side was treated with compound middle-layer acid while the control side was treated with 30% supramolecular salicylic acid at weeks 0 and 4. On week 8, the treated side and control side were treated with 30% supramolecular salicylic acid and compound middle-layer acid, respectively. We compared the area score of facial lesions, skin color, sebum, water content and the severity of melasma-related psychological stress between the two sides. Results The combination therapy significantly decreased the area scores on the forehead, cheek and chin(P<0.05). In contrast, only the area scores on the forehead were decreased on the control side. Although the color scores were decreased on the forehead, cheek and chin of both sides, significant decrease was observed on the treated side(P <0.05 vs. the control side). Similarly, both treatments increased sebum content, with a prominent increase on the treated side(P<0.05 vs. the control side). The changes in water content did not differ significantly between these two treatments(P>0.10). Moreover, the combination therapy decreased both SAS(from 21.62±5.99 to 20.86±6.44, P<0.05) and SDS scores(from 25.05±4.21 to 23.33±5.12, P<0.05). Conclusions The combination therapy of compound middle-layer acid and 30% supramolecular salicylic acid can significantly improve the facial skin lesions and psychological state of patients with melasma. Better results can be achieved by using compound middle-layer acid first, followed by 30% supramolecular salicylic acid.更多还原