【摘要】 目的 探讨聚焦超声与光动力疗法对女阴硬化性苔藓的治疗效果，并比较其疗效差异及安全性。方法 选取2021年6月—2023年6月本院收治的女阴硬化性苔藓患者112例为研究对象，按随机抽签法分为聚焦超声组和光动力组，每组56例，分别采用聚焦超声与光动力治疗。观察两组治疗前、治疗结束、治疗后3个月的症状与体征变化，比较两组临床疗效及治疗期间的不良反应。采用酶联免疫分析法检测两组患者治疗前、治疗结束、治疗后3个月的血清超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)、内皮素1(ET-1)水平，并进行比较。随访6个月，比较两组复发率。结果 共计94例完成治疗计划，其中聚焦超声组、光动力组各47例。两组外阴瘙痒、疼痛、弹性、色素在治疗结束时的评分以及血清hs-CRP、ET-1水平均低于治疗前，在治疗后3个月低于治疗结束时(均P<0.05)。光动力组治疗结束时以上指标评分低于聚焦超声组(均P<0.05),而治疗后3个月两组差异无统计学意义(P>0.05)。两组血清VEGF在治疗结束时的水平均高于治疗前，治疗后3个月的水平高于治疗结束时(均P<0.05)。光动力组治疗结束时血清VEGF水平高于聚焦超声组(P<0.05),而治疗后两组差异无统计学意义(P>0.05)。两组总有效率、总不良反应发生率、复发率比较差异无统计学意义(P>0.05)。结论 聚焦超声与光动力疗法治疗女阴硬化性苔藓的临床疗效、安全性及复发风险相当，但光动力疗法在控制炎症、组织损伤修复和缓解症状与体征方面起效更快。更多还原

【Abstract】 Objective To evaluate and compare the efficacy and safety of focused ultrasound versus photodynamic therapy for treating vulvar lichen sclerosus.Methods A total of 112 patients with vulvar lichen sclerosus treated at our hospital from June 2021 to June 2023 were enrolled in this study. Participants were randomly divided into two groups: the focused ultrasound group(n=56) and the photodynamic therapy group(n=56) by the random number table method. Changes in symptoms and signs were compared between the two groups at baseline, post-treatment, and 3-month follow-up. Clinical efficacy and adverse reactions during the treatment period were also compared. Serum levels of high-sensitivity C-reactive protein(hs-CRP), vascular endothelial growth factor(VEGF), and endothelin-1(ET-1) were detected using enzyme-linked immunosorbent assay(ELISA). A 6-month following-up was conducted to compare the recurrence rates between the two groups. Results Ninety-four patients completed the treatment, with 47 cases in each group. All measured parameters, including symptoms(itching, pain), signs(elasticity, pigmentation), and serum markers(hs-CRP, ET-1), were significantly reduced from baseline to the end of treatment in both groups(all P<0.05), with further significant reductions at the 3-month follow-up(all P<0.05 vs. at the end of treatment). At the end of treatment, these scores were significantly lower in the photodynamic therapy group than in the focused ultrasound group(all P<0.05). No significant differences were observed after the 3-month follow-up(P>0.05). Serum VEGF levels increased significantly from baseline to the end of treatment in both groups(P<0.05), with a further increase at the 3-month follow-up(P<0.05 vs. at the end of treatment). The photodynamic therapy group had significantly higher serum VEGF levels than the focused ultrasound group at the end of treatment(P<0.05), with no significant difference between the two groups after the 3-month follow-up(P>0.05). No significant differences were observed between the two groups in clinical efficacy, total effective rates, total adverse reaction rates, or recurrence rates(P>0.05). Conclusions Focused ultrasound and photodynamic therapy demonstrate comparable clinical efficacy and safety in treating vulvar lichen sclerosus, with similar recurrence risks. However, photodynamic therapy exhibits a faster onset of action in controlling inflammation, promoting tissue repair, and alleviating symptoms and signs.更多还原