三种治疗方法对增生性瘢痕临床疗效的分析

Analysis of the Clinical Effect of Three Treatment Methods on Hypertrophic Scar

摘要: 目的：探讨CO₂点阵激光联合曲安奈德和A型肉毒素治疗增生性瘢痕的影响。方法：将93例增生性瘢痕患者随机分为3组，A组为对照组，给予CO₂点阵激光治疗处理，B、C为观察组，分别给予CO₂点阵激光联合曲安奈德治疗和CO₂点阵激光联合A型肉毒素治疗。观察并比较三组患者的临床疗效。结果：结果显示，B、C组总有效率、患者VSS评分、疼痛和瘙痒评分、瘢痕厚度指标均高于A组(p < 0.05)，其中，C组结果最优；B、C组复发率显著低于A组(p < 0.05)；此外，B、C组治疗后的血清炎症因子(IFN-γ、IL-2、TNF-α和IL-6)水平及免疫功能(IgA、IgG和IgM)均显著低于A组(p < 0.05)，且C组治疗效果最优。结论：CO₂点阵激光联合曲安奈德治疗和A型肉毒素治疗效果比单纯使用CO₂点阵激光治疗效果好，且CO₂点阵激光联合A型肉毒素治疗效果最佳，不良反应较少。

Abstract: Objective: To investigate the effect of CO₂ fractional laser combined with triamcinolone acetonide and botulinum toxin type A in the treatment of hypertrophic scar. Methods: 93 patients with hypertrophic scar were randomly divided into three groups. Group A was the control group, which was treated with CO₂ fractional laser. Group B and C were the observation group, which were treated with CO₂ fractional laser combined with triamcinolone acetonide and CO₂ fractional laser combined with botulinum toxin type A, respectively. The clinical efficacy of the three groups was observed and compared. Results: The results showed that the total effective rate, VSS score, pain and pruritus score, and scar thickness index in groups B and C were higher than those in group A (p < 0.05), and the results in group C were the best. The recurrence rate of group B and C was significantly lower than that of group A (p < 0.05). In addition, the levels of serum inflammatory factors (IFN-γ, IL-2, TNF-α and IL-6) and immune function (IgA, IgG and IgM) in groups B and C after treatment were significantly lower than those in group A (p < 0.05), and the treatment effect in group C was the best. Conclusion: The effect of CO₂ fractional laser combined with triamcinolone acetonide and botulinum toxin type A is better than that of CO₂ fractional laser alone, and the effect of CO₂ fractional laser combined with botulinum toxin type A is the best, with fewer adverse reactions.