左旋維C聯合氨甲環酸射頻導入治療黃褐斑的臨床研究

王興 曲燕

[摘要]目的：觀察左旋維C聯合氨甲環酸射頻導入治療黃褐斑的療效與安全性。方法：選取50例黃褐斑患者，依次射頻導入左旋維C精華液和氨甲環酸精華液，每周1次，共8周。治療中每周及總療程結束后1周隨訪，通過治療前后拍照、無創性皮膚生理功能測試、患者滿意度調查問卷等評估療效以及不良反應。結果：治療結束后，40例患者皮損得到改善，總有效率達80.00%。MASI評分由（24.25±9.26）分降為（15.15±6.55）分（P＜0.05）。面部TWEL值減少、皮膚含水量增加、黑色素含量降低，差異均有統計學意義（P＜0.05）。不良反應輕微。結論：左旋維C聯合氨甲環酸射頻導入治療黃褐斑療效好、安全性高，且隨著治療次數的增加效果更明顯，值得在臨床推廣應用。

[關鍵詞]左旋維C；氨甲環酸；射頻導入；黃褐斑

[中圖分類號]R758.4+2? ? [文獻標志碼]A? ? [文章編號]1008-6455（2023）05-0022-04

Clinical Observation on the Efficacy of Tranexamic Acid Combined with L-ascorbic Acid Imported with Radiofrequency in the Treatment of Melasma

WANG Xing1，QU Yan2

（1.Department of Dermatology，the Affiliated Hospital of Weifang Medical University，Weifang 261035，Shandong，China; 2.Department of Dermatology，Yantai Yuhuangding Hospital Affiliated to Qingdao University School of Medicine，Yantai 264000，Shandong，China）

Abstract： Objective? To observe the effect and safety of melasma treated by L-ascorbic acid imported with radiofrequency combined with tranexamic acid. Methods? Fifty patients with melasma were selected to receive L-ascorbic acid combined with tranexamic acid imported with radiofrequency once a week for 8 weeks.During the treatment， the patients were followed up every week and one week after the end of the total course of treatment. The efficacy differences and adverse reactions were evaluated by taking photos before and after treatment， non-invasive skin physiological function test， patient satisfaction questionnaire， etc. Results? The treatment effect increases with the increase of treatment times.After the total course of treatment， the skin lesions of 40 patients were improved， and the total effective rate was 80.00%.The MASI score decreased from （24.25±9.26） points to （15.15±6.55）points（P＜0.05）.Facial TWEL value decreased， skin moisture content increased， and melanin content decreased， the differences were statistically significant（P＜0.05）. The adverse reactions were mild. Conclusion? L-ascorbic acid combined with tranexamic acid radiofrequency induction in the treatment of melasma has good efficacy and safety， and the effect is more obvious with the increase of treatment times， which is worthy of clinical application.

Key words： L-ascorbic acid; tranexamic acid; radiofrequency; melasma

黃褐斑（Melasma）是一種臨床常見的慢性、獲得性色素增加性皮膚病，亞洲育齡期女性發病率高達30%，且逐年增加。黃褐斑的病因復雜，發病機制尚未完全清楚。臨床表現以面部常見，為對稱分布深淺不一的淡褐色或深褐色斑片。黃褐斑易診難治，包括口服及局部外用藥物、化學剝脫及光電治療等，均易復發，難治愈。對患者造成精神上的壓力，影響其工作、學習及生活等。氨甲環酸（Tranexamic acid，TA）可競爭性抑制酪氨酸酶，減少黑色素合成，同時抑制血管增生，減輕紅斑。左旋維C能阻止多巴氧化，抑制黑色素合成。筆者采用射頻導入氨甲環酸聯合左旋維C治療黃褐斑50例，取得了較好的臨床療效，且不良反應少。……