The Clinical Study Of The Combination Therapy In Moderate To Severe Acne

Objective:To explore the clinical efficacy and safety of the combination therapy in moderate to severe acne.Methods:According to the diagnostic criteria and severity of acne, we selected 100 cases of moderate to severe acne from outpatients, aged between 15-35. They were randomly divided into three groups:22 cases for group A,50 cases for group B, and 28 cases for group C. Learnt the basic conditions of these patients and the relevant factors of the onset detailly, and explained the considerations to these patients carefully before treatment. These patients cleaned facial skin before each time of treatment. A same observer determined the extent and type of the lesions, recorded the conditions of the lesions, and evaluated the efficacy and safety. The Nikon D60 digital camera (Japan) acquested the images of skin lesions. Three groups used high-intensity blue light (405-420nm, ClearLightTM, Lumenis US),15 minutes of irradiation each time,2 times per week,4 weeks for the study. Group A:triple therapy, phototherapy+oral minocycline+extrusion-mask molded, for continuous 4 weeks. Group B:dual therapy, phototherapy+extrusion-mask molded, for continuous 4 weeks. Group C:photo-therapy, for continuous 4 weeks. The observer observered the change of the lesions before and after the treatment and adverse reactions 4 weeks later.Results:The gender, age, disease progression and severity of acne of three groups of patients had no statistical differences (P>0.05). After treatment for 4 weeks, the average reduction rate of skin lesions of group A, Band C are 44.44%,23.47%, 16.07% respectively; the average reduction rate of the inflammatory skin lesions are 43.08%,23.57% ,16.21% respectively; the average reduction rate of non-inflammatory skin lesions (comedo) are 48.08%,23.67%,16.68% respectively. By Chi-square test, the effect of group A is higher than group B (χ=8.337, P=0.003, P <0.05), and the effect of group A is significantly higher than group C (χ=12.406, P=0.000, P<0.05), the differences are statistically meaningful; comparing the effect of group B with group C (χ(?)=1.311, P=0.252, P>0.05), the difference has no statistical significance. To inflammatory papules and pustulars, group A worked best, inflammatory nodules apparently receded. At the end of the treatment, out from 22 cases of group A,7 cases are recovery,1 case is excellent,14 cases are effective,0 case is invalid; out from 50 of group B,4 cases are recovery,2 cases are excellent,29 cases are effective,15 cases are invalid; out from 28 cases of group C,1 case is recovery,1 case is excellent,14 cases are effective,12 cases are invalid. Total effective rate of group A, B and C are 100.00%,70.00%,57.14%respectively. Two patients of group A had dizzy symptom after taken minocyclines by oral, the symptom decleared after 2 or 3 days spontaneously. One patient of group B and one patient of group C had adverse reactions. Adverse reactions included varying degrees of erythema, burning, dryness and desquamation. The differences of adverse reactions in three groups have no statistical significance. Without giving any special treatment, they recovered in the short term. No other adverse reactions occured during and after illumination. All of 100 patients participated in the study completed this observation, the symptom of most patients reduced significantly, and out of which 18 cases of non-obvious improvement had relatively mild illness. The acne of a few patients increased, which are often of sporadic comedoes and papules, causes may be related to daily stress, work or peak study, irregular sleep, etc.Conclusions:Using triple therapy, group A outperformed the others. Triple therapy in moderate to severe acne can act on multiple links of acne pathogenesis, their synergies enhance the effect. With the fast onset time, short courses, and the high remission rate, you can obtain a satisfactory outcome and no the apparent occurrence of adverse reaction. The treatment method has a high security. Single phototherapy or drugs for the treatment of acne has difficulties, and the combination therapy worthy to be applied by clinical dermatologist.