| Objectives:(1)To analyse the clinical characteristics and the previous treatment with acne,provided the basis for improving the curative effect of acne.(2) To observe the clinical curative effect by using drug combine with glycolic acid and intense pulsed light to treat the moderate acne, provided the basis for optimize the treatment of acne.Methods:(1)Clinical analysis:Using the questionnaire survey,which including general data, acne related information and the previous treatment. Evaluate patients lesion and direct to fill out a form by the doctor. The severity of acne, the types of acne (adolescent and adult acne acne) and women with polycystic ovary correlation statistical analysis using SPSS 19.0 software.(2) Clinical observation:Using the prospective cohort study,follow-up the patients with moderate acne who are treated by Five different treatments.In all 215 patients, there are 51 patients choose drug therapy (oral minocycline, tanshinone capsule, vitamin B6 tablets),45 patients choose drug combined with red and blue Light Emitting Diode(LED) phototherapy,46 patients choose drug combined with glycolic acid,3326 patients choose drug combined with intense pulsed light, and patients choose drug combined with glycolic acid and intense pulsed light. Follow-up and keep a record of curative effect and adverse reactions. All the statistical analysis of curative effect using SPSS 19.0 software.Results:(1)Clinical analysis:The severity of skin lesions and the types of acne in sex differences:in all 349 patients,79 patiens (22.6%) are Level 1 (mild), with accounting for 23 males and 56 females,146 patiens (41.8%) are Level 2 (moderate), with accounting for 48 males and 98 females,97 patiens (27.8%) are Level 3 (moderate), with accounting for 35 males and 62 females,27 patiens(7.7%) are Level 4 (severe), with accounting for 12 males and 15 females.243 patients are moderate acne (69.6%). In all 349 patients,254 patients(72.8%) are adolescent acne, with accounting for 87 males and 167 females.95 patients(27.2%) are adult acne, with accounting for 31 males and 64 females. Types of acne(adolescent acne/adult acne) have no significant difference between male and female patients(x2=0.081, P>0.05). In all 64 adolescent acne female patients,48 patients had persistent,16 had late-onset. In all 31 adolescent acne male patients,all 31 patients had persistent. Adult acnes were mainly persistent both in males and females, but the proportion of late-onset acnes was higher in females than in males, the difference was significant (χ2=9.320, P< 0.05). Related study between polycystic ovary and acne:in all 91 female patients whose skin lesion is aggravated before menstruation,31 patients are abnormal menstruation,17 patients of them had polycystic ovary.60 patients are eumenorrhea,4 patients of them had polycystic ovary. Whose skin lesion is aggravated before menstruation and their menstrual abnormalities may have associated with polycystic ovary[χ2=26.719, OR=17.000,95%CI (4.936-58.549), P<0.05].21 patients with polycystic ovary, the severity of skin lesions mainly is moderate acne,the lesion generally distributes in the both sides cheek and jaw. The previous treatment:there are 320 cases of patients in all 349 patients(91.7%) have received acne treatment, Among them,198 patients (61.9%)thought their previous chemotherapy have no effect.271 patients (77.61%)have received oral drug treatment,245 patients (90.4%) received oral Chinese medicine treatment,65 patients (24.0%) received oral antibiotic treatment,68 patients(25.1%) received oral vitamin A acid drugs treatment,39 patients (14.4%) received oral antiandrogen drug treatment,5 patients (1.8%) received oral glucocorticoid treatment.Among them, the treatment time of 77.7% of the patients is less than 1 month. In 349 patients there are 263 cases (75.4%) used medicine for external use,136 (51.7%) patients had external use traditional Chinese medicine,112 (42.6%) patients had external used antibiotic drugs,89 (33.8%) patients had external used vitamin A acid drugs,34 patients (12.9%) had topical benzoyl peroxide, 29(11.0%) patients had external used sulfur agents,5 cases (1.9%) patients had external used corticosteroids; 52 patients (19.8%) said they have erythema after external use medicine,74 cases (28.1%) patients experienced desquamation,19 cases (7.2%) patients’skin become sensitive. Among them, the treatment time of 51.0% of the patients is less than 1 month. In 349 patients,there are 193 cases (55.22%) had local beauty treatment,170 (88.1%) patients underwent acne extrusion technique,121 (62.7%) patients underwent the red and blue light treatment,29 (15.0%) patients underwent acidity treatment,19 (9.8%) patients underwent intense pulsed light treatment,5 (2.6%) patients patients underwent lattice laser treatment.Among them, the treatment time of 77.7% of the patients is less than 1 month.(2)Clinical observation:The effective rate of treatment of drugs(mmocycline, tanshinone capsule, vitamin B6 tablets) combined with glycolic acid and intense pulsed light group(97.0%) is obviously higher than the pure drug therapy group (39.7%), drug combined with red blue light treatment group (48.9%), and drugs combined with acidity treatment group (76.1%), drugs combined with intense pulsed light therapy group (78.8%). There differences between drug combined with glycolic acid and intense pulsed light group with the other four groups showed statistical significance (P< 0.005). There is no serious adverse during treatment.No serious adverse events occurred during the treatment.(2)Clinical observation:The effective rate of treatment of drugs(minocycline, tanshinone capsule, vitamin B6 tablets) combined with glycolic acid and intense pulsed light group(97.0%) is obviously higher than the pure drug therapy group (39.7%), drug combined with red blue light treatment group (48.9%), and drugs combined with acidity treatment group (76.1%), drugs combined with intense pulsed light therapy group (78.8%). There differences between drug combined with glycolic acid and intense pulsed light group with the other four groups showed statistical significance (P< 0.005). There is no serious adverse during treatment.No serious adverse events occurred during the treatment.Conclusions:(1) The patients are mainly moderate acne. Women are more likely to have late-onset acne,.Female patients with acne whose Skin lesions increased before menstruation and menstrual abnormalities may have polycystic ovary.The lack of targets on drug selection, the adverse reactions of external medication,the inaccurate methods selection on local beauty treatment, and the irregular treatment cycle is the key factors that influence the acne treatment effect. To know the clinical features and the previous treatment of patients helps us to develop targeted treatment plan, ensure patients visit regularly, in order to improve treatment effect.(2) The drugs(minocycline, tanshinone capsule, vitamin B6 tablets) combined with glycolic acid and intense pulsed light is superior to the pure drug or drug combined with single medical cosmetology treatment, can get better treatment effect.The side-effect is less and worth to apply in clinics. |
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