| ObjectiveThe clinical efficacy and safety of photodynamic therapy(PDT)combined with isotretinoin,photodynamic therapy alone and isotretinoin alone in the treatment of moderate to severe acne were compared,and the clinical value of photodynamic therapy combined with isotretinoin was discussed.Methods90 patients with moderate and severe acne who met the conditions were randomly divided into three groups: Isotretinoin group,PDT group and PDT combined with isotretinoin group.Isotretinoin group: Isotretinoin capsule,10 mg / time,twice / day,oral 30 days.PDTgroup: 5% 5-of 5-aminolevulinic acid(5-ALA)gel was applied to the skin lesions after cleansing.The film was wrapped in plastic wrap.After 1.5 hours of exposure,it was irradiated with a red light therapeutic apparatus.The dose was 80J/cm-100J/cm-100J/cm,and the illumination time was 20 minutes,treat every 10 days.PDT combined with isotretinoin group: give oral isotretinoin,the method is the same as that of isotretinoin group,and at the same time give PDT treatment,the method is the same as that of PDT group.Before and during the treatment,the skin lesions of all patients were counted by random double-blind method,recorded adverse reactions and judged the efficacy.The skin lesions of three groups were counted at 10 days,20 days and 30 days during the treatment,the curative effect was determined at 30 days and 60 days.The treatment was stopped when the clearance rate of skin lesions ? 60%,and the longest course of treatment was no more than 2 months.The patients were followed up 1,3 and 6 months after the treatment.Results1.The clearance rate of non-inflammatory skin lesions inflammatory skin lesions and total skin lesions in the group of PDT plus isotretinoin on the 10 th,20th and 30 th day was significantly better than that in the group of isotretinoin;the clearance rate of non-inflammatory skin lesions and total skin lesions in the group of PDT plus isotretinoin on the 10 th,20th and 30 th day was significantly better than that in the group of PDT;the clearance rate of inflammatory skin lesions in the group of PDT plus isotretinoin on the 30 th day was significantly better than that in the group of PDT.2.Curative effect the efficiency was 6.90% in isotretinoin group,14.81% in PDT group and 62.96% in PDT plus isotretinoin group at 30 days during the treatment.The effect of photodynamic therapy combined with isotretinoin was better than that of isotretinoin group and PDT group(P < 0.05).The efficiency was 65.52% in isotretinoin group,100% in PDT group and 100% in PDT plus isotretinoin at 60 days during the treatment.The effect of photodynamic therapy combined with isotretinoin and PDT was better than that of isotretinoin(P < 0.05).3.The course of treatment the average course of treatment in PDT group was 45.19 ± 8.02 days,and that in PDT plus isotretinoin group was 40.74 ± 7.30 days.Compared with PDT group,the course of photodynamic therapy combined with isotretinoin was significantly shorter,with statistical difference(P < 0.05).4.Adverse reactions there was no significant difference in PDT plus isotretinoin group compared with isotretinoin group and PDT group(P > 0.05).5.Recurrence rates During the follow-up,the recurrence rates of isotretinoin group,PDT group and PDT plus isotretinoin group were 20.69%,8.11% and 7.41% at the end of one month,34.48%,18.52% and 14.81% at three months,55.17%,29.62% and 25.93% at six months.The recurrence rate of PDT plus isotretinoin group was significantly lower than that of the group of isotretinoin at six months.(P < 0.05).Conclusions1.PDT combined with isotretinoin is better than PDT alone and isotretinoin alone in the treatment of moderate and severe acne.2.Photodynamic therapy combined with isotretinoin has a faster effect in the treatment of moderate and severe acne.The course of treatment is shorter than that of PDT alone.The recurrence rate is low,and has good security.3.Photodynamic therapy combined with isotretinoin is worthy of clinical application. |
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