| Objective:To study the efficacy of intense pulsed light combined with external application of traditional Chinese medicine in the treatment of hypertrophic scar,and to evaluate its side effects,rebound and safety from the aspects of the melanin,hardness,color and subjective feelings of patients.to explore new rules and methods for the treatment of hypertrophic scar.Methods:The patients were selected from the Department of Dermatology,Shanxi Hospital of Integrated traditional Chinese and Western Medicine from September 2019 to January 2020.According to the admission criteria,54 patients were randomly divided into treatment group(n=27)and control group(n=27).The treatment group was treated with intense pulsed light plus external application of traditional Chinese medicine,and the control group was treated with intense pulsed light alone,and the scar sites of the two groups were recorded respectively.After the end of pulsed light therapy,the skin lesions were reexamined every week,once a month,3 times as a course of treatment,a total of 2courses of treatment,6 months after the end of follow-up.The treatment group was treated with traditional Chinese medicine for 30 minutes after intense pulsed light treatment,and then twice a week for a total course of 6 months.before treatment,the age,sex,course of disease,site of disease,length and thickness of scar were compared between the treatment group and the control group.The curative effect of scar was evaluated with Vancouver scale(VSS),visual analogue scale(VAS)and scar length after treatment.At the same time,from the melanin(M),thickness(H),vascular distribution(V),pliability(P)to compare each individual situation,analysis of side effects and rebound,and statistical description,and then clear the advantages of clinical treatment.Results:(1)The overall effective rate of the first course of treatment in the treatment group was better than that of the control group in the first course of treatment(P<0.05),and that of the treatment group was better than that of the control group in the second course of treatment(P<0.05).And the curative effect of the second course of treatment is better than that of the first course of treatment.(2)The effective rate of skin lesions in different parts of the treatment group was compared(P<0.05).In the comparison of curative effect and location,it was necessary to compare the correlation between hands and feet and the skin lesions of the other three parts(P<0.05).There was no significant difference in the curative effect among the other parts(P>0.05).It can be considered that the disappearance of scar in neck,trunk and limbs is better than that in hands and feet.(3)The total VSS scores of the patients in the treatment group after the first course of treatment,the second course of treatment and 6 months after follow-up showed that the short-term and long-term effects of the treatment group were higher than those of the control group.(4)The comparison of scar length between the two groups showed that the curative effect of the treatment group was better than that of the control group after any course of treatment(P<0.05).(5)The VAS scores of one course,two courses and follow-up of the two groups were compared,indicating that the curative effect of the treatment group was significant in different treatment stages.(6)After the first course of treatment,there was no significant difference in VSS score between the treatment group and the control group in terms of color,indicating that the curative effect of the treatment group was not better than that of the control group.There were significant differences in the thickness,vascular distribution and softness of each individual VSS score,indicating that during one course of treatment,the therapeutic effect of the treatment.(7)Adverse reactions in the treatment group were 7.4%,25.9% lower than those in the control group,and all the adverse reactions were mild symptoms,without severe shock,allergy and other serious reactions,and no special treatment was required.Conclusion:(1)The curative effect of intense pulsed light on hypertrophic scar needs enough course of treatment,and external application of traditional Chinese medicine can shorten the course of treatment and improve the relief of scar as a whole.One course of treatment can alleviate the degree of pruritus and improve the quality of life of patients.(2)The external application of intense pulsed light combined with traditional Chinese medicine can significantly improve the length,thickness and softness of the scar,reduce the hardness of the scar and soften the scar,and the external application of traditional Chinese medicine can significantly reduce the degree of pain and itching in a short course of treatment.the effects of clearing heat and relieving itching,promoting blood circulation and relieving pain are significant,and the long-term follow-up effect is long-term.(3)The external application of traditional Chinese medicine has a long-lasting effect on hypertrophic scar and is not easy to recur,which is related to the bidirectional regulation of metabolism of traditional Chinese medicine.(4)The curative effect of external application of traditional Chinese medicine on different parts of scar is different,which is related to the thickness of skin cuticle,light,joint activity,friction and other external factors.(5)The scar of the extremities,especially the hypertrophic scar of the joint movement,is affected by the joint activity and function,and the overall curative effect is worse than that of other parts of the body(such as neck,trunk),and the recovery time is long. |
