| Objective:To study the efficacy of Q-switched Nd:YAG1064nm laser,oral Jingtian Quban tablet and Q-switched Nd:YAG1064nm laser combined with oral Jingtian Quban tablet in the treatment of melasma,and to further analyze and discuss its efficacy and safety.Methods:This study is a clinical study,the selected 121 cases are from February2019 to March 2021 patients with melasma in the Department of Dermatology and Aesthetics,the first people’s Hospital of Yunnan Province.All patients are diagnosed clearly,and can be treated regularly and voluntarily for follow-up.According to the principle of random distribution,the patients were divided into three groups.Laser treatment group:Q-switched Nd:YAG1064nm laser treatment for 12 weeks;drug treatment group:oral Jingtian Quban tablets,1.5g/(3 tablets),twice a day for 12weeks;combined treatment group:Q-switched Nd:YAG1064nm laser combined with oral Jingtian Quban tablets for 12 weeks.Before and after treatment,the patients were photographed and stored with a camera.Methods to evaluate the efficacy include:melasma area severity index modified(m MASI)score,melasma quality of life score(Melas QOL),non-invasive skin detection and so on.The data of three groups of patients before and after treatment were recorded,the occurrence of adverse reactions were counted and dealt with in time,and the data were compared and statistically analyzed.Results:A total of 121 patients,121 female women,0 male;40 laser therapies,41drugs,40 combination therapies;all patients average age were 36.75±7.49,and the average disease treatment was 7.05±5.16 years.1.After 12 weeks of treatment,the m MASI scores of patients with melasma in laser treatment group,drug treatment group and combination treatment group were2.60±1.44,1.53±0.96,2.91±1.12 respectively,and the difference was statistically significant(F=15.040,P<0.001).2.Two types of melasma:simple pigmented type(M type)and pigmented vascular type(M+V type)in different groups:the m MASI scores of patients with M type and M+V type before and after laser treatment were 2.95±1.62,2.03±0.83respectively,and the difference was statistically significant(t=2.040,P<0.05).The decrease of m MASI in patients with type M and type M+V before and after drug treatment was 1.50±0.77 and 1.58±1.20,respectively,and the difference was not statistically significant(t=0.249,P>0.05),and the decrease in m MASI before and after combined treatment in patients with type M and type M+V was 3.25±1.22,2.49±0.84.The difference was statistically significant(t=2.240,P<0.05).3.The decreasing values of Melas QOL in laser treatment group,drug treatment group and combined treatment group after treatment were 11.33±6.14,9.10±5.75,14.05±6.56 respectively,the difference was statistically significant(F=6.574,P<0.05).4.Satisfaction survey:the scores of patients’satisfaction in laser treatment group,drug treatment group and combined treatment group were 77.5%,67.9%and 84.0%,respectively.The difference among the three groups was statistically significant(χ~2=21.391,P<0.05).5.After treatment,the total effective rates of laser treatment group,drug treatment group and combination treatment group were 95%,68.3%and 100%,respectively.The difference of improvement rate among the three groups after treatment(χ~2=57.635,P<0.05).Conclusion:1.Q-switched Nd:YAG1064 nm laser and Q-switched Nd:YAG1064 nm laser combined with Jingtian Quban tablet is effective in the treatment of M-type melasma.2.Compared with the treatment of melasma with Jingtian Quban tablets combined with Q-switched Nd:YAG 1064nm laser,the therapeutic effect is higher than that of only oral Jingtian Quban tablets or Q-switched Nd:YAG1064nm laser. |
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