Efficacy Of Minocycline Combined With Tacrolimus And Red Blue Light In The Treatment Of Papulopustular Rosacea

Objective:To explore the efficacy of minocycline hydrochloride combined with tacrolimus and red-blue light in the treatment of papulopustular rosacea（PPR）and the case of improve the clinical symptoms of patients,also,to have information about whether the treatment can improve the quality of life of patients and the safety of treatment methods.Methods:All the 159 cases were PPR patients who visited the dermatology clinic of Cangzhou people’s Hospital from September 2018 to October 2020.They were randomly divided into groups A,B and C.Group A was treated with minocycline hydrochloride combined with 0.03%tacrolimus ointment and red-blue light,group B was treated with minocycline hydrochloride combined with 0.03%tacrolimus ointment,group C was treated with minocycline hydrochloride and red-blue light.（In group A,B and C,minocycline hydrochloride was 100mg/d;in group A and B,0.03%tacrolimus ointment was given twice a day before 4 weeks and once a day after 4 weeks;in group A and C,red-blue light was given once a week）.In addition,the three groups were routinely treated with medical moisturizers and the course of treatment was 8 weeks.The curative effect was observed by comparing each other.Before therapy（T₀）,after 2 weeks（T₁）,4 weeks（T₂）and 8 weeks（T₃）of treatment,a dermatologist who did not participate in the study took photos with camera and VISIA（45°left and right,front）keep file and record the score value in red area;The general condition of the patient was recorded by another dermatologist who was not involved in the study and according to the national rosacea society（NRS）established clinical score card to score clinical symptoms（using 4-grade scoring method.according to the clinical symptom score,the effective rates were calculated T₁、T₂、T₃stage）,and record adverse reactions and their improvement in treatment;the patients were asked and recorded according to the dermatology life quality index（DLQI）,among them,the values of VISIA red area score,clinical symptom score and DLQI score were lower,the better the effect.For the collected data,the comparison of general conditions,X² test was performed on the gender of three groups of patients,the age was tested by ANOVA,and the course of disease was tested by non parametric test（Kruskal Wallis H test）,P<0.05 showed that the difference was statistically significant;the effective rate was compared byX² test,P<0.05 showed that the difference was statistically significant,X² partition test was used for paired comparison between groups,P<0.0166 showed that the difference was statistically significant;repeated measures analysis of variance was used to test the clinical symptom score,VISIA red area value and DLQI score,P<0.05 indicated that the difference was statistically significant;adverse reactions were compared byX² test,P<0.05 showed that the difference was statistically significant.Results:1 159 patients were enrolled in the group,8 cases were excluded.There was no significant difference in the baseline of sex,age and course of disease between the three groups（P>0.05）.There was no significant difference in total symptom score、VISIA red area score and dermatosis quality of life index score before treatment among the three groups（P>0.05）.The three groups were comparable.2 The effective rate of group A,B and C in T1,T2 and T3 was tested byX² test andX² partition test.2.1 There was significant difference in the effective rate of T₁among the three groups（P<0.05）;The effective rate of group A is higher than that of group C and the difference is statistically significant（P<0.0166）,there was no significant difference between group A and group B（P>0.0166）,group B and group C（P>0.0166）.2.2 There was significant difference in the effective rate of T₂among the three groups（P<0.05）;there were significant differences between group A and group B（P<0.0166）and between group A and group C（P<0.0166）,the effective rate of group A was higher than that of group B and group C;there was no significant difference between group B and group C（P>0.0166）.2.3 There was significant difference in the effective rate of T₃among the three groups（P<0.05）;there was significant difference in the effective rate between group A and group B（P<0.0166）,between group A and group C（P<0.0166）;the effective rate of group A was significantly higher than that of group B and group C;there was no significant difference in the effective rate between group B and group C（P>0.0166）.3 The clinical symptom scores of the three groups decreased gradually with the treatment time.Repeated measurement analysis of variance was used for the clinical symptom scores of group A,B and C.3.1 The time effect（P<0.001）was statistically significant,indicating that with the extension of treatment time,the clinical symptom scores of the three groups were gradually reduced.3.2 There was significant difference in the effect between groups（P<0.05）.There was significant difference between group A and group B（P<0.05）,and there was significant difference between group A and group C（P<0.001）.The clinical symptom score of group A was smaller than that of group B and group C,but there was no significant difference between group B and group C（P>0.05）.3.3 The interaction effect（P<0.001）was statistically significant,indicating that the clinical symptom scores of the three groups changed with the change of treatment time,and the degree of change in each time period was not consistent.In T₁phase,there was significant difference between group A and group C（P<0.05）,but there was no significant difference between other groups（P>0.05）.At T₂stage,there was significant difference between group A and group B,group A and group C（P<0.05）,but there was no significant difference between group B and group C（P>0.05）.At T₃stage,there was significant difference between group A and group B,group A and group C（P<0.05）,but there was no significant difference between group B and group C（P>0.05）.The scores of T₁,T₂and T₃in group A were the lowest.4 There was no significant difference in the values of VISIA red zone score among the three groups before treatment（P>0.05）,and the scores gradually decreased with the treatment time.Repeated measurement analysis of variance was performed for the red zone score of group A,B and C.4.1 The time effect（P<0.001）was statistically significant,which indicated that the value of red area in each group changed with the change of treatment time,the longer the treatment time,the lower the value of the red area of VISIA.4.2 There were significant differences between groups（P<0.001）.By pairwise comparison,there were significant differences between group A and group B,between group A and group C,between group B and group C（P<0.001）,which indicated that there were differences in reducing the value of VISIA red area among the three groups,and the decrease in group A was the most significant.4.3 The interaction effect（P<0.001）was significantly different,which indicated that the reduction of the value of the red area of VISIA was not consistent at all treatment time points.In T₁stage,there was significant difference between group A and group B,group A and group C（P<0.001）,but there was no significant difference between group B and group C（P>0.05）;in T₂and T₃stage,there was significant difference between group A and group B,group A and group C,group B and group C（P<0.001）,which indicated that in T₂and T₃stage,there was significant difference in the value of VISIA red area score among the three groups,and group A was the lowest.5 There was no significant difference in DLQI scores among the three groups before treatment（P>0.05）,and the scores gradually decreased with the treatment time.The DLQI scores of group A,B and C were analyzed by repeated measures ANOVA.5.1 The time effect（P<0.001）was statistically significant,indicating that the DLQI scores of the three groups gradually decreased with the extension of treatment time.5.2 There was significant difference between groups（P<0.05）,paired comparison showed that there was significant difference between group A and group B,group A and group C（P<0.05）,but there was no significant difference between group B and group C（P>0.05）,indicating that group A was the most effective in reducing DLQI score among the three groups,while there was no significant difference between group B and group C.5.3 The difference of interaction effect（P<0.001）was significant,which indicated that the decline of DLQI score was not consistent at different time points of treatment.At T₁stage,there was no significant difference in DLQI score between group A and group B,between group A and group C,between group B and group C（P>0.05）.In T₂stage,there was significant difference between group A and group B（P<0.05）,but there was no significant difference between other groups（P>0.05）.At T₃stage,there were significant differences between group A and group B,between group A and group C,between group B and group C（P<0.001）,There was no significant difference in DLQI score among the three groups in T₁and T₂stage,but there was significant difference in DLQI score among the three groups in T₃stage,and the score of group A was the lowest.6 There were 17 cases with mild adverse reactions,there were 6 cases in group A,and the incidence of adverse reactions was 11.76%,there were 7cases in group B,and the incidence of adverse reactions was 14%,there were 4cases in group C,and the incidence of adverse reactions was 8%.There was no significant difference in the incidence of adverse reactions among the three groups byX² test（P>0.05）.Conclusion:Minocycline hydrochloride combined with 0.03%tacrolimus ointment,red-blue light in the treatment of papulopustular rosacea has good curative effect,quick onset and the treatment can significantly improve the clinical symptoms of patients.Also,the treatment has significant effect on the improvement of telangiectasia.Minocycline hydrochloride combined with0.03%tacrolimus ointment,red-blue light can significantly improve the quality of life of patients.At the same time,the treatment method has less adverse reactions,high safety,simple operation and low price.It’s easier to be accepted by patients.