摘要
目的比较射频微针与火针治疗面部痤疮的临床效果。方法选择2022年1月至2023年12月在温州市中西医结合医院治疗的面部痤疮患者90例为研究对象, 将每例患者两侧面部分为射频微针组和火针组, 治疗间隔2周, 共进行2次治疗。通过痤疮综合分级系统评分表(GAGS)评估患者两侧皮损的改善度, 并选择视觉模拟评分(VAS)评估患者疼痛程度, 统计不良反应发生率、复发率及满意度, 同时利用反射式共聚焦显微镜观察治疗前后皮损的影像学特征。结果治疗后2周、4周, 通过GAGS评估治疗效果, 射频微针组皮损的改善度分别为83.33%(75/90)、90.00%(81/90), 均高于火针组的70.00%(63/90)、78.89%(71/90)(χ^(2)=4.47、4.22, P=0.034、0.040)。射频微针组色素沉着发生率为4.44%(4/90), 稍高于火针组的2.22%(2/90), 但两侧总体不良反应发生率[15.56%(14/90)比20.00%(18/90)]差异无统计学意义(χ^(2)=0.60, P=0.436);与火针组[22.22%(20/90)]相比, 射频微针组复发率[10.00%(9/90)]更低(χ^(2)=4.97, P=0.026)。通过VAS评价疼痛度, 结果发现第1次治疗时、第2次治疗时射频微针组VAS评分分别为(4.12±1.33)分、(3.30±1.05)分, 稍高于火针组的(3.67±1.12)分、(2.88±0.86)分(t=2.45、2.93, P=0.015、0.004)。患者对射频微针组和火针组的治疗效果满意度[92.22%(83/90)比87.78%(79/90)]差异无统计学意义(χ^(2)=0.98, P=0.320)。用反射式共聚焦显微镜观察, 射频微针组和火针组患者治疗后毛囊漏斗形状清晰, 呈椭圆形, 漏斗直径较前明显的缩小, 中央的无定形的物质减少, 边缘明亮带范围缩小, 炎症细胞的浸润减少, 两组的改变无明显的区别。结论对于面部痤疮的炎性皮损(丘疹、脓疱), 经射频微针与火针治疗均有较好效果, 火针治疗时疼痛较轻, 而射频微针的复发率更低, 但色沉风险稍高。
Objective:To investigate the clinical effects of radiofrequency microneedling versus fire needle therapy on facial acne.Methods:Ninety patients with facial acne treated at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023 were included in this study.Each patient's facial areas were divided into a radiofrequency microneedling group and a fire needle group,with treatments conducted every 2 weeks for a total of two sessions.The improvement of skin lesions on both sides was assessed using the Global Acne Grading System(GAGS),while the Visual Analog Scale(VAS)was used to evaluate the severity of pain experienced by patients.The incidence of adverse reactions,recurrence rates,and patient satisfaction were statistically analyzed.Additionally,a reflective confocal microscope was used to observe the imaging characteristics of the lesions before and after treatment.Results:At 2 and 4 weeks post-treatment,GAGS results showed that the improvement rates for skin lesions in the radiofrequency microneedling group were 83.33%(75/90)and 90.00%(81/90),respectively,both of which were significantly higher than those in the fire needle group[70.00%(63/90),78.89%(71/90),χ^(2)=4.47,4.22,P=0.034,0.040].The incidence of pigmentation in the radiofrequency microneedling group was 4.44%(4/90),which was slightly higher than that in the fire needle group[2.22%(2/90)].However,there was no significant difference in overall incidence of adverse reactions between the radiofrequency microneedling and fire needle groups[15.56%(14/90)vs.20.00%(18/90),χ^(2)=0.60,P=0.436].The recurrence rate was lower in the radiofrequency microneedling group[10.00%(9/90)]compared with the fire needle group[22.22%(20/90),χ^(2)=4.97,P=0.026].The VAS score for the radiofrequency microneedling group was(4.12±1.33)during the first treatment and(3.30±1.05)during the second treatment,both of which were significantly higher than those in the fire needle group[(3.67±1.12),(2.88±0.86),t=2.45,2.93,P=0.015,0.004].Patient satisfaction with treatment outcomes did not significantly differ between the radiofrequency microneedling and fire needle groups[92.22%(83/90)vs.87.78%(79/90),χ^(2)=0.98,P=0.320].Results from the reflective confocal microscope indicated that after treatment,the hair follicles in both the radiofrequency microneedling and fire needle groups exhibited a distinct funnel shape and oval appearance,along with a noticeable reduction in funnel diameter compared with pre-treatment observations.Additionally,there was a decrease in the central amorphous material,a reduction in the size of the bright edge zone,and a decline in the infiltration of inflammatory cells,with no significant differences observed between the two groups.Conclusions:For facial inflammatory acne lesions(such as papules and pustules),both radiofrequency microneedling and fire needle treatments have shown good effectiveness.The fire needle treatment leads to less pain,while radiofrequency microneedling has a lower recurrence rate,but it carries a slightly higher risk of hyperpigmentation.
作者
林晓琼
李嫦嫦
张珊
Lin Xiaoqiong;Li Changchang;Zhang Shan(Department of Dermatology,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou 325000,Zhejiang Province,China)
出处
《中国基层医药》
2025年第2期197-203,共7页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省温州市科技局科研项目(Y20210959)。
关键词
寻常痤疮
针刺疗法
脉冲射频术
显微摄影术
皮肤色素沉着
视觉模拟量表
Acne vulgaris
Acupuncture therapy
Pulsed radiofrequency treatment
Photomicrography
Skin pigmentation
Visual analogscale
作者简介
通信作者:林晓琼,Email:linxiaoqiong1983@163.com。
