果酸联合口服氨甲环酸、外用左旋维生素C治疗黄褐斑效果观察

果酸联合口服氨甲环酸、外用左旋维生素 C 治疗黄褐斑效果观察高　云1，刘　敏2

（1.鄂州市疾病预防控制中心皮防所，湖北　鄂州　436000；2.鄂州市中心医院心内科，湖北　鄂州　436000）

【摘要】　目的　观察黄褐斑疾病治疗中联合果酸与口服氨甲环酸、外用左旋维生素C 的疗效。方法　将本皮防所门诊部在2016年9月至2017年3月接收的121例黄褐斑患者随机分成观察组（n=61）与对照组（n=60），对照组给予果酸联合左旋维生素C 治疗，观察组则给予果酸联合口服氨甲环酸及外用左旋维生素C 治疗，比较两组治疗效果及治疗后性激素指标情况。结果　观察组治疗总有效率为93.44%，明显高于对照组78.33%的总有效率（P ＜0.05）；治疗3个月后观察组患者卵泡刺激素、促黄体生成素、雌二醇等性激素指标水平明显低于对照组（P ＜0.05）。结论　针对黄褐斑疾病，临床中采取果酸+氨甲环酸+左旋维生素的联合治疗方法，可取得良好的治疗效果，降低患者性激素水平，值得推广。【关键词】　黄褐斑；果酸；氨甲环酸；左旋维生素C

中图分类号：R751.05；R758.4+

2 文献标志码：A doi ：10.3969/j.issn.1002-1310.2019.03.004

Observation on the effect of glycolic acid combined with oral tranexamic acid and levovitamin C in the treatment of chloasma

GAO Yun 1,LIU Min 2

（1.Ezhou City Center for Disease Control and Prevention, Ezhou, Hubei 436000；2.Department of Cardiology, Ezhou Central Hospital, Ezhou, Hubei 436000）【Abstract 】　Objective To explore the efficacy of glycolic acid combined with oral tranexamic acid and levovitamin C in the treatment of chloasma. Methods 121 cases of chloasma patients received in the outpatient department of our Dermatological Prevention Institute from September 2016 to March 2017 were randomly divided into observation group (n=61) and control group (n=60). The control group was treated with glycolic acid combined with levovitamin C, while the observation group was treated with f glycolic acid combined with oral tranexamic acid and external levovitamin C. The therapeutic effect and sex hormone indexes were compared between the two groups. Results the total effective rate was 93.44% in the observation group, significantly higher than 78.33% in the control group (P ＜0.05). After 3 months of treatment, the levels of sex hormones such as follicle stimulating hormone, luteinizing hormone, and estradiol in the observation group were significantly lower than those in the control group (P ＜0.05). Conclusion In the treatment of chlo-asma, the combination therapy of glycolic acid, tranexamic acid and levovitamin can achieve good therapeutic effect and reduce the level of sex hormones in patients, which is worthy of promotion.【Key words 】　Chloasma; glycolic acid; Tranexamic acid; Levovitamin C

【收稿日期】2018-10-16

黄褐斑是临床中常见的疾病，该病主要由紫外线

辐射、妊娠及肝病等因素所致，患者疾病严重程度常

表明阳性组组织真皮浅层MVD 较阴性组和对照

组组织真皮浅层MVD 差异显著有统计学意义（P ＜0.05），而阴性组和对照组组织真皮浅层MVD 相比较差异无统计学意义（P ＞0.05）。

本研究还发现，MVD 与VEGF 的表达水平呈正相关；MVD 与PEDF 的表达水平呈负相关。VEGF 和PEDF 失衡导致血管增生异常，当VEGF 大量产生使VEGF/PEDF 升高，促进血管增生[8]；高水平VEGF 反馈性使PEDF 生成加速，VEGF/PEDF 恢复平衡，血管增生恢复正常；当刺激因素解除VEGF 生成减少，使VEGF/PEDF 下降，抑制血管增生；跟寻常型银屑病临床分为进行期、稳定期、退行期相吻合。

综上所述，VEGF、PEDF 可能通过调节血管增生参与寻常型银屑病的发病过程，进一步阐述寻常型银屑病的发病机制，为开发新的预防和治疗药物提供理论依据和思路。

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