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A 型肉毒毒素联合光动力疗法在增生性瘢痕中的应用效果分析
Effect Analysis of Treating Hyperplastic Scar with Botulinum Toxin Type A and Photodynamic Therapy

张　易.A 型肉毒毒素联合光动力疗法在增生性瘢痕中的应用效果分析[J].中国烧伤创疡杂志,2022,(2):133~136.

DOI：

中文关键词: 增生性瘢痕 A 型肉毒毒素光动力疗法瘢痕增生磷酸化信号转导与转录激活因子3 早期生长反应因子-1 不良反应

英文关键词:Hyperplastic scar Botulinum toxin type A Photodynamic therapy Scar hyperplasia Phosphorylated signal transducer and activator of transcription 3 Early growth response factor-1 Adverse reactions

基金项目:

作者	单位
张　易	473000 河南南阳，南阳市第二人民医院整形美容外科

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中文摘要:

【摘要】目的观察A 型肉毒毒素(BTXA)联合光动力疗法(PDT)治疗增生性瘢痕(HS)的临床效果。方法选取2018年5月至2020年5月南阳市第二人民医院收治的70例HS患者作为研究对象，按照不同治疗方法将其分为研究组(35例)与对照组(35例)，研究组患者采用BTXA联合PDT治疗，对照组患者单纯采用BTXA治疗，对比两组患者温哥华瘢痕量表(VSS)评分、磷酸化信号转导与转录激活因子3(p-STAT3)及早期生长反应因子-1(Egr-1)表达水平、临床疗效以及不良反应发生情况。结果治疗4个月，研究组患者VSS评分及p-STAT3、Egr-1表达水平均明显低于对照组(t= 4.665、10.583、11.549，P＜0.001)；研究组患者中显效19例、有效11例、无效5例，明显优于对照组患者的显效12例、有效10例、无效13例(Z =-2.129，P =0.033)；研究组患者不良反应发生率为20.00%，与对照组患者的不良反应发生率11.43%无明显差异(χ2 =0.971，P =0.324)。结论 BTXA联合PDT治疗HS，可降低瘢痕组织中p-STAT3、Egr-1的表达水平，有效促进瘢痕组织消退，改善瘢痕症状，提高治疗效果，且安全性较高，值得临床推广应用。

英文摘要:

【Abstract】 Objective To observe the clinical efficacy of botulinum toxin type A (BTXA) combined with photodynamic therapy (PDT) in the treatment of hyperplastic scar (HS). Methods 70 HS patients, admitted into Nanyang Second General Hospital from May 2018 to May 2020, were enrolled as research subjects and divided into study group (n =35), treated with BTXA combined with PDT, and control group (n=35)，treated with BTXA only. The Vancouver scar scale (VSS) score, levels of phosphorylated signal transducer and activator of transcription 3 (p-STAT3) and early growth response factor-1(Egr-1), clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results After 4 months of treatment, the VSS score, and the expression levels of p-STAT3 and Egr-1 in study group were significantly lower than control group (t = 4.665, 10.583 and 11.549, all P＜0.001). In study group the treatment was markedly effective in 19 cases, effective in 11 cases and ineffective in 5 cases, which was much better than control group(Z = -2.129, P =0.033) where markedly effective in 12 cases, effective in 10 cases, and ineffective in 13 cases. Theincidence of adverse reactions in study group was 20.00%, which showed no significant difference as compared with the corresponding 11.43% in control group (χ2 =0.971, P =0.324). Conclusion BTXA combined with PDT in the treatment of HS can reduce the expression levels of p-STAT3 and Egr-1 in scar tissues, accelerate the regression of scar tissues, improve scar symptoms, and realize good therapeutic effects. Besides, the treatment protocol is very safe, and is worthy of promotion in clinical practice.