A型肉毒素与复方倍他米松注射液联用治疗瘢痕疙瘩患者的疗效及安全性研究

目的:分析A型肉毒素与复方倍他米松注射液联用治疗瘢痕疙瘩患者的疗效及安全性。方法:选取2015年1月-2016年8月期间我院收治的90例瘢痕疙瘩患者为研究对象,根据治疗方法将患者随机分为A组、B组和C组各30例。A组给予A型肉毒素治疗,B组给予复方倍他米松注射液治疗,C组给予A型肉毒素联合复方倍他米松注射液治疗。比较三组患者的相关指标改善评分、临床疗效、不良反应发生率和复发率。结果:C组患者体积、痛痒觉、硬度和自我评价的改善评分均高于B组和A组(P0.05),B组的各项指标改善评分和A组相比差异无统计学意义(P0.05)。三组总有效率比较差异有统计学意义,且C组高于B组(P0.05),A组和C组总有效率比较差异无统计学意义(P0.05)。A组不良反应总发生率低于B组和C组,差异有统计学意义(P0.05),B组与C组不良反应总发生率相比,差异无统计学意义(P0.05)。A组和C组治疗后半年、1年瘢痕疙瘩复发率均低于B组(P0.05),但A组和C组比较差异无统计学意义(P0.05)。结论:与单独使用A型肉毒素或复方倍他米松注射液相比,A型肉毒素与复方倍他米松注射液联合使用治疗瘢痕疙瘩能显著提高疗效,降低复发率,且不会增加不良反应发生率,安全性较高,值得进一步推广应用。

Research of Efficacy and Safety of Botulinum Toxin Type A Combined with Compound Betamethasone Injection in Treatment of Patients with Keloid

ABSTRACT Objective: To analyze the efficacy and safety of botulinum toxin type A combined with compound betamethasone in- jection in treatment of patients with keloid. Methods: 90 patients with keloid who were treated in our hospital from January 2015 to Au- gust 2016 were selected as the research object, and they were randomly divided into A group, B group and C group according to different of treatment methods, 30 cases in each group. The A group were treated with botulinum toxin type A, the B group were treated with com- pound betamethasone injection and the C group were treated with botulinum toxin type A combined with compound betamethasone in- jection. Related indexes improvement score, clinical efficacy, the incidence of adverse reaction and the recurrence rate were compared between three groups. Results: The improvement score of keloid volume, hardness, pain/itching sensation and self-evaluation of patients in C group were higher than those in B group and A group (P<0.05). There was no statistical difference in improvement score of various indexes between the B group and the A group (P>0.05). The total effective rate of the three groups was statistically significant,and the C group was higher than that of the B group (P<0.05). There was no significant difference in the total effective rate between the A group and the C group (P>0.05). The total incidence of adverse reactions in A group was lower than those in B group and C group, the difference was statistically significant (P<0.05), while there was no difference between B group and C group (P>0.05). The recurrence rate of keloid in A group and C group was lower than that in B group at half a year and 1 years after treatment(P<0.05), but there was no significant dif- ference between A group and C group (P>0.05). Conclusion: Compared with the use of botulinum toxin type A or compound betametha- sone injection alone, the combined use of botulinum toxin type A and compound betamethasone injection in the treatment of keloid can significantly improve the efficacy, reduce the recurrence rate, and it does not increase the incidence of adverse reactions, safety is high, which is worthy of further application.