Chen Xiao-E, Liu Juan, Bin Jameel Afzaal Ahmed, Valeska Maya, Zhang Jia-An, Xu Yang, Liu Xing-Wu, Zhou Hong, Luo Dan, Zhou Bing-Rong
Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.
Department of Dermatology and Venereology, Nanjing Jingdu Hospital, Nanjing, Jiangsu 210002, P.R. China.
Exp Ther Med. 2017 Jun;13(6):3607-3612. doi: 10.3892/etm.2017.4438. Epub 2017 May 8.
Keloids are benign tumors that originate from scar tissues, but they usually overgrow beyond the original wounds. In a three-month single-center clinical trial, 69 patients were randomly divided into three groups. Patients in group 1 were treated with intralesional injection of diprospan (2 mg betamethasone disodium phosphate and 5 mg betamethasone dipropionate in 1 ml) with one-month intervals for three months. Patients in groups 2 and 3 were injected with a combination of 0.5 ml 5-fluorouracil (5-FU; 25 mg/ml) and diprospan as above for three months also. Prior to each injection, the keloids of patients in group 3 were additionally irradiated by a 1,064-nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser with a single pulse at an energy density of 90-100 J/cm and a pulse width of 12 msec. Clinical responses were evaluated by patient self-assessment and overall assessment by an observer according to the clinical signs of erythema, pruritus and pliability. A total of sixty-two patients completed the tests of the present study. At 2 and 3 months, the patients in all treatment groups showed an acceptable improvement in nearly all measurements. At the end of the study, the erythema and toughness score was significantly reduced and itch reduction was significantly greater in the diprospan + 5-FU + Nd:YAG group when compared to those in the other groups (P<0.05 for all indexes). The acceptable responses (good to excellent improvements) reported by blinded observers were as follows: 12% in the diprospan group, 48% in the diprospan + 5-FU group and 69% in the diprospan + 5-FU + Nd:YAG group. All of the results indicated that the combination of diprospan + 5-FU + Nd:YAG was the most efficacious therapy for keloid scars.
瘢痕疙瘩是起源于瘢痕组织的良性肿瘤，但它们通常会过度生长，超出原始伤口范围。在一项为期三个月的单中心临床试验中，69名患者被随机分为三组。第1组患者接受病灶内注射得宝松（1毫升中含2毫克倍他米松磷酸二钠和5毫克倍他米松二丙酸酯），每隔一个月注射一次，共注射三个月。第2组和第3组患者也接受上述0.5毫升5-氟尿嘧啶（5-FU；25毫克/毫升）与得宝松的联合注射，为期三个月。在每次注射前，第3组患者的瘢痕疙瘩还接受波长为1064纳米的钕钇铝石榴石（Nd:YAG）激光照射，单脉冲能量密度为90-100焦耳/平方厘米，脉冲宽度为12毫秒。通过患者自我评估以及观察者根据红斑、瘙痒和柔韧性等临床体征进行的综合评估来评价临床反应。共有62名患者完成了本研究的测试。在第2个月和第3个月时，所有治疗组的患者在几乎所有测量指标上都有可接受的改善。在研究结束时，与其他组相比，得宝松 + 5-FU + Nd:YAG组的红斑和硬度评分显著降低，瘙痒减轻也更为显著（所有指标P<0.05）。盲法观察者报告的可接受反应（良好至极佳改善）如下：得宝松组为12%，得宝松 + 5-FU组为48%，得宝松 + 5-FU + Nd:YAG组为69%。所有结果表明，得宝松 + 5-FU + Nd:YAG联合治疗是治疗瘢痕疙瘩最有效的方法。
