Wu Yun, Wang Peiru, Zhang Linglin, Wang Bo, Wang Xiuli
Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, People's Republic of China.
Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
Dermatol Surg. 2018 Dec;44(12):1516-1524. doi: 10.1097/DSS.0000000000001608.
Bowen's disease (BD) is treated effectively with 5-aminolevulinic acid (ALA)-photodynamic therapy (ALA-PDT). Plum-blossom needling (PBN) may enhance topical drug delivery.
To compare the effects of and adverse reactions to PBN and ALA-PDT of BD with those associated with ALA-PDT alone.
Forty-three lesions from 24 patients were randomly assigned to 2 groups. The PBN-ALA-PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow-band light-emitting diode irradiation (λ = 633 ± 10 nm; 100-200 J/cm). The ALA-PDT group received ALA cream and irradiation only.
At 6 weeks, the PBN-ALA-PDT and ALA-PDT groups achieved complete response (CR) rates of 77.78% (14/18 lesions) and 40% (7/20 lesions), respectively, (p < .05), and 2/18 and 10/20 lesions, respectively, achieved CRs after further treatment; 2.9 ± 0.8 sessions and 3.4 ± 0.7 sessions, respectively, were required for the lesions to achieve CRs. The PBN-ALA-PDT group required fewer treatment sessions and had higher protoporphyrin IX fluorescence levels (p < .05).
Plum-blossom needling may improve the efficacy of ALA-PDT by enhancing ALA delivery for BD treatment.
5-氨基酮戊酸（ALA）光动力疗法（ALA-PDT）可有效治疗鲍温病（BD）。梅花针（PBN）可能会增强局部药物递送。
比较BD患者PBN联合ALA-PDT与单纯ALA-PDT的疗效及不良反应。
将24例患者的43个皮损随机分为2组。PBN-ALA-PDT组在涂抹10%ALA乳膏并进行窄带发光二极管照射（波长 = 633±10nm；100 - 200J/cm²）之前先用PBN垂直叩刺皮肤。ALA-PDT组仅接受ALA乳膏和照射。
6周时，PBN-ALA-PDT组和ALA-PDT组的完全缓解（CR）率分别为77.78%（14/18个皮损）和40%（7/20个皮损）（p < 0.05），分别有2/18和10/20个皮损在进一步治疗后达到CR；皮损达到CR分别需要2.9±0.8次和3.4±0.7次治疗。PBN-ALA-PDT组所需治疗次数更少，原卟啉IX荧光水平更高（p < 0.05）。
梅花针可能通过增强ALA递送改善ALA-PDT治疗BD的疗效。
