Department of Medical Aesthetics, the Third People's Hospital of Chengdu, Southwest Jiaotong University, Chengdu, 610000, Sichuan, China.
Lasers Med Sci. 2023 Aug 8;38(1):179. doi: 10.1007/s10103-023-03846-7.
Melasma is a common, relapsing, multifactorial disease for which the treatment decision remains extremely difficult. This study was designed to compare the efficacy and safety of the combination of tranexamic acid (TA) injection and electro-optical synergy (ELOS) versus TA injection alone in treating melasma. A retrospective study was undertaken for patients with facial epidermal or mixed-type melasma to compare clinical data between 15 patients receiving a combination regimen and 15 patients with TA injection only. The study administered TA through intravenous injection to the combination group (twice weekly for 12 weeks) followed by ELOS therapy (once a month for three times). The TA group, on the other hand, received only TA injection (twice weekly for 12 weeks). The evaluation of clinical effectiveness was based on comparing the Melasma Area Severity Index (MASI) scores before and one month after treatment (at 4 months). The Physician Global Assessment (PGA) and Patient satisfaction were documented, and adverse reactions were recorded. All patients were followed up for one year to observe the relapse. After treatment, the MASI scores and melasma severity were significantly reduced in both groups. The combination group showed better efficacy than the TA only group (P < 0.05). The Physician Global Assessment (PGA) and Patient satisfaction showed superior efficacies of the combination group. No significant difference was observed between the two groups in terms of treatment-related side effects. Both groups experienced a certain degree of recurrence during the one-year follow-up, but the TA only group had a significantly higher recurrence rate than the combination group (P < 0.01). Together, the combination of TA injection and ELOS is a safe and effective treatment strategy for melasma and should be promoted.
黄褐斑是一种常见的、易复发的多因素疾病，其治疗决策仍然极具挑战性。本研究旨在比较氨甲环酸（TA）注射联合光电协同（ELOS）与单独 TA 注射治疗黄褐斑的疗效和安全性。
对 15 例接受联合治疗的患者和 15 例仅接受 TA 注射的患者的临床资料进行了回顾性研究，这些患者患有面部表皮或混合性黄褐斑。研究组采用静脉注射 TA（每周 2 次，共 12 周），然后进行 ELOS 治疗（每月 1 次，共 3 次）。TA 组仅接受 TA 注射（每周 2 次，共 12 周）。临床疗效评价基于治疗前和治疗后 1 个月（治疗后 4 个月）的黄褐斑面积严重程度指数（MASI）评分比较。记录了医师整体评估（PGA）和患者满意度，并记录了不良反应。所有患者均随访 1 年，观察复发情况。
治疗后，两组 MASI 评分和黄褐斑严重程度均显著降低。联合组疗效优于 TA 组（P < 0.05）。医师整体评估（PGA）和患者满意度显示联合组疗效更佳。两组治疗相关不良反应无显著差异。两组在 1 年随访期间均有一定程度的复发，但 TA 组的复发率明显高于联合组（P < 0.01）。
综上所述，TA 注射联合 ELOS 是一种安全有效的治疗黄褐斑的方法，值得推广。
