强脉冲光联合Q开关1064nm Nd:YAG激光治疗黄褐斑的临床观察OA

Objective To investigate the therapeutic effect of IPL and Q-switched neodymium-doped yttrium aluminum garnet(Nd:YAG)laser in the treatment of melasma.Methods A total of 120 cases of melasma patients admitted to our hospital from August 2022 to August 2023 were selected and divided into the intense pulsed light group(n=38,IPL treatment),the Q-switched Nd:YAG laser group(n=41,Q-switched Nd:YAG laser treatment),and the combined treatment group(n=41,IPL combined with Q-switched Nd:YAG laser treatment)based on the method of randomized numerical table,with reference to Melasma Area and Severity Index Score(MASI)to assess the efficacy of the treatment,and compared the characteristics of laser scanning confocal microscopy images(CLSM)and skin barrier indexes before and after treatment.Results The total effective rate of the combined treatment group(97.56%)was higher than that of the intense pulsed light group(84.21%)and the Q-switched 1 064 nm Nd:YAG laser group(80.49%),and the difference was statistically significant(P<0.05);After treatment,the content of epidermal granular layer,Acanthous layer,pigment granular layer and TEWL in the combined treatment group were significantly lower than those in the intense pulsed light group and Q-switched 1 064 nm nd:yag laser group,while the water content and sebum content in the stratum corneum were higher than those in the intense pulsed light group and Q-switched 1 064 nm nd:yag laser group,and the differences were statistically significant(P<0.05).Conclusions The efficacy of IPL and Q-switched Nd:YAG laser combined treatment for melasma was significantly higher than that of single treatment,and it could improve the function of the skin barrier,which is of high value in clinical application and is worthwhile to learn from.