摘要
Abstract
Objective To evaluate and compare the efficacy and safety of focused ultrasound versus photodynamic therapy for treating vulvar lichen sclerosus.Methods A total of 112 patients with vulvar lichen sclerosus treated at our hospital from June 2021 to June 2023 were enrolled in this study.Participants were randomly divided into two groups:the focused ultrasound group(n=56)and the photodynamic therapy group(n=56)by the random number table method.Changes in symptoms and signs were compared between the two groups at baseline,post-treatment,and 3-month follow-up.Clinical efficacy and adverse reactions during the treatment period were also compared.Serum levels of high-sensitivity C-reactive protein(hs-CRP),vascular endothelial growth factor(VEGF),and endothelin-1(ET-1)were detected using enzyme-linked immunosor-bent assay(ELISA).A 6-month following-up was conducted to compare the recurrence rates be-tween the two groups.Results Ninety-four patients completed the treatment,with 47 cases in each group.All measured parameters,including symptoms(itching,pain),signs(elasticity,pigmentation),and serum markers(hs-CRP,ET-1),were significantly reduced from baseline to the end of treatment in both groups(all P＜0.05),with further significant reductions at the 3-month follow-up(all P＜0.05 vs.at the end of treatment).At the end of treatment,these scores were significantly lower in the photodynamic therapy group than in the focused ultrasound group(all P＜0.05).No significant differences were observed after the 3-month follow-up(P＞0.05).Serum VEGF levels increased significantly from baseline to the end of treatment in both groups(P＜0.05),with a further increase at the 3-month follow-up(P＜0.05 vs.at the end of treat-ment).The photodynamic therapy group had significantly higher serum VEGF levels than the fo-cused ultrasound group at the end of treatment(P＜0.05),with no significant difference between the two groups after the 3-month follow-up(P＞0.05).No significant differences were observed between the two groups in clinical efficacy,total effective rates,total adverse reaction rates,or re-currence rates(P＞0.05).Conclusions Focused ultrasound and photodynamic therapy demon-strate comparable clinical efficacy and safety in treating vulvar lichen sclerosus,with similar recur-rence risks.However,photodynamic therapy exhibits a faster onset of action in controlling inflam-mation,promoting tissue repair,and alleviating symptoms and signs.关键词
女阴硬化性苔藓/聚焦超声/光动力疗法/复发率/不良反应/炎症/修复Key words
vulvar lichen sclerosus/focused ultrasound/photodynamic therapy/recur-rence rate/adverse reactions/inflammation/repair
