| Objectives1.To explore the clinical efficacy,safety and recurrence of Photodynamic therapy（PDT）combined with minocycline in the treatment of severe acne.2.Evaluate the effect of PDT combined with minocycline on the mental health status and quality of life of patients with severe acne.Method100 patients with severe acne who attended the Dermatology Clinic of the First Affiliated Hospital of Dali University from January 2020 to June 2021 were randomly divided into a research group and a control group.Research group: Photodynamic therapy with 5-aminolevulinic acid（5-ALA-PDT）was given 7-14 days apart from each treatment,four times as a course.At the same time,every morning and dinner after oral administration of minocycline hydrochloride capsules 50 mg,the lesions every night external rubbing 0.1% Adapalene gel.Control group: oral minocycline combined with topical adapalene,the method is the same as the study group,6 weeks for a course of treatment.Before treatment,during treatment and after the end of treatment,the data of the two groups of patients were statistically analyzed from the levels of clinical efficacy,treatment time,safety,mental health,quality of life and recurrence.Statistical analysis of experimental data was done using SPSS 26.0 statistics software,and mapping was done using Graphpad Prism 8 software.Results1.Baseline data: Among all patients,64 were male（66.00%）,with an average age（19.41±3.475）years old,and 88 students（90.70%）.There were no significant differences in age,course,BMI,sex,Fiztpatrick typing,and occupational distribution between the two groups（P>0.05）,which was comparable.2.Efficacy comparison: in the 2,4 and 6 weeks of treatment,in the 2,4 and 6weeks of treatment,the total effective rate of the study group was 58.33%,95.83%,97.92%,respectively,which was higher than the total efficiency of the control group of the same period of 30.61%,77.55% and 83.67%,the difference was statistically significant（P<0.05）;the apparent efficiency of the study group was 22.92%,77.08%,93.75%,respectively,which was higher than the total efficiency of the control group of6.12% and 51.02% in the same period.61.22%,the difference was statistically significant（P<0.05）.3.Comparison of acne severity scores: Before treatment,the global acne grading system（GAGS）scores of the research group and the control group were similar,and the difference was not statistically significant（P>0.05）,which was comparable.After treatment,the GAGS scores of the patients in the study group and the control group decreased compared with before,and the difference in GAGS scores between the two groups before and after treatment was statistically significant（P<0.05）,suggesting that after treatment,the patients in the study group and the control group were in a better condition than before.Comparing the GAGS scores of the post-treatment study group and the control group,there was no statistically significant difference in GAGS scores between the study group and the control group in week 2（P>0.05）,and the GAGS scores of the study group were lower than those in the control group at the 4th and 6th weeks of treatment,and the difference was statistically significant（P<0.01）.Suggestive of weeks 4 and 6 of treatment,the study group was more effective than the control group.4.Comparison of VISIA detection values: Before treatment,the absolute scores of each item in the research group and the control group were similar,and the difference was not statistically significant（P>0.05）,which was comparable.The absolute score of "red area,texture,pores and violet" in the post-treatment research group was improved compared with before（P<0.05）,indicating that after treatment,the facial inflammation,skin smoothness and pore thickness of the patients in the research group were improved compared with before,and the secretion of porphyrin and oil was also reduced compared with before treatment;the score of "purple matter" in the control group after treatment was improved（P<0.05）,indicating that the secretion of porphyrin and oil in the control group after treatment was reduced.After the treatment,the absolute score of the "Pores,Violet" item in the research group was lower than that in the control group（P<0.05）.This suggests that the role of the study group in antibacterial and inhibition of lipid secretion is better than that of the control group.5.Comparison of treatment time: when the efficacy is effective,the treatment time of the research group is（25.63±10.008）days,the control group takes（37.65±11.624）days,and the effect time of the research group is shorter（P<0.000）.6.Comparison of mental health status: Before treatment,the self-rating Anxiety Scale（SAS）and self-rating Depression Scale（SDS）of the study group and the control group had similar scores,and the difference was not statistically significant（P>0.05）,which was comparable.After treatment,the SAS and SDS scores of both groups were lower than before（P<0.05）,and the SAS and SDS scores of the study group were lower than those of the control group（P<0.05）,indicating that the mental health status of the patients in the post-treatment study group and the control group improved compared with before,and the psychological status of the patients in the study group was better than that in the control group.7.Comparison of quality of life: Before treatment,the total scores of acne-quality of life（Acne-Qo L）in the research group and control group were similar,and the difference was not statistically significant（P>0.05）,which was comparable.After treatment,the total score of Acne-Qo L and the scores of each part of the study group and the control group were higher than before（P<0.05）,and the total score of Acne-Qo L and the score of each part of the study group were higher than those of the control group（P<0.05）,indicating that the quality of life of the patients in the two groups after treatment was better than before,and the quality of life of the patients in the study group was better than that of the control group.8.Comparison of adverse reactions: The adverse reactions of the two groups of patients during treatment are as follows:Among the systemic adverse reactions,1 person（2.08%）in the study group had gastrointestinal reactions（loss of appetite,nausea）,and 1 person（2.04%）in the control group had headaches,and the incidence of adverse reactions was compared,and the difference was not statistically significant（P>0.05）.Among the local adverse reactions,7 people（14.58%）in the study group had pigmentation and 3 people（6.12%）in the control group had pigmentation,and the incidence of adverse reactions was compared,and the difference was not statistically significant（P>0.05）.The study group had mild,transient local reactions.Specific manifestations were facial erythema in 19 people（39.58%）,swelling in 3 people（6.25%）,reactive acne in13 people（27.08%）,and desquamation in 14 people（29.17%）.To a mild degree,it can disappear without treatment and does not affect subsequent treatment.During treatment,pain is tolerated and has an NRS score of 2.60（2.50-2.62）.9.Comparison of recurrence: After follow-up in January,March and June after the end of treatment,the recurrence rates of the research group were 2.08%,6.25%,and22.92%,respectively,and the recurrence rates of the control group were 6.12%,12.24%,and 28.57%,respectively,and the difference was not statistically significant（P>0.05）.Conclusions1.Minocycline has curative effect on severe acne,can improve mental health and improve quality of life,less adverse reactions.2.PDT combined with minocycline in the treatment of severe acne has better efficacy,can shorten the course of treatment,and has positive significance for reducing scarring,and has a better effect on improving mental health status and improving quality of life,with mild adverse reactions and good safety.3.PDT combined with minocycline can be used as an optimal treatment plan for severe acne. |
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