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目的：探讨黄褐斑应用激光联合氨甲环酸、谷胱甘肽及维生素C 治疗的临床效果。方法：选择2012 年6 月~2014 年6 月期间我院皮肤科门诊收治的黄褐斑女性患者117 例，根据随机数字表将其平均分为三组，即激光组、药物组、联合治疗组各39 例。激光组单纯应用激光治疗，药物组应用氨甲环酸、谷胱甘肽及维生素C治疗，联合治疗组应用激光联合氨甲环酸、谷胱甘肽及维生素C 治疗。对比三组治疗前后黄褐斑面积及黄褐斑颜色评分、临床疗效及治疗后不良反应。结果：联合组治疗后黄褐斑面积及黄褐斑颜色评分显著低于激光组、药物组及治疗前（P<0.05）。联合组治疗的总有效率显著高于激光组及药物组（P<0.05）。药物组不良反应发生率为2.56%,其他两组未见明显不良反应。结论：激光联合氨甲环酸、谷胱甘肽及维生素C 治疗黄褐斑的疗效确切，可以有效改善黄褐斑面积及颜色，安全性佳，适于临床应用。

英文摘要:

Objective:To investigate the clinical efficacy of laser combined with tranexamic acid, glutathione and vitamin C in the treatment of chloasma.Methods:Selected 117 cases of chloasma women who were treated in the department of dermatology of our hospital from June 2012 to June 2014, they were averagely divided into three groups according to the random number table method, which were laser group, medicine group and combined treatment group, with 39 women in each group. Laser group was treated with laser, medicine group was treated with tranexamic acid, glutathione and vitamin C, and the combined group was treated with laser combined with tranexamic acid, glutathione and vitamin C. Then compared the chloasma size, chloasma color score, clinical efficacy before and after treatment and the incidence of adverse reaction after treatment in three groups.Results:Chloasma size and color score in combined group after treatment were significantly lower than laser group, medicine group and before treatment (P<0.05). Total efficiency rate of combined group was significantly higher than laser group and medicine group (P<0.05). The incidence of adverse reaction in medicine group was 2.56%, while there was no adverse reaction in the other two groups.Conclusion:Laser combined with tranexamic acid, glutathione and vitamin C has a exact effect in the treatment of chloasma, it can effectively improve the chloasma size and color and safety, which is suitable for clinical application.

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