【2017年整理】口服氨甲环酸治疗黄褐斑.doc

口服氨甲环酸治疗黄褐斑 全网发布：2012-06-27 14:53 发表者：吴溯帆 (访问人次：6962) 【摘要】 目的 尝试并评价口服氨甲环酸治疗黄褐斑的新方法。 方法: 使用低剂量长时间口服氨甲环酸治疗256例黄褐斑患者，服药时间6-15个月，平均服药时间9.6个月，分别观察服药后的临床效果、疗效出现时间、复发情况及不良反应等。结果 大部分患者（80.9%）出现了不同程度的色斑减退，其中多数患者（65.0%）在服药后2个月开始出现色斑减轻的效果，部分患者（35.0%）在服药1个月就出现效果。服药6个月之后的基本治愈、明显消退和好转的比例分别为10.5%、18.8%和51.6%。停药后复发的比例大约为8.2%（21/256）。除了4.3%的患者出现轻度胃肠道反应、3.5%的患者出现月经量减少以外，未发现其他明显的不良反应。结论 低剂量长时间口服氨甲环酸是一种安全有效的黄褐斑治疗手段。浙江省人民医院整形外科吴溯帆 【关键词】氨甲环酸 黄褐斑 面部色斑 【中图分类号】 【文献标识码】 【文章编号】 Treatment of melasma with oral administration of tranexamic acid WU Su-fan, SHI Hang-yan, CHEN Yong, YAN Sheng, CHEN Da, GUO Jin-cai, HAN Fei. (Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People’s Hospital, Hangzhou, 310014, China) Abstract: Objective To evaluate the clinical application and effects of oral tranexamic acid on the treatment of melasma. Methods Two hundred and fifty-six patients of melasma were treated with oral administration of tranexamic acid in a method of lower dose and long term. The treatment period was 6-15 months (mean 9.6 months). A retrospective study was made on the therapeutic effect and safety. Results Many patients (65%) showed their clinical effect at the second months after treatment, whereas 35% at the first months after treatment. The percentages of basically cured, excellent and good were 10.5%、18.8% and 51.6%, respectively. The total improvement rate was 80.9%. The recurrent rate was 8.2%（21/256). There was no obvious side effects of the treatment except gastrointestinal reaction in 4.3% patients and hypomenorrhea in 3.5% patients. Conclusion Oral administration of tranexamic acid in a way of lower dose and long term is a safe and effective therapy in the treatment of melasma. Key words: tranexamic acid; melasma; facial pigmentation 黄褐斑是一种常见的后天性面部色素性病变，属于慢性难治性色素沉着性疾病，表现为面部两侧对称性的棕褐色病变，会随着季节或女性的生理周期出现色泽和色斑大小的变化[1，2]。黄褐斑多见于育龄期妇女，男女发病比例约为1: 9 [3]。常见于居住在紫外线照射强烈地区的IV 型至 VI型肤色的人，尤其以亚洲人和西班牙人为多[3，4]。紫外线是黄褐斑最主要的影响因素，黄褐斑好发于暴露部位如面部和手臂，色斑会在夏季加剧[5，6]。黄褐