Clinical effect observation of compound betamethasone local injection combined with photodynamic therapy for small keloids

doi:10.3877/cma.j.issn.1673-9450.2024.05.006

Abstract

Abstract:

Objective

To observe the clinical effect of compound betamethasone injection combined with photodynamic therapy forsmall keloid treatment.

Methods

63 patients in the Department of Burns and Surgery of the PLA 943rd Hospital with small keloid treated from February 2021 to February 2023 were randomly divided into three groups (betamethasone group, photodynamic group and combined treatment group), with 21 patients in each group. The betamethasone group received compound betamethasone injection for local injection, the photodynamic group wastreated with photodynamic therapy, and the combined treatment group received betamethasone for local injection followed by combined photodynamic therapy. After 6 months of continuous treatment, the 3 groups will compare the scar morphology, pruritus and pain symptoms, clinical effects, adverse effects and recurrence rate.

Results

Before treatment, the Vancouver scar scale (VSS) and visual analog scale (VAS) were not statistically different (P>0.05).6 months after treatment, The VSS of the combined treatment group was(2.95±0.50), which was lower than of betamethasone group(6.57±0.75)and photodynamic group(6.52±0.75).Combination treatment group VAS in pruritus(2.10±0.99), pain(1.19±0.81), lower than betamethasone group in pruritus(4.14±0.79), pain (3.10 ± 0.63) and photodynamic group in pruritus(4.38±0.92), pain(3.14±0.66).The above differences were statistically significant (P<0.05).At 6 months after treatment, the overall response rate in the combined treatment group was 95.24%, which was significantly higher than that in the betamethasone group, 61.90% and 57.14% in the photodynamic group, Statistically significant difference(χ²=8.867, P=0.012).The adverse reaction rate was 4.76%, which was lower than that in the betamethasone group 42.86% and 33.33% in the photodynamic group(χ²=8.379, P=0.015)The recurrence rate was 4.76% in the combined treatment group, which was lower than that in the betamethasone group 42.86%, and 38.10% in the photodynamic group(χ²=8.867, P=0.012).

Conclusion

Compound betamethasone local injection combined with photodynamic therapy treats small keloid more effectively than the single method, which can significantly improve keloid morphology, reduce pain and itching, reduce recurrence rate, and have high safety.

Key words: Keloid, Photochemotherapy, Betamethasone injection, Clinical efficacy

Shengjun Nie, Yu Wang, Yi Wang, Xiaoqing Xian, Shengcheng Ma. Clinical effect observation of compound betamethasone local injection combined with photodynamic therapy for small keloids[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(05): 404-410.

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Figures/Tables 7

References 26

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组别	治疗前	治疗后1个月	治疗后3个月	治疗后6个月
倍他米松组(n＝21)	10.86±1.06	7.48±0.81	6.57±0.75	5.62±0.74
光动力组(n＝21)	11.00±1.00	7.48±0.75	6.52±0.75	5.62±0.81
联合治疗组(n＝21)	10.95±1.16	3.95±0.50	2.95±0.50	2.00±0.45
F值	0.096	177.217	198.641	197.133
P值	0.909	<0.01	<0.01	<0.01

组别	治疗前	治疗后1个月	治疗后3个月	治疗后6个月
倍他米松组(n＝21)	10.86±1.06	7.48±0.81	6.57±0.75	5.62±0.74
光动力组(n＝21)	11.00±1.00	7.48±0.75	6.52±0.75	5.62±0.81
联合治疗组(n＝21)	10.95±1.16	3.95±0.50	2.95±0.50	2.00±0.45
F值	0.096	177.217	198.641	197.133
P值	0.909	<0.01	<0.01	<0.01

组别	瘙痒评分				疼痛评分
组别	治疗前	治疗后1个月	治疗后3个月	治疗后6个月	治疗前	治疗后1个月	治疗后3个月	治疗后6个月
倍他米松组(n＝21)	7.81±0.68	5.05±0.87	4.62±0.97	4.14±0.79	6.05±0.80	3.90±0.77	3.38±0.50	3.10±0.63
光动力组(n＝21)	8.05±0.92	5.24±0.83	4.86±0.79	4.38±0.92	6.00±0.84	4.10±0.77	3.48±0.75	3.14±0.66
联合治疗组(n＝21)	8.10±0.77	3.52±1.12	2.76±1.14	2.10±0.99	6.10±0.77	2.10±0.77	2.19±1.03	1.19±0.81
F值	0.777	20.600	28.920	40.328	0.074	43.333	17.277	52.765
P值	0.464	<0.01	<0.01	<0.01	0.929	<0.01	<0.01	<0.01

组别	瘙痒评分				疼痛评分
组别	治疗前	治疗后1个月	治疗后3个月	治疗后6个月	治疗前	治疗后1个月	治疗后3个月	治疗后6个月
倍他米松组(n＝21)	7.81±0.68	5.05±0.87	4.62±0.97	4.14±0.79	6.05±0.80	3.90±0.77	3.38±0.50	3.10±0.63
光动力组(n＝21)	8.05±0.92	5.24±0.83	4.86±0.79	4.38±0.92	6.00±0.84	4.10±0.77	3.48±0.75	3.14±0.66
联合治疗组(n＝21)	8.10±0.77	3.52±1.12	2.76±1.14	2.10±0.99	6.10±0.77	2.10±0.77	2.19±1.03	1.19±0.81
F值	0.777	20.600	28.920	40.328	0.074	43.333	17.277	52.765
P值	0.464	<0.01	<0.01	<0.01	0.929	<0.01	<0.01	<0.01

组别	显效	有效	无效	总有效率
倍他米松组(n＝21)	6(28.57)	7(33.33)	8(38.10)	13(61.90)
光动力组(n＝21)	6(28.57)	6(28.57)	9(42.86)	12(57.14)
联合治疗组(n＝21)	11(52.38)	9(42.86)	1(4.76)	20(95.24)
χ²值				8.867
P值				0.012

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