摘要目的:观察皮下剥离联合黄金射频点阵微针治疗萎缩性痤疮性瘢痕的疗效及安全性。方法:前瞻性纳入2023年1月至2024年1月东营市人民医院萎缩性痤疮性瘢痕患者122例，采用随机数字表法分成两组：（1）观察组：接受皮下剥离联合黄金射频点阵微针治疗，共61例，包括男37例，女24例，年龄20~43（31.5±4.7）岁；（2）对照组：接受皮下剥离治疗，共61例，包括男33例，女28例，年龄22~44（32.6±4.5）岁。两组患者均每4周治疗1次，共治疗3次。比较两组治疗后总有效率、皮肤屏障功能、创口恢复时间、瘢痕情况及不良反应情况。结果:观察组总有效率为93.4%（57/61），高于对照组的75.4%（46/61），差异有统计学意义（ P=0.005）。治疗后，观察组角质层蛋白质含量、乳酸刺激试验评分、皮肤红斑情况（a值）、经皮水分丢失量（TEWL）分别为（29.52±3.22）μg、（1.72±0.18）分、15.10±2.21、（18.31±3.35）g/（h·m 2），均低于对照组的（35.24±4.17）μg、（2.75±0.24）分、19.14±2.57、（21.23±4.52）g/（h·m 2）（均 P<0.001）。观察组创口愈合时间、脱落时间与结痂时间分别为（3.42±0.67）、（6.57±1.21）、（1.73±0.32）d，均短于对照组的（5.31±0.99）、（8.26±1.48）、（2.85±0.47）d（均 P<0.001）。观察组痤疮瘢痕临床评分量表（ECCA）、温哥华瘢痕量表（VSS）分别为（38.10±5.29）、（5.23±0.82）分，均低于对照组的（43.65±6.44）、（6.34±0.97）分（均 P<0.001）。观察组不良反应发生率为11.5%（7/61），对照组为8.2%（5/61），差异无统计学意义（ P=0.540）。 结论:采用皮下剥离联合黄金射频点阵微针治疗萎缩性痤疮性瘢痕效果较好，可改善患者皮肤屏障功能，缩短创口恢复时间，改善瘢痕症状，且安全性良好。

abstractsObjective:To observe the efficacy and safety of subcutaneous stripping combined with gold radiofrequency dot matrix microneedles in the treatment of atrophic acne scar.Methods:A total of 122 patients with atrophic acne scar in Dongying People′s Hospital from January 2023 to January 2024 were prospectively included and divided into two groups by random number table method: Observation group, 61 patients, including 37 males and 24 females, aged 20-43 (31.5±4.7) years, received subcutaneous stripping combined with gold radiofrequency dot matrix microneedles; Control group, 61 patients, including 33 males and 28 females, aged 22-44 (32.6±4.5) years, were treated with subcutaneous dissection. Patients in both groups were treated once every 4 weeks for a total of 3 times. The total effective rate, skin barrier function, wound recovery time, scar condition and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 93.4% (57/61), which was higher than that of the control group [75.4% (46/61), P=0.005]. After treatment, the corneum protein content, lactate stimulation test score, skin erythema (a value), and transdermal water loss (TEWL) of the observation group were (29.52±3.22) μg, (1.72±0.18) min, 15.10±2.21, and (18.31±3.35) g/(h·m 2), respectively. They were lower than those (35.24±4.17) μg, (2.75±0.24) min, 19.14±2.57, and (21.23±4.52) g/(h·m 2) in the control group (all P<0.001). The wound healing time, shedding time and scab time in the observation group were (3.42±0.67), (6.57±1.21) and (1.73±0.32) d, respectively, which were shorter than those (5.31±0.99), (8.26±1.48) and (2.85±0.47) d in the control group (all P<0.001). The acne scar clinical score scale (ECCA) and Vancouver scar scale (VSS) scores in the observation group were (38.10±5.29) and (5.23±0.82) points, respectively, which were lower than those (43.65±6.44) and (6.34±0.97) points in the control group (all P<0.001). The incidence of adverse reactions was 11.5% (7/61) in the observation group and 8.2% (5/61) in the control group, the difference was not statistically significant ( P=0.540). Conclusion:Subcutaneous stripping combined with gold radiofrequency dot matrix microneedles is effective in the treatment of atrophic acne scars, which can improve skin barrier function, shorten wound recovery time, and improve scar symptoms with good safety.