目的: 探讨咪喹莫特乳膏联合艾拉－光动力治疗尖锐湿疣( CA) 的临床疗效。方法: 选取2014－01 ～
2017－03 期间我院103 例CA 病人，根据治疗方案分为观察组( n= 52) 与对照组( n= 51) 。对照组行单纯艾拉－光
动力治疗，观察组行艾拉－光动力联合咪喹莫特乳膏治疗。对比两组临床疗效、治疗前后机体免疫功能［T 淋巴
细胞亚群( CD3+、CD4+、CD4+ / CD8+ ) ］、安全性，治疗结束后随访6mo，对比两组复发率、治疗前及治疗后6mo
生活质量( SF－36 评分) 。结果: ( 1) 临床疗效: 观察组治疗总有效率94．23%( 49 /52) 高于对照组80．39%( 41 /51)
( P＜0．05) ; ( 2) 免疫功能: 治疗前两组CD3+、CD4+、CD4+ / CD8+ 比较无显著差异( 均P＞ 0．05) ，治疗后两组
CD3+、CD4+、CD4+ / CD8+较治疗前提高( 均P＜0．05) ，且观察组CD3+、CD4+、CD4+ / CD8+ 高于对照组( 均P＜
0．05) ; ( 3) 安全性: 艾拉－光动力治疗过程中，观察组出现2 例局部轻度疼痛，对照组出现3 例局部疼痛，照射治
疗后对照组及观察组各出现1 例轻度红肿; 观察组涂抹咪喹莫特乳膏后部分病人有轻微烧灼( 3 例) 、瘙痒( 1
例) 、刺痛感( 1 例) ; ( 4) 复发率: 治疗后3mo 观察组复发率1．92%( 1 /52) 与对照组5．88%( 3 /51) 比较无显著差异
( P＞0．05) ，治疗后6mo 观察组复发率3．85%( 2 /52) 低于对照组17．65%( 9 /51) ( P＜0．05) ; ( 5) 生活质量: 治疗前
两组SF－36 评分比较无显著差异( P＞0．05) ，治疗后6mo 两组SF－36 评分较治疗前提高( 均P＜0．05) ，且观察组
SF－36 评分高于对照组( P＜0．05) 。结论: 艾拉－光动力联合咪喹莫特乳膏治疗CA 疗效显著，可有效改善病人免
疫功能、降低复发率，且具有一定安全性，有利于提高病人生活质量。

Objective: To investigate the clinical effect of imiquimod cream combined with Ella
photodynamic therapy in the treatment of condyloma acuminata( CA) ．Methods: A total of 103 cases of
CA patients in our hospital from 2014－01 to 2017－03 were selected and divided into the observation
group( n = 52) and the control group( n = 51) according to the treatment plan．The control group was treated
only with Ella － photodynamic therapy，and the observation group was treated with Ella －
photodynamic combined with imiquimod cream．The clinical efficacy， the immune function Tlymphocyte
subsets( CD3+，CD4+，CD4+ / CD8+ ) ，and the safety of the body before and after treatment of the two
groups were compared．After 6months of follow－up， the recurrence rate，and the quality of life( SF－36
score) before and after 6months of the treatment of the two groups were compared．Ｒesults: ( 1) Clinical
efficacy: the total effective rate of treatment in the observation group［94．23%( 49 /52) ］was higher than
that of the control group［80．39%( 41 /51) ］( P＜0．05) ．( 2) Immune function: there were insignificant
differences in CD3+，CD4+and CD4+ / CD8+between the two groups before treatment( each P＞0．05) ．
After treatment，CD3+，CD4+and CD4+ / CD8+of two groups were improved compared with those before
treatment( each P＜0．05) ．And the CD3+，CD4+ and CD4+ / CD8+ in the observation group were higher
than those in the control group( each P＜0．05) ．( 3) Safety: during the Ella photodynamic therapy， there
were 2 cases of mild local pain in the observation group and 3 cases in the control group．After irradiation，
1case in the control group and 1 case in the observation group appeared mild redness and swelling．
The patients in the observation group had mild cauterization ( 3 cases) ，pruritus ( 1 cases) and
prickle sensation( 1 cases) after smearing Imiquimod Cream in the observation group． ( 4) Ｒecurrence
rate: there were insignificant differences in the recurrence rate between the observation group［1．92%
( 1 /52) ］and the control group［5．88%( 3 /51) ］after 3months of treatment( P＞0．05) ．After 6months of
treatment， the recurrence rate of the observation group［3．85%( 2 /52) ］was lower than that of the control
group ［17．65%( 9 /51) ］( P＜0．05) ． ( 5) Quality of life: before treatment， there were insignificant
differences in the SF－36 scores between the two groups( P＞0．05) ．After 6months， the SF－36 scores of
two groups were higher than those before treatment( P＜0．05) ，and the SF－36 score in the observation
group was higher than that in the control group( P＜0．05) ．Conclusion: The effect of imiquimod cream
combined with Ella photodynamic therapy in the treatment of CA is significant． It can effectively
improve the immune function of the patients，and reduce the recurrence rate．It is safe to a certain degree，
which is beneficial to the improvement of the quality of life of the patients．

752．2+3

 收稿日期: 2018－01－09; 修回日期: 2018－05－05
基金项目: 内蒙古自治区卫生计生科研计划项目( 201701061)
作者简介: 陈加媛( 1980－) ，女，中山大学附属第八医院皮肤科主治医师。
通讯作者: 孙立，主任医师，E－mail: sunnyhong618@ sina．com 内蒙古医科大学附属医院皮肤科， 010010