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目的:探讨清热利湿方联合5-氨基酮戊酸光动力疗法对中、重度痤疮患者疗效及对基质金属蛋白酶-1(MMP-1)、基质金属蛋白酶-9(MMP-9)、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)的影响。方法:选择宁波市中医院2017年3月至2019年3月收治的中重度痤疮患者106例，应用随机数字表法分为观察组(n n＝53)与对照组(n n＝53)。对照组患者采用5-氨基酮戊酸光动力疗法治疗，观察组在对照组基础上联合清热利湿方治疗。两组疗程均为6周。比较两组治疗疗效，治疗前后皮肤损害情况、皮肤病生活质量指数(DLQI)评分、MMP-1、MMP-9、IL-1β和TNF-α水平变化，及不良反应发生情况。n 结果:观察组治疗总有效率(94.34%)高于对照组(73.58%)(χn 2＝8.477，n P<0.05)；观察组治疗后粉刺[(19.32±2.37)分]、炎性丘疹[(25.42±4.17)分]和脓疱[(14.32±3.29)分]评分均低于对照组[(28.74±3.46)分、(32.87±3.78)分和(23.78±4.76)分](n t＝16.352、9.637、11.902，均n P<0.05)；观察组治疗后DLQI量表评分(0.65±0.13)分、(0.63±0.15)分、(1.23±0.16)分、(1.18±0.19)分、(1.39±0.23)分和(1.45±0.28)分，均低于对照组的(1.20±0.17)分、(1.14±0.18)分、(1.92±0.23)分、(1.79±0.13)分、(1.81±0.27)分和(1.87±0.21)分(n t＝18.710、15.846、17.929、19.290、8.621、8.736，均n P<0.05)；观察组治疗后血清MMP-1(34.25±7.48)μg/L、MMP-9(108.98±14.25)μg/L、IL-1β(137.98±10.23)μg/L和TNF-α(103.24±10.18)μg/L，均低于对照组的(59.37±4.56)μg/L、(164.32±18.48)μg/L、(156.37±13.10)μg/L和(137.91±8.29)μg/L(n t＝20.875、17.264、8.055、19.226，均n P<0.05)。两组患者均未发生严重不良反应。n 结论:清热利湿方联合5-氨基酮戊酸光动力疗法对中、重度痤疮患者疗效明显，可降低患者血清MMP-1、MMP-9、IL-1β和TNF-α水平。“,”Objective:To investigate the effect of heat-clearing and dampness-eliminating therapy combined with 5-aminolevulinic acid photodynamic therapy on moderate and severe acne and its influence on matrix metalloproteinase-1 (MMP-1), matrix metalloproteinase-9 (MMP-9), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α).Methods:From March 2017 to March 2019, 106 patients with moderate to severe acne admitted to the Traditional Chinese Medicine Hospital of Ningbo were divided into observation group (n n=53) and control group (n n=53) according to the random digital table method.The control group was treated with 5-aminolevulinic acid photodynamic therapy, while the observation group was treated with heat-clearing and dampness-eliminating therapy on the basis of the control group.Both two groups were treated for 6 weeks.The therapeutic effects, skin lesions, dermatological quality of life index (DLQI), MMP-1, MMP-9, IL-1β and TNF-α levels, and adverse reactions were compared between the two groups before and after treatment.n Results:The total effective rate of the observation group (94.34%) was higher than that of the control group (73.58%) (χn 2=8.477, n P<0.05). The scores of acne[(19.32±2.37)points], inflammatory papules [(25.42±4.17)points] and pustules[(14.32±3.29)points] in the observation group after treatment were lower than those in the control group [(28.74±3.46)points, (32.87±3.78)points, (23.78±4.76)points](n t=16.352, 9.637, 11.902, all n P<0.05). After treatment, the scores of DLQI scale in the observation group[(0.65±0.13)points, (0.63±0.15)points, (1.23±0.16)points, (1.18±0.19)points, (1.39±0.23)points, (1.45±0.28)points] were lower than those in the control group [, (1.20±0.17)points, (1.14±0.18)points, (1.92±0.23)points, (1.79±0.13)points, (1.81±0.27)points, (1.87±0.21)points] (n t=18.710, 15.846, 17.929, 19.290, 8.621, 8.736, all n P<0.05). After treatment, the serum levels of MMP-1[(34.25±7.48)μg/L], MMP-9 [(108.98±14.25)μg/L], IL-1β [(137.98±10.23)μg/L] and TNF-α[(103.24±10.18)μg/L] in the observation group were lower than those in the control group [(59.37±4.56)μg/L, (164.32±18.48)μg/L, (156.37±13.10)μg/L and (137.91±8.29)μg/L](n t=20.875, 17.264, 8.055, 19.226, all n P<0.05). There were no serious adverse reactions in both two groups.n Conclusion:The method of heat-clearing and dampness-eliminating combined with 5-aminolevulinic acid photodynamic therapy is effective in treating moderate and severe acne, and can reduce the serum levels of MMP-1, MMP-9, IL-1β and TNF-α.