伊曲康唑連續(xù)療法與沖擊療法治療兒童白癬的療效比較.docx
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1、伊曲康唑連續(xù)療法與沖擊療法治療兒童白癬的療效比較【摘要】 目的: 探索伊曲康唑治療兒童白癬的優(yōu)化方案. 方法: 93例明確診斷的白癬患兒隨機(jī)分為2組. 治療組51例,給予伊曲康唑膠囊沖擊療法: 5 mg/kg,口服,1次/d,服藥1 wk,停藥1 wk,同時(shí)給予30 g/L碘酊,涂患處,2次/d,50 g/L水楊酸軟膏與50 g/L硫磺軟膏等量混合后涂患處,2次/d,4 wk為1個(gè)療程;對(duì)照組42例,給予伊曲康唑膠囊連續(xù)療法: 5 mg/kg,1次/d,外用藥同治療組,4 wk為1個(gè)療程. 治療結(jié)束后每2 wk隨訪1次,每次隨訪時(shí)進(jìn)行真菌鏡檢、培養(yǎng),至治療結(jié)束后6 mo,對(duì)于隨訪過(guò)程中真菌學(xué)陽(yáng)
2、性的患兒,按原治療方案繼續(xù)服藥2 wk. 結(jié)果: 在服藥4 wk時(shí),臨床及真菌學(xué)痊愈: 治療組49例,對(duì)照組41例,二者之間無(wú)統(tǒng)計(jì)學(xué)差異(). 治療組2 (%)例患兒出現(xiàn)不良反應(yīng),對(duì)照組為5 (%)例, 其發(fā)病率明顯高于治療組(). 結(jié)論: 伊曲康唑治療兒童白癬安全、有效、療程短;沖擊療法比連續(xù)療法更經(jīng)濟(jì).【關(guān)鍵詞】 白癬;沖擊療法;伊曲康唑【Abstract】 AIM: To explore the optimum regimen for tinea capitis of childhood with itraconazole. METHODS: A prospective, randomi
3、zed, open parallel controlled clinical trial was conducted. A total of 93 cases of tinea capitis of childhood were divided into 2 groups. Itraconazole capsules 5 mg/kgd were given orally once every day for every other week in pulse therapy group (n=51) and every day in continuous therapy group (n=42
4、), with 4 weeks as a course of treatment. Concomitant topical therapy was composed of 30 g/L iodine lotion used twice daily, and equivalent admixture of 50 g/L salicylic ointment and 50 g/L sulphur ointment used twice daily. The followup was conducted every 2 weeks for mycological examination until
5、6 months after treatment. If the mycological examination showed positive in the followups, the other 2week same treatment was given until the mycological examination became negative. RESULTS: At the 4th weeks, 49 casesin pulse therapy group and 41 cases in continuous therapy group were cured and pre
6、sented negative in clinical and mycological examinations, and there was no statistical difference between the 2 groups (). Side effect occurred in 2 cases (%) of pulse therapy group and in 5 cases (%) of continuous therapy group, and the incidence of side effect was significantly lower in pulse ther
7、apy group than in continuous therapy group. CONCLUSION: Itraconozole is safe and effective and of shorter treatment period for the tinea capitis of children. Pulse therapy is more economical than continuous therapy.【Keywords】 tinea capitis; pulse therapy; itraconazole0 引言近10 a來(lái)隨著飼養(yǎng)寵物的增多,兒童白癬的發(fā)病率迅速上升
8、. 伊曲康唑是一種三唑類抗真菌藥,其優(yōu)點(diǎn)是在皮膚、毛發(fā)、指甲等靶組織中濃度高且保留時(shí)間長(zhǎng),國(guó)外已有較多報(bào)道伊曲康唑治療兒童白癬安全有效. 我們參考國(guó)外報(bào)道,借助伊曲康唑治療甲真菌病沖擊療法的經(jīng)驗(yàn),采用不同給藥方法治療兒童白癬,探索伊曲康唑治療兒童白癬的優(yōu)化方案.1 對(duì)象和方法對(duì)象 200308/200705將在我院就診的白癬患兒93(男56, 女37)例納入研究. 其中發(fā)病前有寵物接觸史89例,理發(fā)后患病4例;家中有2個(gè)孩子共同患病35例,有3個(gè)孩子共同患病3例,僅有1個(gè)孩子患病14例;僅有白癬89例,同時(shí)患有體癬4例;皮損數(shù)目超過(guò)3處83例;就診前未進(jìn)行過(guò)任何治療39例,經(jīng)外用皮炎平、皮康王
9、等治療無(wú)效就診54例. 患兒頭皮片狀斷發(fā)斑,表面附著細(xì)小灰白色鱗屑或有膿皰、結(jié)痂,皮損數(shù)目不限;病發(fā)及皮屑真菌鏡檢,真菌培養(yǎng)出致病真菌;3 mo內(nèi)未使用過(guò)其它口服抗真菌藥物;無(wú)肝、腎疾病病史,肝功能檢查無(wú)異常;征得患兒直系家屬的正式同意.方法用藥方法 采用隨機(jī)、開(kāi)放、平行對(duì)照試驗(yàn). 對(duì)符合入選標(biāo)準(zhǔn)的患兒詳細(xì)記錄患者的病史資料,拍照以備治療后對(duì)比;治療開(kāi)始前先行真菌鏡檢與真菌培養(yǎng),肝功能檢查;給患兒家屬詳細(xì)交待治療過(guò)程中可能發(fā)生的副作用及注意事項(xiàng),并囑咐詳細(xì)記錄患兒服藥過(guò)程中所出現(xiàn)的異?,F(xiàn)象;治療過(guò)程中要求家屬對(duì)患兒進(jìn)行隔離,對(duì)與患兒頭部接觸密切的用品進(jìn)行煮沸消毒,隔日1次. 秤量患兒體質(zhì)量,根
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