外用5%咪喹莫特乳膏与局部注射α-1b干扰素治疗肛周尖锐湿疣临床疗效比较

The comparison of theapeutic effect between external use of 5% imiquimod cream and local injection ofα-1b interferon on perianal condyloma acuminatum

目的比较外用5%咪喹莫特乳膏与局部注射α-1b干扰素治疗肛周尖锐湿疣的临床疗效。方法符合入组标准的患者160例,随机分为3组,A组仅使用二氧化碳激光烧灼疣体;B组二氧化碳激光烧灼疣体后外用5%咪喹莫特乳膏,每周1次,共6周;C组二氧化碳激光烧灼疣体后肛周皮下注射α-1b干扰素每周1次,共6次。3组患者均于第4周末、第8周末及第12周末记录疗效及复发情况。结果 12周末观察期结束,A、B、C组治愈率分别为72.0%、88.7%、92.6%,B组、C组治愈率和A组比较有统计学差异(P<0.05);B组治愈率与C组相比,无统计学差异(P>0.05);第4周末、8周末、12周末C组复发率与A组相比,均有显著性差异;4周末、8周末B组复发率与A组相比无显著性差异。3组患者均无严重不良反应出现。结论二氧化碳激光治疗术后外用5%咪喹莫特乳膏及局部注射α-1b干扰素均能提高肛周尖锐湿疣患者的治愈率,两者疗效相当;局部注射干扰素可以更快的降低复发率,咪喹莫特乳膏外用则临床应用简便,均值得临床推广应用。

Objective To compare the efficacy between external use of 5% imiquimod cream and local injection of α-1b interferon on perianal condyloma acuminatum （CA）.Methods The 160 cases of perianal CA were divided into 3 groups, a imiquimod group with 53 cases, a interferon group with 54 cases and a control group with 53 cases. After removing all the lesions by CO2 laser, external use of 5% imiquimod cream was administered weekly for 6 weeks in the imiquimod group; local injection of α-1b interferon was administered weekly for 6 weeks in the interferon group. Cases in control group were only received CO2 laser. The efficacy was evaluated 12 weeks after the treatment. ResultsThe markedly effective rate in imiquimod group and interferon group 12 weeks after the treatment was 88.7% and 92.6% respectively, significantly higher than that in the control group, revealed significant difference, while with no significant difference between imiquimod group and interferon group. Compared with that of the control group, the recurrent rates of interferon group at 4 weeks, 8 weeks and 12 weeks were significantly lower. While the recurrent rate of imiquimod group showed significantly lower than that of control group only at 12 weeks. No severe site effect was observed in 3 groups.Conclusion External use of 5% imiquimod cream and local injection of α-1b interferon both are useful treatment alternatives for patients with perianal CA.