慢性丝虫病患者下肢象皮肿疗效观察

RESEARCH IN THE TREATMENT OF CHRONIC FILARIAS PATIENTS WITH ELEPHANTIASIS

[目的]观察乙胺嗪、消肿乳糜清和自我照料3种方法对慢性丝虫病患者下肢象皮肿的疗效,探索慢性丝虫病下肢象皮肿的治疗、照料方法。[方法]选择河南省固始县321名慢性丝虫病患者,按乡随机分为4组:A组100例,每人口服乙胺嗪片剂100mg/d;B组74例,口服消肿乳糜清胶囊6粒/d(基质9g);C组96例,按WHO推荐象皮肿处理基本措施实施自我照料;D组51例为对照组,口服安慰剂胶囊6粒/d,均持续3月。采取双盲法分别在3个月和1年后随访患者症状、体征,并测量下肢排水量,观察比较疗效。[结果]1年后随访A组63%(63/100)、B组48.61%(35/72)的患者症状有不同程度减轻,高于C组和D组,差异有统计学意义(P﹤0.001)。B组有48.61%的患者(35/72)下肢皮肤变软,高于A组、C组和D组,差异有统计学意义(P﹤0.001)。下肢排水量测量显示B组和A组总有效率分别为73.17%、50%;高于C组和D组,差异有统计学意义(P﹤0.001),两组显效率分别为13.41%、7.37%,两组之间有效和显效差异均无统计学意义(P﹥0.05)。[结论]消肿乳糜清和乙胺嗪均对慢性丝虫病患者下肢象皮肿有一定疗效,实施自我照料措施效果不明显。

[ Objective] To observe the effect of different treatments in chronic filarias patients With elephantiasis by diethylcarbanazine, herbal medicine of xiaozhongrumiqing and self care respectively, search the ideal treatment in chronic filarias patients with elephantiasis. [ Methods] 321 chronic filarias patients lived in Gushi County of Henan Province were selected and divided into 4 groups according to different townships： 100 patients were in Group A and were orally given 100mg diethylcarbamazine per day; 74 patients were in Group B and were orally given 6 capsules of herbal medicine of xiaozhongrumiqing per day; 96 patients were in Group C and were taken self care according to WHO recommend methods; 51 patients were in Group D and were orally given 6 placebo capsules per day. Treatment was carried for 3 months in all groups. Data of symptom, physical sign and displacement in lower limbs were surveyed and analyzed after 3 month and 1 year treatment. [ Results] 63% （63/ 100） and 48.61% （35/72） of patients in Group A and Group B had different degree decreasing symptoms respectively after 1 year treatment, were dramatically better than that in Group C and Group D, and had statistic difference （P 〈 0.001 ）. 48.61% （35/72） of patients in Group B had softening skin of lower extremity, and better than that in other Groups, and statistic differences were found （P 〈 0.001）. The total effective rate was 73.17%, 50% in Group A and Group B by the measurement of displacement in lower limbs respectively, and better than that in Group C and Group D, and had statistic difference （P 〈 0.001）. Excellence rate in Group Aand Group B was 13.41% and 7.37% and no statistic difference was found （P 〉 0.05）. [Conclusion] Treatment of diethylcarbamazine, herbal medicine of xiaozhongrumiqing have some effect on chronic filarias patients with elephantiasis. Self care do not show effective treatment.