伊曲康唑间歇冲击疗法治疗甲真菌病临床追踪观察

Itraconazole Pulse Therapy For Patients with Onychomycosis

目的评价伊曲康唑间歇冲击疗法治疗由皮肤癣菌、酵母菌和霉菌引起的甲真菌病的有效性、安全性及停药2年内的复发率。方法采用间歇冲击疗法,连续服用伊曲康唑(2次/d,200mg/次,国药准字H20020367)7d,停药21d为1个疗程。指甲真菌病服药2个疗程;趾甲真菌病服药3个疗程。观察疗程结束、停药3个月、6个月指(趾)甲真菌病的临床治愈率及2年内甲真菌病的复发率。结果疗程结束时,停药后3个月、6个月时指甲真菌病的临床治愈率分别为23.17%、80.49%和91.46%;指(趾)甲同患真菌病的临床治愈率分别为13.56%、62.71%和81.36%。疗程结束后,经追踪观察,随时间延长治愈率不断提高,停药后6个月达到最高。指甲真菌病治愈率高于趾甲真菌病。停药2年内复发率为14%。结论伊曲康唑间歇冲击疗法治疗甲真菌病具有疗效高、副作用小、安全性好、耐受性高、复发率低的特点。

Objective To evaluate the efficiency,safety and tolerability of itraconazole pulse therapy for onychomycosis due to dermatophytes,yeasts and molds. Methods With pulse therapy,the course of treatment was to take orally itraconazole capsule twice per day. Each time 200mg for 7 days and to stop taking it for 21 days. For fingernail onychomycosis 2 courses were needed,and for toenail onychomycosis 3courses. Results At the end of therapy, 3rd and 6th month after therapy,in fingernail onychomycosis the clinical cure rates were 23.17%, 80.49% and 91.46%. In toenail onychomycosis the clinical cure rates were 13.56% ,62.71% and 81.36%. The cure rate of fingernail ony- chomycosis was significantly higher than that of toenail onychomycosis. The mycologic cure rate was greatly higher than the clinical cure rate. No severe adverse reactions were observed. The relapse rate was 14% at 2 years after therapy. Conclusion Itraconazole short-phase therapy is a high-efficient,small side-effect, high safety and low recurrent therapy for noychomycosis.