盐酸小檗碱联合抗真菌药物对红色毛癣菌的体外药敏实验

Susceptibility Test by Berberine Hydrochloride Combined with Antifungal Agents Against Trichophyton Rubrum in Vitro

目的观察盐酸小檗碱联合不同浓度抗真菌药物对红色毛癣菌的体外抗菌活性。方法参照美国临床实验室标准化研究所(CLSI)颁布的M38-A2方案和相关文献对临床分离的30株红色毛癣菌进行体外药敏实验。其中盐酸小檗碱的MIC值定义为与生长对照相比,肉眼观察出现80%生长抑制的最低药物浓度。采用分数抑菌浓度(FIC)评定两药联合效果。FIC≤0.5,两药为协同作用;0.5<FIC≤4,两药为无关作用;FIC>4,两药为拮抗作用。结果盐酸小檗碱和不同浓度伊曲康唑联合,主要为无关作用。盐酸小檗碱和不同浓度特比奈芬、伏立康唑联合,均为拮抗作用。16.0μg/mL氟康唑组与盐酸小檗碱联合时FIC≤0.5所占比例为83.33%,协同作用最强;2.0～8.0μg/mL卡泊芬净组与盐酸小檗碱联合时,FIC≤0.5所占比例最高,均为63.33%,协同作用最强,差异均有统计学意义(P均<0.05)。结论盐酸小檗碱与高浓度氟康唑、卡泊芬净联合,体外对红色毛癣菌有较强的协同作用。

Objective To explore the antifungal activity of Berberine hydrochloride combined with different concentrations of antifungal agents against trichophyton rubrum in vitro. Methods According to the program of M38- A2 from the United States National Clinical and Laboratory Standards Institute （CLS1） and relevant literatures, susceptibility test was done with 30 clinical isolates of trichophyton rubrum in vitro. The MIC value of Berberine was defined as that growth compared with the naked eye control showing appear 80% growth inhibition of the minimum drug concentration. Fractional inhibitory concentration （FIC） assessed the joint effect of the two drugs. Synergy was defined as an FIC of ≤0.5, while antagonism was defined as an FIC value of 〉 4. An FIC result between 0.5 and 4 （0.5 〈 FIC ≤4） was considered indifferent. Results Using Berberine hydrochloride with the different concentrations of itraconazole cross combination, the effect was considered indifferent. Using Berberine hydrochloride with the different concentrations of terbinafine and voriconazole cross combination, the effect was antagonised. Using Berberine hydrochloride with 16.0μg/mL fluconazole cross combination, the results was FIC ≤0. 5 up to 83.33%, the synergy was the strongest. Berberine hydrochloride and 2.0 - 8.0μg/mL caspofungin group cross combination, the results was FIC ≤ 0.5 up to 63.33% in and the synergy was the strongest. The difference was statistically significant（all P 〈0.05）. Conclusion Berberine hydrochloride combined with high concentrations of fluconazole and caspofungin has good synergistic effect on trichophyton rubrum in vitro.