复发性生殖器疱疹的诊断及治疗

Diagnosis and treatment of recurrent genital herpes

目的观察以注射用胸腺肽为主的综合疗法治疗复发性生殖器疱疹(RGH)的效果。方法 66例RGH患者接受综合治疗,其中38例单用胸腺肽注射液,1.6mg,皮下注射,1次/隔日×8次、之后2次/周×8次、最后1次/周×8次;10例加用伐昔洛韦0.5g,口服,2次/d×7d;6例加用更昔洛韦氯化钠0.25g/250ml,静脉滴注,2次/d×7d;9例合并尿道炎患者加用注射用氟氧头孢钠1.0g,静脉滴注,2次/d×5d;另6例患者合并尖锐湿疣行激光治疗,其中3例复发患者局部外用5-氟脲嘧啶注射液,局部应用1∶5000呋喃西林液浸泡,红外线照射15min,1次/d×7d;保持局部清洁和干燥,局部有溃疡者用3%～5%硝酸银软膏。结果平均随访8个月,痊愈61例占92.2%,另有5例占7.6%复发,仍在继续治疗中,其中3例伴有衣原体感染性尿道炎,66例患者行HIV检测均为阴性,6例合并梅毒及阴茎冠状沟部位溃疡患者,换药1～3个月痊愈。结论联合应用抗病毒药物及胸腺肽、增强机体免疫力药物,是系统治疗RGH的有效方法。

OBJECTIVE To explore the best approach for the treatment of recurrent genital herpes with thymosin. METHODS A total of 66 cases of recurrent genital herpes have been treated united with thymosin and anti-virus drugs, out of which 38 had been treated by thymosin only, 1. 6mg, subcutaneous injection, 1 time/ next day× 8 times, then 2 times/week× 8 times, last 1 time/week × 8 times; 10 cases with valaciclovir 0.5, orally bid for 7 days, 6 cases with 0. 25/250 ml ganciclovir and sodium chloride injection VD, bid for 7 days, and 9 cases complicating urethal infection of 1.0 g flomoxef sodium,bid for 5 days. Another 6 cases complicating genital wart were treated with laser, in 3 of which recurrence occurred, locally treated with fluorouracil injection （5-FU）. Recurrent genital herpes were locally immersed by 1 ： 5 000 furaciline and infra-red radiation once every day for 7 days to keep clean and dry. RESULTS The patients were followed up for 3 months to 5 years （8 months on average）. The curable rate of them was 92. 2%. But 5 cases （7. 6%） were recurrent during following up and remained on the treatment, 3 cases were combined with chlamydia urethritis. 6 cases of syphilis with penis ulcer were cured after 1-3 months by dressing change every clay. No HIV-positive patients had been found in 66 cases. CONCLUSION Medical combination such as thymosin plus ganciclovir can enhance the immunological function and anti-infection ability of human being during the systematic treatment of the recurrent genital herpes and can produce dramatic therapeutic effectiveness.