国产氟康唑片局部用药治疗慢性阻塞性肺疾病合并口腔念珠菌病的临床观察

The clinical effect of local application of domestic fluconazole in treatment of chronic obstruction pulmonary disease complicated with oral candidiasis

目的：观察国产氟康唑片局部用药治疗慢性阻塞性肺疾病（COPD）患者合并口腔念珠菌病的疗效、安全性及药效经济学。方法：选取我院2013年5月至2015年5月COPD急性加重期合并口腔念殊菌病患者74例，按照随机数字表随机分为观察组35例。对照组39例，观察组给予国产氟康唑片碾碎患处局部应用，对照组给予进口氟康唑胶囊口服。比较两组患者的临床疗效、用药疗程及药物副作用。结果：观察组的总有效率为100％高于对照组的97．4％，但差异无统计学意义（χ^2=0．0029，P〉0．05）。观察组痊愈率为94.3％高于对照组的87．2％，但差异无统计学意义（χ^2=0．0069，P〉0．05）。观察组的疗程平均为2．9d较对照组（5．2d）缩短，差异有统计学意义（Z=-6．246，P〈0．01）。观察组无不良反应，对照组不良反应发生率为5．1％，但两者相比差异无统计学意义。观察组抗真菌药费低于对照组。差异有统计学意义（t=-23．398，P=0．000）;观察组的成本一效果比明显低于对照组。结论：国产氟康唑局部应用治疗慢阻肺合并口腔念珠菌病疗效及副作用与全身应用氟康唑无明显差异，但用药疗程缩短，且费用低，药效经济学更好。

Objective To study the safety, efficiency and efficacy economics of local application of domestic fluconazole in treatment of chronic obstruction pulmonary disease （COPD） complicated with oral candidiasis. Methods Selected 74 patients with chronic obstruction pulmonary disease （COPD） complicated with oral candidiasis from May, 2013 to Oct. 2015 in our hospital were divided into the observation group in 35 cases and the control group in 39 cases according to table of random number. The observation group was given local application of domestic fluconazole, and the control group was given systemic application of imported fluconazole. The clinical effects and side effects of both groups were observed and compared. Results The total effect rate in observation group （100%） was higher than that in the control group （97.4%） without significant difference （P 〉 0.05）. The cute rate in observation group （94.3%） was higher than that in control group （87.2.4%） without significant difference （P 〉 0.05）. The average course of treatment was shorter in the observation group （2.9 d） than that in control group（5.2 d）, with significant difference （P 〈 0.01 ）. The observation group had no adverse reaction and the control group had 5.1% （P 〉 0.05）. The cost of antifungal drugs in the observation group was lower than that in the control group, （t = -23.398, P = 0.000）. The cost-effectiveness ratio in the observation group was lower than that in the control group. Conclusion Local application of domestic fluconazole has similar effect and side effect to systemic application of imported fluconazole in treatment of COPD complicated with oral candidiasis, but has short course of treatment and low cost .