克拉霉素与阿奇霉素和多西环素在生殖道衣原体感染患者中的疗效

Efficacy of clarithromycin,azithromycin and doxycycline in the treatment of Chlamydia trachomatis infection in genital tract

目的比较克拉霉素与阿奇霉素、多西环素在生殖道衣原体感染患者中的疗效,为临床治疗提供理论依据。方法选择2015年1月-2016年1月在医院就诊的生殖道衣原体感染患者124例,按照随机数表法将患者分为三组,克拉霉素组(A组)42例、阿奇霉素组(B组)41例、多西环素组(C组)41例;三组患者均连续用药2周,治疗2周后进行疗效评价,根据患者的临床体征进行疗效判定,统计三组患者症状改善时间和衣原体清除率及不良反应发生情况。结果 A组治疗有效率为92.86%,B组治疗有效率为78.05%,C组治疗有效率为73.17%,A组患者的治疗有效率显著高于B组和C组,差异有统计学意义(P<0.05);A组患者阴转例数为39例,衣原体清除率为92.86%,症状改善时间为(7.49±4.03)d,B组患者阴转例数为32例,衣原体清除率为78.05%,症状改善时间为(11.03±4.93)d,C组患者阴转例数为30例,衣原体清除率为73.17%,症状改善时间为(12.37±4.85)d,A组患者的阴转例数和衣原体清除率显著高于B组和C组,症状改善时间显著短于B组和C组(P<0.05),A组不良反应发生率为4.76%,B组不良反应发生率为7.32%,C组不良反应发生率为9.76%,A组患者不良反应发生率显著低于B组和C组(P<0.05)。结论克拉霉素对生殖道衣原体感染的治疗具有较好的临床效果,且具有较好的安全性。

OBJECTIVE To compare the efficacy of clarithromycin,azithromycin and doxycycline in patients with genital tract Chlamydia trachomatis infection,so as to provide theoretical basis for clinical treatment.METHODS A total of 124 cases of patients with C.trachomatis infection were selected in our hospital from Jan.2015 to Jan.2016.According to the random number table method,the patients were divided into three groups,clarithromycin group（group A,42 cases）,azithromycin group（group B,41 cases）,and doxycycline group（group C,41 cases）.Three groups of patients were treated for 2 weeks.The efficacy was evaluated after treatment for 2 weeks,according to the clinical signs of patients.The improvement time of symptoms,clearance rate of C.trachomatis and incidence of adverse reactions of the three groups were statistically analyzed.RESULTS The effective rate of group A was 92.86%,of group B was 78.05%,and of group C was 73.17%,the effective rate of group A was significantly higher than that of group B and group C,and the difference was statistically significant（P〈0.05）.In group A,39 cases were negative,the clearance rate of chlamydia was 92.86%,and the time of symptom improvement was（7.49±4.03）d.In group B,32 cases were negative,the clearance rate of chlamydia was 78.05%,and the time of symptom improvement was（11.03±4.93）d.In group C,30 cases were negative,the clearance rate of chlamydia was 73.17%,and the time of symptom improvement was（12.37±4.85）d.The negative cases and chlamydia clearance rate of group A were significantly higher than those of group B and group C,and symptom improvement time was significantly lower than that of group B and group C（P〈0.05）.The incidence of adverse reaction of group A was 4.76%,of group B was 7.32%,and of group C was 9.76%,and the adverse reaction rate of group A was significantly lower than that of group B and group C（P〈0.05）.CONCLUSION Clarithromycin has good clinical efficacy in the treatment of C.trachomatis infection,and has good safety.