三苯双脒治疗华支睾吸虫病的效果观察

Observation on the efficacy of different doses of tribendimidine for patients with clonorchiasis

目的 观察三苯双脒抗华支睾吸虫的临床疗效,为治疗华支睾吸虫病的药物选择提供依据。方法 采用分层随机抽样,将2020年8月—2022年8月南宁市武鸣区疾控中心门诊治疗的华支睾吸虫感染患者分为采用三苯双脒治疗的试验组和采用吡喹酮治疗的对照组,其中试验组分A、B、C三组:A组为单剂次顿服;B组为2剂次隔周顿服;C组为3剂次连续3日顿服。每剂次剂量均为400 mg。对照组(D组)使用吡喹酮治疗,每日3次,800 mg/次,连服3日。治疗一个月后复诊复检,观察治疗前后虫卵变化及药物不良反应,评定治疗效果。结果 三苯双脒试验组149例,其中A组45例,B组51例,C组53例;吡喹酮对照组99例。试验组A、B、C各组虫卵阴转率分别为86.67%、94.12%和92.45%;对照组虫卵阴转率为97.98%。各组间虫卵阴转率差异无统计学意义(χ^(2)=7.146,P>0.05)。轻度感染患者试验组A、B、C各组虫卵减少率分别为79.27%、88.47%和82.11%,对照组为87.91%;中度感染患者试验组各组虫卵减少率分别为78.86%、97.43%和98.65%,对照组为99.15%。试验组总不良反应发生率和不良反应平均持续时间分别为5.37%和3.9 h;对照组不良反应发生率和平均持续时间分别为13.13%和50.9 h,两组不良反应发生率及平均持续时间差异均有统计学意义(χ^(2)=4.624,t=6.423,P均<0.05)。结论 三苯双脒治疗华支睾吸虫有较好疗效,不良反应发生率和持续时间低于吡喹酮,可应用于临床治疗华支睾吸虫病。

Objective To observe the clinical efficacy of triphenylamidine against Clonorchis sinensis for evidence to screen the optimal drug in the treatment of clonorchiasis. Methods By stratified random sampling, patients infected with Clonorchis sinensis, treated in the outpatient department of Wuming District Disease Prevention and Control Center of Nanning City, were included from August 2020 to August 2022, and divided into observational group(treated with tribendimidine) and control group(treated with praziquantel). Then patients in the observational group were sub-grouped into group A(400 mg, single dose), group B(two doses of daily dose every other week), and group C(three doses for three consecutive days). Patients in the control group(group D) were was treated with praziquantel in dose of 800 mg/time, tid, for 3 days. After one month of medication, all patients underwent reexamination to observe the changes of worm eggs and adverse drug reactions before and after treatment, and treatment effect was evaluated. Results In total,149 patients received medication with tribendimidine, including 45 patients in group A, 51 in group B, and 53 in group C. Ninety-nine patients were treated with praziquantel. Negative conversion rate in for the egg the observational group was 86.67%, 94.12% and 92.45% respectively, and 97.98% for the control group. There was no significant difference in the conversion rate among groups(χ^(2)=7.146, P>0.05). The egg reduction rate was 79.27%, 88.47% and 82.11% in the three sub-groups, respectively, and 87.91% in the control group for patients with mild infection. For patients with moderate infection, the egg reduction rate was 78.86%, 97.43% and 98.65% in the tribendimidine group, and 99.15% in the praziquantel control group. The total incidence of adverse reaction and the average duration of adverse reaction were 5.37%and 3.9 h, and 13.13% and 50.9 h, respectively in the observational group and control group. The incidence and average duration of adverse reaction were lower in the tribendimidine group than in the praziquantel group, with statistical significance(χ^(2)=4.624, t=6.423, both P<0.05). Conclusion Tribenzamidine can be used for clonorchiasis in clinic, because it shows better efficacy and has has lower incidence and duration of adverse reaction compared to praziquantel.