两性霉素B联合过氧化氢治疗真菌性外耳道炎的临床研究

Clinical study on amphotericin B combined with hydrogen peroxide in treatment of fungal otitis externa

目的探讨两性霉素B溶液联合过氧化氢溶液治疗真菌性外耳道炎的临床疗效。方法选取2021年9月—2023年9月青岛市城阳区人民医院收治的真菌性外耳道炎患者82例,随机分为对照组(41例)和治疗组(41例)。对照组给予过氧化氢溶液,3%溶液冲洗外耳道,3次/d。在对照组基础上,治疗组患者滴耳注射用两性霉素B,25 mg溶于注射用水5 mL,药液耳浴10 min,3次/d。两组治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,气导(AC)和耳骨导(BC)听阈值,血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)和白细胞介素-6(IL-6)水平。结果治疗后,治疗组总有效率为92.68%,明显高于对照组(78.05%,P<0.05)。治疗后,治疗组症状缓解时间均明显短于对照组(P<0.05)。治疗后,两组患耳AC听阈值、BC听阈值比治疗前明显降低(P<0.05),且治疗组患耳的AC听阈值、BC听阈值低于对照组(P<0.05)。治疗后,两组患者血清TNF-α、PCT、TGF-β1、IL-6水平低于治疗前(P<0.05),且治疗组明显低于对照组(P<0.05)。结论两性霉素B联合过氧化氢治疗真菌性外耳道炎,可有效改善患耳症状,听力能力明显缓解,降低外耳道炎性反应。

Objective To explore the clinical effect of amphotericin B combined with hydrogen peroxide in treatment of fungal otitis externa.Methods Patients(82 cases)with fungal otitis externa in Qingdao Chengyang People’s Hospital from September 2021 to September 2023 were randomly divided into control(41 cases)and treatment(41 cases)group.Patients in the control group were administered with Hydrogen Peroxide Solution,rinsed external ear canal with 3%solution,three times daily.Patients in the treatment group were administered with Amphotericin B for injection on the basis of the control group,25 mg added into injection water 5 mL for 10 min,three times daily.Patients in two groups were treated for 14 d.After treatment,the clinical evaluations were evaluated,the symptom relief time,the AC and BC hearing thresholds,the levels of serum TNF-α,PCT,TGF-β1 and IL-6 in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group was 92.68%,which was significantly higher than that of the control group(78.05%,P<0.05).After treatment,the time of symptom relief in the treatment group was significantly earlier than that in the control group(P<0.05).After treatment,the AC hearing threshold and BC hearing threshold in two groups were significantly lower than those before treatment(P<0.05),and which in the treatment group were lower than those of the control group(P<0.05).After treatment,the levels of serum TNF-α,PCT,TGF-β1 and IL-6 in two groups were lower than those before treatment,and which in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion The synergistic treatment of hydrogen peroxide solution and amphotericin B is effective in improving the symptoms of the affected ear,can obviously alleviate the hearing ability and reduce the inflammatory reaction of the external auditory canal.