Effectiveness of Chuzhi Shengfa Tablets Combined with Ketoconazole Shampoo and Chuzhi Shengfa Tablets Combined with 5%Minoxidil Foam in the Treatment of Male Androgenetic Alopecia

Objective:To investigate the clinical efficacy and safety of Chuzhi Shengfa Tablets combined with ketoconazole shampoo and Chuzhi Shengfa Tablets combined with 5%minoxidil foam in the treatment of male androgenetic alopecia.Methods:From July 2022 to July 2023,120 male patients with androgenetic alopecia were selected from our Department of Dermatology and randomly divided into Control Group 1,Control Group 2,Observation Group 1,and Observation Group 2,with 30 patients in each group.Control Group 1 was treated with ketoconazole shampoo,Control Group 2 with 5%minoxidil foam,Observation Group 1 with ketoconazole shampoo combined with Chuzhi Shengfa Tablets,and Observation Group 2 with 5%minoxidil foam combined with Chuzhi Shengfa Tablets.Hair density,hair diameter,scalp oil secretion(using oil secretion scoring),and adverse reactions were compared before and after treatment across the four groups.Results:After treatment,hair density and hair diameter significantly increased in all four groups compared to before treatment,while scalp oil secretion scores significantly decreased(P<0.05).The improvements in Observation Groups 1 and 2 were significantly better than those in Control Groups 1 and 2(P<0.05).No significant differences in the incidence of adverse reactions were observed among the four groups(P>0.05).Conclusion:Chuzhi Shengfa Tablets combined with ketoconazole shampoo and Chuzhi Shengfa Tablets combined with 5%minoxidil foam are both effective and safe for treating male androgenetic alopecia.These combinations can significantly improve hair growth and are worthy of clinical promotion.

国产Naftifine体外抗真菌作用和对豚鼠皮肤真菌病的疗效观察

1978年Naftifine首先由Berney等合成,后来Georgopoulus等发现具有广谱抗真菌活性,特别对皮肤真菌的活性较好,最小抑菌浓度(MIC)为0.01～0.2mg/L。1985年Naftifine首批在西德、奥地利、马来西亚和新加坡等国上市,其商品名为Exoderil。1989年我们用Naftifine进行了体外试验和动物试验,其结果表明Naftifine对皮肤真菌的抗菌作用,比克霉唑和咪康唑好,特别对临床分离72株红色毛癣菌和24株羊毛状小孢子菌效果较好,MIC_(90)较低。1％Naftifine霜剂和溶液对豚鼠皮肤真菌病的疗效,比1％克霉唑软膏好,并且达到或超过2％达克宁霜和3％克霉唑软膏效果,证明Naftifine是一种较好的新型抗真菌药。

Qualitative and quantitative assessment of related substances in the Compound Ketoconazole and Clobetasol Propionate Cream by HPLC-TOF-MS and HPLC

Related substances in pharmaceutical formulations are associated with their safety, efficacy and stability. However, there is no overall study already published on the assessment of related substances in the Compound Ketoconazole and Clobetasol Propionate Cream. In this work, a reliable HPLC-TOF-MS qualitative method was developed for the analysis of related substances in this preparation with a quick and easy extraction procedure. Besides the active pharmaceutical ingredients, two compounds named ketoconazole impurity B′ optical isomer and ketoconazole impurity E were identified. Furthermore, a new HPLC method for qualitative and quantitative assessment on related substances and degradation products, which were found in the stability test, was established and validated. The single standard to determine multi-components method was applied in the quantitative analysis, which was an effective way for reducing cost and improving accuracy. This study can provide a creative idea for routine analysis of quality control of the Compound Ketoconazole and Clobetasol Propionate Cream.

Ketoconazole Associated Hepatotoxicity: A Systematic Review and Metaanalysis

Objective To evaluate the incidence of Ketoconazole associated hepatotoxicity and related factors Methods Literature retrieval was conducted by using multi-databases for meta-analysis on Ketoconazole associated hepatotoxicity. The data were collected with a standardized form. Overall estimation of incidence of hepatotoxicity for specific study type was calculated by using a DerSimonian-Laird random-effects model owing to the substantial differences among the studies. Results Totally 204 eligible studies were included in the analysis. The incidence of Ketoconazole associated hepatotoxicity was 3.6%-4.2%. The dosage and duration specific subgroup analyses did not show any significant difference among groups, while the age specific subgroup analysis showed the incidence in children and people aged 〉60 years was 1.4% （95% CI 0.5%-4.2%） and 3.2% （95% Cl： 1.1%-8.7%） respectively. Additionally, the incidence of the hepatotoxicity was higher in people who had oral administration of ketoconazole beyond the provisions of the usage instructions, and the incidence was 5.7% （95% CI： 4.5%-7.2%）. Conclusion Ketoconazole associated hepatotoxicity was common. Off-label use might increase the risk of liver damage. Well-designed large sample studies are needed to identify the risk factors in future.

Spectrophotometric method for the determination of ketoconazole based on amplification reactions

This paper describes a sensitive spectrophotometric method developed for determination of Ketoconazole (KC) in tablets based on amplification reactions. Ketoconazole was oxidized with periodate, resulting in formation of KC2t and iodate ions. After masking the excess periodate with molybdate, the iodate was treated with iodide to release iodine. The liberated iodine was transformed to ICl2 species and extracted as ion-pair with rhodamine 6G into toluene for spectrophotometric measurement at 535 nm. A linear calibration graph was obtained between 0.2136 mg/mL and 1.7088 mg/mL of Ketoconazole with a molar absorptivity of 5 105 mol L 1 cm 1. The procedure was successfully applied for the determination of ketoconazole in tablet formulation.

Long-term outcome of ketoconazole and tacrolimus coadministration in kidney transplant patients

AIM： To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipi-ents. METHODS： From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 year or until graft failure （Group 1）, while 149 patients did not receive any ketoconazole （Group 2）. A combina-tion of tacrolimus, mycophenolate and steroid was used as maintenance therapy. High risk patients received basiliximab induction. RESULTS： Basic demographic data was similar be-tween the 2 groups. The 5-year cumulative incidence of biopsy-confrmed and clinically-treated acute rejection was signifcantly higher in Group 1 than in Group 2 （34% vs 18%, P = 0.01）. The 5-year Kaplan-Meier estimated graft survival （74.3% vs 76.4%, P = 0.58） and patient survival （87.8% vs 87.5%, P = 0.93） were not different between the 2 groups. Multivariable analyses identifed ketoconazole usage as an independent risk of acute rejection （HR = 2.33, 95%CI： 1.33-4.07; P = 0.003） while tacrolimus dose in the 2nd month was protective （HR = 0.89, 95%CI： 0.75-0.96; P = 0.041）. CONCLUSION： Co-administration of ketoconazole and tacrolimus is associated with significantly higher inci-dence of acute rejection in kidney transplant recipients.

The prognostic factors of effective ketoconazole treatment for metastatic castration-resistant prostate cancer： who can benefit from ketoconazole therapy？

We investigated the prognostic value of some variables of effective ketoconazole treatment for metastatic castration-resistant prostate cancer （mCRPC）. In total, 163 patients with mCRPC were eligible, receiving ketoconazole 200-400 mg three times daily with replacement doses of prednisone. Progression-free survival （PFS） was calculated from the beginning of the ketoconazole therapy to the onset of disease progression. The prognostic value of different variables for PFS was assessed by Cox regression analysis. The median PFS was 2.6 months （0.5-8.6 months） for these patients. The serum testosterone level changed during therapy, which decreased when the prostate-specific antigen （PSA） declined; the serum testosterone level increased as the levels of PSA relapsed. The median PFS values for patients associated with different factors were the following： 1.4 and 3.5 months for a nadir PSA of ≥ 0.2 and 〈0.2 ng ml- 1, respectively （hazard rate （HR）=4.767, P〈0.001）; 3.1 and 1.6 months for a baseline testosterone of ≥0.1 and 〈0.1 ng m1-1, respectively （HR=2.865, P=0.012）; 2.8 and 1.9 months for a baseline haemoglobin of ≥ 120 and 〈120 g 1-1, respectively （HR= 1.605, P〈0.001）; and 3.0 and 1.9 months for a PSA doubling time （PSADT） of ≥ 2.0 and 〈2.0 months, respectively （HR= 1.454, P=-0.017）. A risk model was constructed according to the four factors that divided patients into three subgroups of low risk （0-1 factors）, moderate risk （2 factors） and high risk （3-4 factors） with PFS values of 3.6, 3.0 and 1.4 months, respectively （HR=1.619, P〈0.001）. A nadir PSA of ≥0.2 ng m1-1, a baseline testosterone of 〈0.1 ng m1-1, a baseline haemoglobin of 〈 120 g I- 1 and a PSADT of 〈2 months were associated with a poor PFS. This risk model could provide evidence to predict the survival benefit of ketoconazole therapy.

Ketoconazole治疗大鼠0HSS的实验研究

目的观察酮康唑作用后的卵巢过度刺激征(OHSS)大鼠模型的血清和卵巢提取液中血管紧张素Ⅱ(AT-Ⅱ)和白细胞介素-6(IL-6)的浓度,进一步探讨酮康唑在治疗OHSS中的作用机理。方法120只OHSS大鼠模型,随机分成4组,每组30只。用酮康唑(0.4mg/mL)0.5mL给大鼠灌胃,为治疗组,用10%白蛋白0.1mL皮下注射,为阳性对照组;用生理盐水0.1mL皮下注射,为阴性对照组,hCG0.1mL(300U/mL)皮下注射,为刺激组。用药48h后,取大鼠血和两侧卵巢提取物,用放射免疫测定法测定AT-Ⅱ和IL-6的浓度。结果血清中AT-Ⅱ的浓度,在治疗组(36.2±0.34pg/mL/h)显著低于阴性对照组(51.7±0.38pg/mL/h)和刺激组(83.3±0.67pg/mL/h)(P<005);IL-6的含量,治疗组与刺激组及阴性对照组之间相比,无显著差异(P>0.05)。血清中AT-Ⅱ和IL-6的含量,在阳性对照组(35.4±0.46pg/mL/h&68.9±3.21IU/mL)显著低于阴性对照组(51.7±0.38pg/mL/h&332.7±10.08IU/mL)和刺激组(83.3±0.67pg/mL/h&431.7±9.38IU/mL)。在卵巢提取物中,AT-Ⅱ和IL-6的含量,治疗组(40.1±0.39pg/mL/h&258.3±4.79IU/mL)和阳性对照组(32.6±0.50pg/mL/h&74.6±5.78IU/mL)均明显低于阴性对照组(49.4±0.29pg/mL/h&330.4±9.7IU/mL)和刺激组(72.3±0.52pg/mL/h&387.4±10.22IU/mL)。结论酮康唑与白蛋白一样能有效降低大鼠OHSS的发生,其结果显示其作用机制可能是通过降低血清和卵巢中AT-Ⅱ及IL-6的浓度而达到了治疗效果。

The Safety of Oral Ketoconazole in the Treatment of Skin Diseases (Single Blinded, Therapeutic, Comparative Study)

Background: Ketoconazole was introduced in 1981 as the first in a series of antifungal agents that are characterized by nitrogen-containing ring. Ketoconazole acts against many different kinds of fungi such as candida, dermatophytes and as pergillus. Also oral ketoconazole had proved its effectiveness in the treatment of cutaneous Leishmaniasis. Objective: To evaluate the safety of oral ketoconazole in the treatment of different skin diseases like cutaneous Leishmaniasis (CL), tineacapitis, tineacorporis and tineaversicolor. Patients and Methods: This is a single, blinded, therapeutic, controlled study that was carried out in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq, during the time, January 2015 to July 2016. In total, 951 patients with acute cutaneous leishmaniasis, tineacapitis, tineacorporis and tineaversicolor were enrolled in this study. The diagnosis was confirmed by smear and histopathology. Patients were divided into two groups: 51 patients in Group 1;24 of them were treated with oral ketoconazole tablets 200 mg twice daily for 6 weeks and 27 of them were treated orally with a combination of zinc sulfate 10 mg/kg/day and ketoconazole for 6 weeks. All patients were seen regularly every 2 weeks for 6 weeks of treatment period, then monthly for the next three months as follow up period. Liver enzymes monitoring was done for every patient in this study every two weeks. Elevated liver enzymes were considered as features of hepatotoxicity in the examined patients. While group 2 included 900 patients and was divided into 3 subgroups: A: 600 patients with tineacapitis and tineacorporis, B: 100 patients with tineaversicolor, and C: 200 patients with CL. All patients in group 2 were treated with oral KC tablets 200 mg twice daily for 6 weeks. The dose of oral KC in children is 3.3 - 6.6 mg/Kg/day. All patients in group 2 were not investigated for ketoconazole biochemical side effects but watched for any clinical symptoms and signs of any side effects. Results: After six weeks, 951 patients had completed the treatment. In the first group (51 patients), only two out 27 patients (7.4%) from the combined group showed elevated liver enzymes while the ketoconazole treated group showed no increase in liver enzymes, hence only 3.9% showed elevated liver enzymes that went to normal during follow up. In the second group (900 patients) there were no clinical symptoms and signs in favor of hepatic toxicity or other related organs. Conclusion: Ketoconazole has been used tremendously in treating of different skin diseases including fungal and Leishmania infection but without side effects, accordingly this drug seems safe to be used in treatment of different skin diseases whether adults or children.

Exploring the safety and efficacy of adding ketoconazole to tacrolimus in pediatric renal transplant immunosuppression

BACKGROUND Guatemala is a developing country in Central America with limited health resources.In order to expand successful renal transplant care to children and adolescents at the lowest possible cost,our pediatric renal transplant clinic uses a post-transplant tacrolimus-sparing strategy via inhibition of CYP3A4.AIM To study the safety,efficacy and the associated cost reduction of ketoconazole in combination with tacrolimus in this pediatric population.METHODS A retrospective chart review was carried out among the cohort of pediatric renal transplant recipients treated at the Foundation for pediatric renal patients(Fundación para el Niño Enfermo Renal-FUNDANIER),a pediatric tertiary care renal transplant center in Guatemala City,Guatemala.Patient charts were reviewed to ascertain the number of transplant recipients who were transitioned from tacrolimus based immunosuppression to combination therapy with ketoconazole and tacrolimus.Twenty-five post-transplant patients that used ketoconazole combined with tacrolimus were identified.Anthropometric,clinical and laboratory data was collected from patient charts before and after the transition.RESULTS Of the 25 patient charts reviewed 12(48%)patients were male and the average patient age was 13 years.Twenty-four(96%)transplants were from living donors.There was a non-significant difference between the mean tacrolimus doses six months and two months prior to ketoconazole:-0.10±0.04(95%CI:0.007,-0.029),P=0.23.However,the difference between the mean tacrolimus doses six months prior to ketoconazole initiation and six months after ketoconazole addition was significant:0.06±0.05(95%CI:-0.034,-0.086)P<0.001.All tacrolimus doses were reduced by 45%after the addition of ketoconazole.Therapeutic levels of tacrolimus ranged between 6.8-8.8 ng/mL during the study period and patients demonstrated an increase in estimated glomerular filtration rate.The combination of tacrolimus and ketoconazole resulted in a 21%reduction in cost.CONCLUSION Patients experienced an effective dose-reduction of tacrolimus with the administration of ketoconazole.There was no relevant variations in tacrolimus serum levels,number of rejections,or significant liver toxicity.The strategy allowed a cost reduction in pediatric immunosuppressive therapy.

Determination of Ketoconazole in Pharmaceutical Formulations

Ketoconazole has been widely used as an antifungal drug ketoconazole shampoo. The aim of this research was to study and to that is formulated as tablets, cream and over-the-counter standardize an UV （ultraviolet spectrophotometric） method, potentiometry and a HPLC （high performance liquid chromatographic） method for the determination ofketoconazole in commercially available tablets. These three methods were compared and discussed with respect to their sensitivity, selectivity and ready-applicability in routine analytical work. Absorption spectra and spectrophotometric determinations were carried out on the UV spectrophotometer. Investigated concentrations that ranged from 0.003 mg·dm^-3 to 0.02 mg·dm^-3. The absorbance was measured at 224 nm. In potentiometric titrations, glass and saturated （KCI） calomel electrodes were used to determine the end point of the titration. HPLC analyses of ketoconazole were carried in the presence ofeconazole as internal standard. It was concluded that the described methods are simple, fast and reliable for the identification of ketoconazole in pharmaceutical preparations. The preparation of the samples was easy, the excipients did not interfere with the active substance in the methods, so they can be used in routine quality control analysis.

纳米塑料和酮康唑对霍甫水丝蚓肠道的影响

采用亚急性毒性试验方法,研究原始及不同官能团修饰的聚苯乙烯纳米塑料(NPs)和环境相关浓度酮康唑(KCZ)共暴露条件下霍甫水丝蚓的生物累积、组织病理学及肠道微生物响应.结果表明,共暴露7d,3种NPs均能被水丝蚓吸收并累积在体内,氨基修饰NPs的累积水平最低(2.78ng/mg),羧基修饰NPs的累积水平最高(22.85ng/mg).共存NPs显著减少了KCZ的生物累积,抑制率在第7d达到最高(88.9%~94.8%).KCZ单独及与NPs共暴露诱导了霍甫水丝蚓的肠道损伤,出现表皮和肠细胞退化、表皮和肠细胞增生、表皮表面不规则和产氯组织变性等病理变化.3种NPs的共存都显著降低了KCZ对胃蛋白酶和纤维素酶活性的抑制;而氨基修饰NPs的共存使D乳酸盐含量显著下降,羧基修饰NPs的共存使二胺氧化酶活性显著下降.KCZ单独暴露显著增加了水丝蚓肠道微生物的多样性,官能团修饰NPs的共存使微生物多样性降低,并改变了门水平的丰度和优势菌属,尤其是氨基修饰NPs共存时优势菌属均为致病菌,增加了水丝蚓感染的风险.

社区卫生服务中心外科常用西药药膏使用情况分析

目的:分析门诊处方中外科常用西药药膏的用药情况。方法:采集2020年1月—2022年12月期间中心外科处方进行统计、分析、讨论。结果:其中排名前3的药膏为莫匹罗星软膏、酮康唑乳膏(金达克宁)和丁酸氢化可的松乳膏,多用于治疗皮疹,其中用于治疗皮疹最多的药膏是莫匹罗星软膏,用于治疗癣最多的药膏是酮康唑乳膏(金达克宁)。此外,还存在少数莫匹罗星软膏和丁酸氢化可的松乳膏联用情况。结论:莫匹罗星软膏的总用量和总销售金额均排名第一,这3种药膏单用于疾病的情况基本合理,莫匹罗星软膏与丁酸氢化可的松乳膏联合使用具有可行性,可尝试推广于临床。

加味蛇黄膏治疗面部脂溢性皮炎疗效观察

【目的】观察加味蛇黄膏(由蛇床子、黄柏、花椒等中药组成)治疗面部脂溢性皮炎的临床疗效。【方法】将72例面部脂溢性皮炎患者随机分为观察组和对照组,每组各36例。2组患者均给予口服阿伐斯汀胶囊、维生素B6片治疗,在此基础上,观察组给予加味蛇黄膏外用治疗,对照组给予2%酮康唑乳膏外用治疗,疗程均为4周。观察2组患者治疗前后临床症状积分、皮肤病生活质量指数(dermatology life quality index,DLQI)评分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)治疗4周后,观察组的总有效率为88.89%(32/36),对照组为72.22%(26/36),组间比较,观察组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的红斑、鳞屑、油脂、皮疹面积、瘙痒程度等临床症状积分均较治疗前明显降低(P<0.05),且观察组治疗后的各项临床症状积分均明显低于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者的DLQI评分均较治疗前明显降低(P<0.05),且观察组患者治疗后的DLQI评分明显低于对照组,差异有统计学意义(P<0.05)。(4)治疗期间,2组患者均无明显不良反应发生,具有较高的安全性。【结论】在常规西药治疗基础上联合加味蛇黄膏外用治疗面部脂溢性皮炎疗效确切,可有效缓解患者临床症状,提高患者生活质量。

银屑病患者真菌分布特点及萘替芬酮康唑乳膏辅助治疗的应用效果

目的:分析银屑病患者真菌分布特点及萘替芬酮康唑乳膏辅助治疗效果。方法:选取2022年1月—2023年5月监利市中医医院皮肤科收治的120例银屑病患者。根据随机数表法将其分为研究组与对照组,各60例。对照组给予卤米松乳膏,研究组在对照组基础上给予萘替芬酮康唑乳膏。分析所有患者真菌分布情况。比较两组临床疗效,治疗前、治疗4周后皮损情况及瘙痒程度、炎症因子及不良反应。结果:120例银屑病患者中,共检出病原菌141株,真菌37株(26.24%),其中球形马拉色菌16株(43.24%),限制性马拉色菌10株(27.03%),酵母菌4株(10.81%),皮肤癣菌4株(10.81%),其他3株(8.11%)。治疗4周后,研究组总有效率(86.67%)明显高于对照组(71.67%),差异有统计学意义(P<0.05)。治疗4周后,两组银屑病皮损面积及严重程度指数(PASI)、视觉模拟评分法(VAS)评分均明显低于治疗前,研究组PASI评分、VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)及γ干扰素(IFN-γ)水平均降低,研究组IL-17、IFN-γ和TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。两组治疗期间均未出现刺激性疼痛、皮肤过敏等严重不良反应。结论:银屑病患者真菌以球形/限制性马拉色菌为主,在卤米松乳膏基础上加用萘替芬酮康唑乳膏辅助治疗,能取得更佳效果,可以让炎症因子水平下降,同时没有增加不良反应。

复方银唑散的含量测定及微生物限度检查方法学验证

目的建立反向高效液相色谱法同时测定复方银唑散中磺胺嘧啶银和酮康唑的含量并探讨其微生物限度检查方法。方法色谱柱为Agilent C_(18)(250 mm×4.6 mm,5μm);流动相:0.07%三乙胺(A,冰醋酸调节pH至5.07)-甲醇(B),梯度洗脱:0~6 min,A80%;6~8 min,A80%~22%;8~21 min,A保持22%;21~22 min,A22%~80%,流速1.0 mL/min,检测波长:240 nm,柱温:30℃。采用培养基稀释法作为需氧菌总数、霉菌及酵母菌总数计数方法并按《中国药典》2020年版四部通则微生物限度检查法对控制菌检查法进行验证。结果磺胺嘧啶银在0.02964~0.06915 g/L浓度范围下与峰面积呈良好的线性关系(r=0.9999),酮康唑在0.03054~0.07126 g/L浓度范围下与峰面积呈良好的线性关系(r=0.9998),磺胺嘧啶银和酮康唑的平均回收率分别为101.5%(n=6,RSD=0.33%)和98.8%(n=6,RSD=0.65%)。采用培养基稀释法,各试验菌的回收率均在0.5~2.0。结论所建立的高效液相色谱法定量准确、专属性良好,可用于同时测定复方银唑散中磺胺嘧啶银和酮康唑的含量。采用培养基稀释法对复方银唑散进行微生物限度检查可行。

中药外洗癣病方联合复方酮康唑软膏治疗手足癣临床观察

目的:观察中药外洗癣病方联合复方酮康唑软膏治疗手足癣的疗效。方法:132例分为两组,对照组61例用复方酮康唑软膏治疗,观察组71例用中药外洗癣病方及复方酮康唑软膏治疗。结果:总有效率观察组高于对照组(P<0.05)。治疗14d后临床症状积分观察组低于对照组(P<0.05)。治疗后1个月、3个月复发率观察组均低于对照组(P<0.05)。不良反应发生率观察组与对照组比较差异无统计学意义(P>0.05)。结论:中药外洗癣病方联合复方酮康唑软膏治疗手足癣有良好疗效,且不增加不良反应。

中药颗粒浸泡方联合萘替芬酮康唑治疗间擦糜烂型手足癣的疗效观察

目的观察中药颗粒浸泡方联合萘替芬酮康唑乳膏治疗间擦糜烂型手足癣患者的临床效果。方法选取2023年4月至2024年4月广州市皮肤病医院门诊部收治的120例间擦糜烂型手足癣患者进行前瞻性研究,采取随机数字表法分为对照组和观察组,各60例。对照组男35例、女25例,年龄(37.65±10.66)岁,病程(16.75±9.16)个月;采用萘替芬酮康唑乳膏外涂治疗,用药量参照一指尖单位使用,2次/d。观察组男32例、女28例,年龄(38.25±10.17)岁,病程(15.23±8.41)个月;在对照组的治疗基础上联合协定中药颗粒浸泡方泡洗治疗,颗粒剂配方:苦参、蛇床子、黄柏、地榆颗粒,1次/d,每次20 min。两组均治疗4周。比较两组治疗前、后皮肤相关症状评分、治疗效果及治疗安全性。统计学方法采用χ^(2)检验和t检验。结果治疗后,观察组患者皮肤破损、瘙痒、渗液、疼痛症状积分均低于对照组[(0.45±0.15)分比(1.34±0.17)分、(0.66±0.14)分比(1.42±0.21)分、(0.53±0.14)分比(1.38±0.18)分、(0.55±0.12)分比(1.33±0.19)分],差异均有统计学意义(t=10.78、10.53、10.56、10.11,均P<0.05)。观察组治疗总有效率高于对照组[88.33%(53/60)比65.00%(39/60)],差异有统计学意义(χ^(2)=9.37,P<0.05)。观察组真菌清除率高于对照组[86.67%(52/60)比68.33%(41/60)],差异有统计学意义(χ^(2)=8.67,P<0.05)。治疗期间,两组患者均未见明显的不良反应。结论在萘替芬酮康唑乳膏的基础上辅以中药颗粒浸泡方治疗间擦糜烂型手足癣患者,可提高治疗效果,且安全性好,值得临床推广。

葛根素通过抑制AHR/氧化应激途径改善酮康唑诱导的大鼠肝损伤研究

目的探讨葛根素保护酮康唑诱导的大鼠肝损伤的机制。方法将48只SD大鼠随机分为对照组、模型组、大、小剂量葛根素干预组(n=12),采用酮康唑灌胃造模或在造模的同时给予葛根素灌胃干预。采用RT-PCR法检测肝组织芳香烃受体(AHR)、细胞色素p450家族CYP1A1和CYP2E1 mRNA水平,采用免疫组化法检测肝组织AHR蛋白表达。结果模型组大鼠血清酶和氧化应激指标显著升高,提示造模成功,而葛根素干预显著降低了它们的水平(P<0.05);小剂量葛根素处理组肝组织谷胱甘肽(GSH)水平为(148.2±9.5)μM,显著高于模型组【(77.0±9.1)μM,P<0.05】,而氧化型谷胱甘肽(GSSG)水平为(84.7±9.3)μM,显著低于模型组【(131.4±13.4)μM,P<0.05】,大剂量葛根素处理组有类似的变化,只是作用更强;小剂量葛根素处理组肝组织AHR、CYP1A1和CYP2E1 mRNA相对水平分别为(28.4±3.3)、(23.7±1.8)和(9.0±1.5),均显著低于模型组【分别为(51.7±7.8)、(36.2±4.7)和(14.0±1.5),P<0.05】,大剂量葛根素组表现为作用更强;葛根素处理组动物肝组织AHR表达显著弱于模型组。结论葛根素可能通过抑制芳香烃受体介导的氧化应激反应改善酮康唑诱导的大鼠肝损伤。

耳内镜下外耳道冲洗联合酮康唑纱条对霉菌性外耳道炎的治疗效果分析

目的研究耳内镜下外耳道冲洗联合酮康唑纱条在霉菌性外耳道炎治疗中的应用价值。方法100例霉菌性外耳道炎患者,运用随机数字分组法分为观察组和对照组,每组50例。对照组采用耳内镜下外耳道冲洗治疗,观察组采用耳内镜下外耳道冲洗联合酮康唑纱条填充治疗。比较两组治疗效果,治疗前后炎性相关因子[超敏C反应蛋白(hs-CRP)、高迁移率族蛋白B1(HMGB1)、脂联素(ADP)、抵抗素(RES)]水平,复发率。结果观察组治疗总有效率86.00%高于对照组的62.00%(P<0.05)。治疗后,观察组hs-CRP(2.07±0.21)mg/L、HMGB1(1.08±0.05)mg/L、RES(6.02±0.89)ng/ml低于对照组的(5.89±0.26)mg/L、(2.82±0.28)mg/L、(7.58±0.88)ng/ml,ADP(11.88±1.52)mg/L高于对照组的(9.08±1.27)mg/L(P<0.05)。观察组总复发率4.00%低于对照组的18.00%(P<0.05)。结论采用耳内镜下外耳道冲洗联合酮康唑纱条对霉菌性外耳道炎患者进行治疗,能够提升治疗效果,改善炎性相关因子水平,复发率比较低,值得推荐。