特比萘酚联合氟康唑治疗真菌性角膜炎的药效观察

发布时间：2018-03-07 20:50

本文选题：特比萘酚　切入点：氟康唑　出处：《青岛大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：特比萘酚为新型丙烯胺类抗真菌药,抗菌谱较广,其片剂、膏剂在皮肤科已得到广泛应用,效果较好,在眼科的应用研究较少。而另一种抗真菌药氟康唑,因眼内渗透性好,半衰期较长,副作用少,在眼科治疗真菌性角膜炎有广泛的应用,对曲霉菌、念珠菌、青霉菌等疗效较好,而对镰刀菌属的敏感性降低。据统计,真菌性角膜炎的发病率逐年升高,且致病菌种已发生改变,以镰刀菌属及曲霉菌属为主,临床用于治疗真菌性角膜炎的药物数量有限,且部分药物价格昂贵,在广大基层医院并未得到普及。特比萘酚与氟康唑两药联合有协同作用。研究两药联用治疗真菌性角膜炎的方法及疗效,并进行统计学分析,为临床应用提供参考方法：1.临床病例的采集：收集我院门诊及住院真菌性角膜炎病人,根据病史及临床表现对怀疑真菌性角膜眼的病人,进行刮片镜检及真菌培养,明确诊断。2.病人的分组：根据两组平衡及随机的原则,把所选病人,依据所制定的轻、中、重的分类标准,使两组病人的病变程度基本平衡。3.治疗方案的选择：将特比萘酚粉末配制成0.5%的特比萘酚眼药水,频繁点眼,同时应用氟康唑眼水(静达),与前者交叉点眼。并静点氟康唑,口服特比萘酚,同时全身及局部应用消炎、促修复类药物。单用组未用特比荼酚眼药水及口服药,余用药两组相同。观察疗效,并记录疗程。4.数据处理：将观察所得数据进行统计学分析,比较两组用药疗效及疗程上是否有统计学差异结果：观察期间共收集到真菌性角膜炎病人27人,均做了刮片镜检及细菌培养,且至少有一项阳性,才能确诊。此27例病人联合组分得14例,轻、中、重病人数分别为8,5,1,单用组分得13例,轻、中、重病人数分别为8,4,1。联合组治愈率71.43%,治愈周期平均为21.4天,单用组治愈率30.77%,治愈周期平均为23.1天。两组比较进行统计学分析。结论：特比萘酚联合氟康唑治疗真菌性角膜炎疗效优于单用氟康唑治疗组,尤其是角膜炎属于轻、中组的病人,联合用药治疗效果明显好于单用氟康唑治疗组的病人。治愈病人的治疗周期联合用药组较单用药组略短。
[Abstract]:Objective: terbinaphthol is a new antifungal agent with broad antibacterial spectrum. Its tablets and plasters have been widely used in dermatology with good results and less research in ophthalmology, while fluconazole, another antifungal drug, has been widely used in dermatology. Because of its good permeability, long half-life and less side effects, it has been widely used in the treatment of fungal keratitis in ophthalmology, and has a better effect on Aspergillus, Candida and Penicillium, but its sensitivity to Fusarium is reduced. According to statistics, The incidence of fungal keratitis has increased year by year, and the pathogenic species have changed, mainly in Fusarium and Aspergillus. The number of drugs used in clinical treatment of fungal keratitis is limited, and some drugs are expensive. The combination of terbinaphthol and fluconazole has synergistic effect. To study the method and curative effect of the two drugs in the treatment of fungal keratitis, and to carry on the statistical analysis, to provide the reference for the clinical application. Methods: the collection of clinical cases: the patients with fungal keratitis were collected from outpatients and inpatients in our hospital. According to the history and clinical manifestations, the patients suspected of fungal keratoderma were examined by scrape microscopy and fungal culture. Categorization of patients: according to the principles of balance and randomness in two groups, the selected patients are classified according to the established criteria of light, medium and heavy, The degree of lesion in the two groups was basically balanced .3. the choice of treatment plan: terbinol powder was prepared into 0.5% terbinol eye drops, frequent eye drops, and fluconazole eye water (Jingda, intersecting point eye with the former), and intravenous fluconazole, Oral terbinol, systemic and local use of anti-inflammatory, pro-repair drugs. Single use of terbiol eye drops and oral medicine, the rest of the two groups were the same. And record the course of treatment .4. data processing: observe the data for statistical analysis, to compare the efficacy of the two groups and whether there is statistical difference in course of treatment. Results: a total of 27 patients with fungal keratitis were collected during the observation period, all of whom were examined by scraping and bacterial culture, and there was at least one positive test before the diagnosis could be confirmed. The combined group of 27 patients was divided into 14 cases, mild and moderate. The number of patients with severe diseases was 80.13 cases were divided into two groups: mild, moderate and severe. The cure rate of the combined group was 71.433.The average cure period was 21.4 days, the cure rate was 30.77 and the average cure period was 23.1 days in the single use group. Statistical analysis was carried out between the two groups. Conclusion: terbinol combined with fluconazole is more effective than fluconazole alone in the treatment of fungal keratitis, especially in patients with mild and moderate keratitis. The effect of combination therapy was better than that of fluconazole group, and the treatment cycle of cured patients was shorter than that of single drug group.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R772.21

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