泼尼松治疗麻风无痛性神经炎的研究

目的 :　评价不同剂量泼尼松治疗麻风无痛性神经炎的效果。方法 :　 84例共 10 2条神经分两组进行治疗。标准剂量组用泼尼松 4 0mg d ,1个月后渐减量 ,疗程 6个月 ;强化剂量组 6 0mg d,15天后渐减量 ,疗程 3个月。结果 :　标准剂量组的有效率为 6 1.6 % ,强化剂量组为 5 9.4 % ,差异无显著性 (P >0 .0 5 ) ,两组对不同部位神经炎的有效率无显著差异 (P >0 .0 5 )。结论 :　标准剂量泼尼松治疗麻风无痛性神经炎是有效和安全的。     

48例麻风病人神经炎监测及治疗结果

我们对4个试点的48例现症麻风病人定期进行神经功能检查，发现神经炎12例(25％)，其中1例无痛性神经炎，9例急性神经炎，2例混合性神经炎；共累及周围神经28条，尺神经和腓总神经受累所占比例较高，均为39．28％。结果：经泼尼松标准方案治疗，有效率达91．67％，其中急性神经炎有效率达100％，表明泼尼松治疗麻风神经炎行之有效。     

麻风无痛性神经炎的预防和治疗效果观察

我们自1994年起，对全市136例治愈麻风患者和30例现症病人进行无痛性神经炎的调查，对查出的8例无痛性神经炎患者和其他25例现症病人采用强的松规则服药6个月，以治疗和预防麻风无痛性神经炎，现将观察结果报告如下。     

泼尼松联合沙利度胺治疗重度II型麻风反应患者的疗效评价

目的：评价泼尼松联合沙利度胺治疗重度II型麻风反应患者的疗效。方法：重度II型麻风反应患者38例给予泼尼松30mg/d早晨顿服同时给予沙利度胺100mg/次,每日 3次,待症状控制后逐渐减量至停药,总疗程 4个月。结果：重度II型麻风反应患者痊愈率86.84％、显效率94.73％。结论：泼尼松联合沙利度胺治疗重度II型麻风反应患者疗效显著     

麻风无痛性神经炎的早期发现及治疗

对200例麻风现症和监测期病人进行3至30个月的系统观察,发现无痛性神经炎12例(6.0％),涉及14条神经,其中尺神经2条,腓总神经2条,面神经2条,胫神经8条。对所有病例用强的松标准方案治疗6个月,疗效按神经计为优7条(50％),良2条(14.3％),尚可4条(28.6％),无效1条(7.1％)。感觉和运动功能的恢复率分别为60％(6/10)和66.7％(4/6)(P>0.05)。本组所有接受强的松治疗者,均未见明显的副作用。对无痛性神经炎的诊断方法和治疗方案进行了讨论。     

强的松治疗麻风无痛性神经炎7例疗效报告

本文报告麻风无痛性神经炎7例,用强的松治疗6个月,治疗期间未出现任何明显的副作用。治疗结果令人鼓舞。     

麻风无痛性神经炎早期发现的研究

目的 :　了解麻风无痛性神经炎在各型及实施MDT治疗的不同时期的发生情况。方法 :　定时测试周围神经的感觉和运动功能 ,前后对照 ,以发现早期无痛性神经炎。结果 :　观察 4 5 6例MDT治疗期 ,监测期及解除监测期患者 ,发现无痛性神经炎 4 8例 ,累计检出率 10 .5 3%。治疗期患者的发生率明显高于监测期及解除监测期患者 (P <0 .0 1) ,尺神经和胫神经检出率明显高于其它神经 (P <0 .0 1)。结论 :定期检测周围神经功能 ,早期发现无痛性神经炎十分重要     

多菌型麻风在联合化疗期间发生神经损害及治疗效果的观察

研究MB麻风在MDT期间发生神经损害的情况及评估泼尼松治疗效果。定期对患者的神经功能进行检测并详细填写《麻风患者畸残记录表》;对麻风反应所致的神经损伤亦详细记录;对泼尼松的治疗效果进行全面评估。每例患者在初治前均有多条神经受累,MDT后神经粗大的例数和条数显著减少(P<0.01)。泼尼松对疼痛性神经炎及无疼痛性神经炎均有良好疗效,但对已发生运动功能障碍者效果有限。早期发现和早期治疗麻风病,以及在MDT期间注重对麻风反应的合理有效处置是防治神经功能发生障碍的主要措施和环节。泼尼松对各类神经炎具有良好疗效,但尚需采取其它综合措施以期取得更好效果。     

麻风无痛性神经炎——康复试点报告

对八个康复试点的3571例病人定期进行神经功能检查,发现无痛性神经炎151例(4.2％),共累及330条神经,包括面神经15条,尺神经98条,正中神经36条,胫后神经148条及腓总神经33条。经强的松标准方案治疗,神经功能好转235条(71.2％),其中恢复优、良者196条(59.4％),表明强的松治疗麻风无痛性神经炎既简单又行之有效,可作为常规,以减少神经不可逆性损害。讨论了无痛性神经炎与MDT的关系及其感觉与运动功能的恢复。     

麻风无痛性神经炎—康复试点报告

对八个康复试点的３５７１例病人定期进行神经功能检查，发现无痛性神经炎１５１例，共累及３３０条神经，包括面神经１５条，尺神经９８条，正中神经３６条，胫后神经１４８条及腓总神经３３条。经强的松标准方案治疗，神经功能好转２３５条，其中恢复优，良者１９６条，表明强的松治疗麻风无痛性神经炎既简单又行之有效，可作为常规，以减少神经不可逆性损害。     

Cyclosporine A treatment of leprosy patients with chronic neuritis is associated with pain control and reduction in antibodies against nerve growth factor

OBJECTIVES: Chronic neuritis (CN) is still a major problem in leprosy and is difficult to manage in patients who do not respond well to prednisone. In this study we (i) evaluate the efficacy of cyclosporine A (CyA) in controlling CN patients, and (ii) analyse the presence of anti-NGF antibodies in the sera of leprosy patients, and their behaviour during CyA treatment. DESIGN: This was an open, prospective, non-comparative study. Sixty-seven leprosy patients in three different institutions in Pará, Brazil were studied from January, 2001 to January, 2004. Of these, 47 had no CN and 20 were leprosy patients suffering from CN and taking at least 40 mg/day prednisone to control nerve impairment and pain. Patients received 12 months reducing course CyA starting at 5 mg/kg per day. The outcome measure was sensory impairment, assessed using Semmes-Weinstein monofilament examination (SWME), muscular force and spontaneous or palpation-related pain. RESULTS: Antibodies against NGF were detected in the sera of leprosy patients, which may explain the depletion of NGF in leprosy contributing to neuritis, inflammation and loss of cutaneous nociception. The levels of these antibodies in CN patients were slightly lower than in patients with no CN. However, anti-NGF titres in CN patients treated with CyA were lowered to levels similar to those in the normal subjects. There was also improvement in sensory impairment, muscular force and pain. CONCLUSIONS: These data suggest that anti-NGF antibodies are present in the sera of leprosy patients and may influence the outcome of neuritis, and that CyA might be a useful drug in controlling nerve impairment and pain in leprosy patients.     

山东省麻风畸残预防试点项目3年实施结果评价

目的：评价国际麻风救济会与山东麻风畸残康复合作项目３年效果。方法：本研究共包括山东省６个县、市１１３２名麻风畸残者。项目实施包括神经料的检测和治疗、自我护理培训、提供防护鞋、安装假肢及必要的外科手术。结果：４５例ＭＤＴ病人中,确诊神经炎３人,经６个月泼尼松治疗后,神经疼痛和压痛消失,１例病人的足底麻木得到改善。项目中多数病人已基本掌握了自我护理知识的技能。眼、手、足的继发性损害改善率分别为９６．９％、１００％、和７５．４％。结论：项目中所实施２的技术措施,特别是对病人进行的自我护理基本知识和技能,对改善病人的生活质量是极为有用的,但该项目的持久性问题有待进一步研究。     

ki-67和CD—1a的表达对5-ALA光动力治疗尖锐湿疣疗效的影响

目的：评价5-ALA光动力治疗尖锐湿疣（CA）的临床疗效，并探讨疗效与ki-67和CD—1a蛋白表达的相关性。方法：采用5-ALA光动力法对78例CA患者进行治疗，并采用免疫组化法检测ki-67、CD—1a在CA中的表达。结果：5-ALA光动力治疗CA，治愈率78．2％，复发率19．23％；CA皮损中ki-67高表达、CD—1a低表达的患者光动力治疗的临床治愈率低，易复发。结论：5-ALA光动力治疗CA的疗效与ki-67、CD-1a的蛋白表达可能具有一定相关性。     

2011-2020年山东省麻风现症病例管理方式改革效果评价

目的:以麻风反应、神经炎、药物不良反应的发现率和救治率,以及现症病例新畸残发生率为评价指标,评价我省现症病例管理措施的成效。方法:近十年来,我省采取常规麻风现症病例管理措施有人员培训、耐药监测、病例管理信息化、工作督导和技术指导等,我省的特色管理措施包括氨苯砜(DDS)超敏综合征(DHS)精准预防、病例省级管理、麻风反应神经炎和药物不良反应的省级确认与救治。结果:2011-2020年期间,我省共有麻风现症病例328例,失访20例,死亡26例,外迁2例,判愈224例,截止到2020年底,尚有现症患者56例。全省共救治麻风反应312人次,神经炎106人次,药物不良反应8例,救治率均达到100%。规划期间,共有新发及重症麻风现症患者41例接受了住院治疗,救治神经炎34人次,麻风反应41人次。通过实施现症病例管理措施,我省麻风现症病例的麻风反应、神经炎和药物不良反应早期发现和及时救治率达到100%。联合化疗期间新畸残发生率为1.3%,明显低于国家规划不超过10%的控制目标。山东省皮防所首先成功定位了DHS的风险位点,为2015年以来全国21省份的3197例新发麻风病例进行疗前监测,阳性者避免服...     

Effectiveness of the retreatment of patients with multibacillary leprosy and episodes of erythema nodosum leprosum and/or persistent neuritis: a single-center experience

Background: Erythema nodosum leprosum may appear before, during or after treatment of leprosy and is one of the main factors for nerve damage in patients. When it occurs or continues to occur after treatment, it may indicate disease recurrence and a new treatment may be instituted again.Objective: To evaluate the retreatment of patients with multibacillary leprosy who underwent standard treatment with multidrug therapy, but developed or continued to present reactions of erythema nodosum leprosum and/or neuritis 3-5 years after its end.Method: For this objective, a new treatment was performed in 29 patients with multibacillary leprosy who maintained episodes of erythema nodosum and/or neuritis 3-5 years after conventional treatmentResults: In general, we observed that 27 (93.10%) had no more new episodes after a follow up period of eight months to five years. In five of these patients the reason for the retreatment was the occurrence of difficult-to-control neuritis, and that has ceased to occur in all of them.Study limitations: Small number of patients.Conclusion: In the cases observed, retreatment was an effective measure to prevent the occurrence of erythema nodosum leprosum and/or persistent neuritis.     

1010例麻风畸残预防及康复项目3年评价

目的：评价英国国际麻风救济会和江苏省盐城市麻风康复合作项目的效果。方法：在广泛宣传传动员社区参与的基础上,由康复专业医生与乡村初保医生一道对１０１０例康复对象进行定期康复干预,其中８８例参加了神经炎早期发现和治疗项目,９２０例参加了眼手足自我护理项目,５９２例参加了防护鞋的使用和观察项目,１５３例参加了复杂性足底溃疡综合防治项目,１２例参加了假肢安装与使用项目。     

Reduction in caseload after multidrug therapy in an urban leprosy control programme--a retrospective study in Bombay

A fall in the active registered case prevalence rate together with a fall in the active caseload per worker after the introduction of multidrug therapy (MDT) is becoming a managerial issue in leprosy control. A retrospective analysis was undertaken to assess the caseload per paramedical worker with reference to active cases for treatment (3341), cases for surveillance (2227) and cases for care after cure (165) at the end of December 1989. All these cases were under the care of 24 paramedical workers. The analysis showed that the caseload per worker was 239 (active cases 139, plus surveillance cases 93, plus care after cure cases 7), though active registered case prevalence rate declined from 1.82/1000 (before starting MDT) to 0.79/1000 by the end of December 1989. The case detection rate was 0.49/1000 by the end of 1989. So, although the active registered case prevalence rate declines, the worker will have enough to do because of the need for surveillance and the detection of relapses, early neuritis, early disabilities and care after cure. Simultaneously, new case detection and treatment must be continued. All these aspects need to be considered when programme managers are reviewing leprosy control strategy.