蒿甲醚伍用伯氨喹治疗恶性疟的研究

目的　观察蒿甲醚伍用伯氨喹治疗恶性疟的疗效和副作用。　方法　在中非共和国选择恶性疟12 1例 ,随机分为两组。伍用组 :口服蒿甲醚 80mg ,qd× 5d ,首日蒿甲醚 16 0mg加服伯氨喹 3片 (含基质 7 5mg ,qd× 3～ 4d)治疗 32例 ;肌注蒿甲醚加服伯氨喹 ,治疗 2 9例 ;对照组 :单用口服蒿甲醚治疗 33例和肌注蒿甲醚治疗 2 7例 ,B组、C组和D组所用剂量与疗程均同A组。上述病例于用药前及后 6、 14、 2 1、及 2 8d各随访1次 ,密切观察病例的临床症状与体征变化。　结果　A组、B组、C组和D组病例的平均退热时间分别为(47 6± 15 7)、 (36 9± 10 7)、 (48 5± 18 4 )和 (42 2± 9 5 )h。其临床治愈率依次为 84 4 %、 10 0 %、 90 1和96 3% ,其复燃率依次为 6 3%、 3 4 %、 2 1 2 %和 18 5 %。 4组药物副作用均轻。　结论　蒿甲醚伍用伯氨喹及单用蒿甲醚 (口服或肌注 )对恶性疟治疗作用均良好 ,但联合使用药物能降低恶性疟的复燃率     

比较蒿甲醚配伍苯芴醇及氯喹单用治疗坦桑尼亚恶性疟患儿的效果和安全性

CGP56697是一种口服的、用蒿甲醚和苯芴醇按固定剂量配伍的复方,该药产于中国,已用于治疗恶性疟病人。单用蒿甲醚治疗恶性疟病人常发生复燃,苯芴醇是一种高效抗疟药,但作用缓慢。把蒿甲醚的快速作用和苯芴醇的高治愈率相结合是合理的。作者选择坦桑尼亚Ifakara某医院门诊的260名患恶性疟儿童为研究对象,用该药治疗,并对其效果和安全性进行评价。     

复方蒿甲醚及复方甲氟喹治疗恶性疟56例

2001~2003年,作者在西非马里采用WHO推荐的复方蒿甲醚及复方甲氟喹治疗方案,治疗4~14岁恶性疟各28例。平均退热时间、无性体阴转时间及治愈率,复方蒿甲醚组分别为(35.3±6.4)h、(34.7±6.9)h及100%,复方甲氟喹组分别为(32.6±5.8)h、(36.8±5.3)h及96.4%。两组间差异均无显著性(P>0.05)。     

双氢青蒿素-磷酸哌喹和蒿甲醚-本芴醇两种复方对海南岛无并发症恶性疟的疗效观察

目的 观察双氢青蒿素-磷酸哌喹和蒿甲醚-本芴醇两种复方抗疟药对海南岛无并发症恶性疟的治疗效果。 方法 2005-2006年在海南省5县（市）恶性疟流行区,选择1～60岁无并发症单纯恶性疟病例107例（原虫无性体密度为1 000～200 000个/μl）,病例随机分为2组,A组55例, 口服双氢青蒿素-磷酸哌喹治疗（成人总剂量8片,1次/d,疗程为3 d,首日4片）, B组52例,口服蒿甲醚-本芴醇治疗（成人总剂量24片,2次/d,早晚各服4片,疗程为3 d）。 按照WHO体内法观察标准进行治疗、观察和随访。 结果 A组55例,全部完成治疗、观察和28 d随访,平均退热时间为(22.35±13.26） h,平均原虫转阴时间为（34.99±12.28） h;B组52例中有51例完成治疗、观察和28 d随访, 平均退热时间为（20.99±11.38） h,平均原虫转阴时间为（36.45±12.60） h,两组间差异均无统计学意义（P>0.05）。28 d随访两组病例均未出现复燃。个别病例在服药后出现中枢神经系统及胃肠道反应, 如头痛、恶心、呕吐等,症状较轻,停药后即自行消失。未出现严重的不良反应。 结论 双氢青蒿素-磷酸哌喹和蒿甲醚-本芴醇两复方治疗海南岛无并发症恶性疟效果好,控制症状快,治愈率高。     

复方蒿甲醚片治疗抗药性恶性疟临床研究

复方蒿甲醚片是由抗疟新药苯芴醇与蒿甲醚配伍的新制剂，在抗药性恶性疟流行区治疗恶性疟现症病人５７例，临床治愈率１００％；平均退热时间３５．７±１８．２ｈ，原虫无性体转阴时间４０．１±１０．８ｈ，２８ｄ根治率９４．６％。用药后无不良反应，原虫配子体出现率２．１％。它对原虫在蚊体内孢子增殖有抑制效果。对减少疟疾传播有益，适宜于抗药性恶性疟的治疗。     

复方蒿甲醚片治疗疟疾46例的疗效观察

198 9-1 990年在海南和云南用复方蒿甲醚片治疗抗药性恶性疟和间日疟 ,取得了良好的效果 [1 ] 。为了解 6年后的有效性、敏感性和对间日疟的远期疗效 ,我们于1 996-1 997年在滇南抗药性恶性疟和间日疟混合流行区进行了如下观察。1　材料和方法1 .1　观察对象血检确诊的无并发症恶性疟、间日疟现症患者。恶性疟原虫密度 4 0 0 0个 /μl以上 ,间日疟 80 0个 /μl以上 ,年龄 5～ 68岁 ,一周内未服用过抗疟药 ,以及磺胺、四环素、砜类药物等。1 .2　药物及治疗方案复方蒿甲醚片为昆明制药股份有限公司生产 ,每片含蒿甲醚 2 0 mg、本芴醇 1 2 0 m…     

复方蒿甲醚片治疗间日疟的效果

目的： 观察复方蒿甲醚片治疗间日疟疗效的影响。方法：用复方蒿甲醚片（每片含苯芴醇 １２０ ｍ ｇ、蒿甲醚 ２０ ｍ ｇ）１６ 片３ ｄ 分服（ Ａ 组）、２０ 片５ ｄ 分服（ Ｂ组）,氯喹 伯氨喹８ 日疗法（ Ｃ对照组）三组分别治疗３６ 例、４１ 例和 ５５ 例。结果： Ａ、 Ｂ、 Ｃ三组的平均退热时间相近,分别为 ２２．３ ｈ、２３．２ ｈ 和２５．０ ｈ;平均原虫转阴时间为３３．５ ｈ、３０．５ ｈ 和４４．９ ｈ; Ａ、 Ｂ两组均显著快于 Ｃ组（ Ｐ＜ ０．０１）。治后９ 个月的临床复发率： Ａ、 Ｂ、 Ｃ组各为８４．９％ 、７８．８％和 ２２．９％ ; Ａ、 Ｂ组均显著高于 Ｃ组（ Ｐ均＜ ０／０１）。结论：两种治疗方案治疗间日疟均具有速效。     

复方萘酚喹片治疗恶性疟的临床观察

目的　临床观察复方萘酚喹片对恶性疟的疗效和安全性。　方法　在海南省疟疾流行区共收治恶性疟病人32 0例 ,其中 10 0例病人进行了血常规、血生化、尿、心电图等指标的检测。患者一次口服复方萘酚喹片 14 0 0 mg,住院 3～ 7d,随访 2 8d。　结果　收治的 32 0例中 ,2 8d治愈率为 97.5 % (312 /32 0 ) ,有 8例复燃。平均退热时间为 (17.5±11.4 ) h,2 4 h原虫下降率为 (97.3± 8.8) % ,原虫转阴时间为 (2 9.9± 8.7) h,临床及实验室检查均未见明显不良反应。　结论　复方萘酚喹片是一个高效、速效、服药简便且安全的新复方抗疟药。     

青蒿琥酯分别与氯喹、克林霉素联用对恶性疟的疗效

目的　了解青蒿琥酯分别与氯喹、克林霉素联用对抗药性恶性疟的疗效。　方法　在中老、中缅边境抗药恶性疟流行区 ,采用青蒿琥酯与氯喹 (A组 )或克林霉素 (B组 )联用 3d疗法治疗和观察无并发症的恶性疟。　结果　共完成96例观察 ,A组 34例、B组 6 2例 ,平均退热时间分别为 (2 8.6± 13.9) h和 (2 8.3± 18.7) h;平均原虫无性体转阴时间分别为 (31.8± 11.1) h及 (32 .7± 9.9) h,2 8d复燃率分别为 12 .0 % (3/ 2 5 )、13.6 % (8/ 5 9)。　结论　青蒿琥酯与氯喹或克林霉素联用对抗药性恶性疟的治疗具有一定的增效作用 ,但根治率均在 90 %以下     

复方蒿甲醚和本芴醇胶丸治疗恶性疟疗效对比

１９９６年６—１１月在海南省三亚市对复方蒿甲醚与本芴醇胶丸治疗恶性疟的疗效进行了比较,实验采用随机、对比的方法。病人入院后实行２８天封闭观察。实验共收治１００例病人,其中复方蒿甲醚组（Ａ）５１例,本芴醇胶丸组（Ｂ）４９例。Ａ、Ｂ两组的平均退热时数分别为１７．１±８．６、２９．４±２４．９小时;平均原虫转阴时间分别为２９．７±８．９、５４．７±１７．４小时;Ａ、Ｂ两组的治愈率分别为９８．０％、９５．９％。结果表明,复方蒿甲醚和本芴醇胶丸对恶性疟均有良好的治疗作用,但复方蒿甲醚在杀虫速度和控制症状方面明显优于本芴醇胶丸。     

双氢青蒿素与磷酸萘酚喹伍用治疗恶性疟的疗效观察

目的　观察双氢青蒿素与磷酸萘酚喹配伍使用治疗恶性疟的疗效。　方法　以显微镜血检单纯恶性疟原虫阳性患者为观察对象 ,药物为双氢青蒿素 1 60mg加磷酸萘酚喹 40 0mg(成人量 ) ,一次顿服 ,服药后按时测量体温和血检原虫 ,随访 2 8d ,观察治疗效果。　结果　收治 37例恶性疟患者 ,有 1例复燃 ,治愈率为 97.3 %。平均退热时间为(1 5 .8± 8.7)h ,2 4h平均原虫下降率为 96 .7%± 2 6 .5 % ,原虫无性体转阴时间平均为 (2 7.6± 1 3 .2 )h ,药后无明显不良反应。　结论　双氢青蒿素与磷酸萘酚喹配伍使用治疗恶性疟具有良好的效果     

Dose findings of dihydroartemisinin in treatment of falciparum malaria

Forty patients with uncomplicated P. falciparum malaria were respectively treated in an open randomized comparative study of dihydroartemisinin tablets given at total doses of 480 mg over 5 days and 640 mg over 7 days in a drug-resistant malaria endemic area in Hainan, China. The result showed that all patients were clinically cured. In 5-day and 7-day groups, the mean fever clearance times (FCT) were 26.1+/-10.2 and 21.1+/-11.8 hours respectively; the mean parasite clearance times (PCT) were 58.7+/-20.9 and 59.4+/-20.9 hours respectively, which showed no significant difference. 28-day follow-ups were accomplished on 39 and 37 cases respectively in two groups, the recrudescence rates were 20.5% (8/39) in 5-day group, while 2.7% (1/37) in 7-day group with significant difference (chi2=4.19, p<0.05). No clinical drug-related side effect was found in two groups during treatment.     

双氢青蒿素治疗37例疟疾患者的疗效观察

为评价双氢青蒿素对疟疾的疗效，以双氢青蒿素总剂量４８０ｍｇ的７天疗法治疗３７例疟疾患者，其中恶性疟２５例，间日疟１２例。２５例恶性疟患者中５例为早期脑型疟，３例并发血红蛋白尿。２５例的平均末梢血疟原虫数为７３２１８／μｌ，治疗后平均退热时间为３６．２４±１５．３０小时，平均原虫转阴时间为４４．８０±１９．０９小时。随访２１例，１例在１９天后复燃，复燃率为４．８％。１２例间日疟患者的平均血疟原虫数为４９５０／μｌ，治疗后平均退热时间为１６．７５±１４．５５小时，平均原虫转阴时间为２９±９．５２小时，其中１例在３５天后复发，经再次双氢青蒿素及伯喹治疗后痊愈。全部病例服药后无明显不良反应。     

Artemether treatment of recrudescent Plasmodium falciparum malaria in children

Summary Intramuscular artemether given for five days was evaluated prospectively in 32 patients with acute recrudescent Plasmodium falciparum malaria. All patients had experienced one or more treatment failures with one or more courses of the following drugs: chloroquine, amodiaquine, sulphadoxine-pyrimethamine and erythromycin given alone or in combination. There was a prompt response to treatment with fever and parasite clearance times of 10.7 (3.6) h (range 6–24) and 32.3 (8.3) h (range 24–48) respectively. Parasite reduction at 24 h was 93.2 (7.8)% (range 75–100). The cure rate on day 14 was 100%. The drug was well tolerated. These results suggest that artemether is rapidly effective in acute recrudescent Plasmodium falciparum malaria and is without deleterious side effects.     

Treatment of patients with recrudescent falciparum malaria with a sequential combination of artesunate and mefloquine.

A sequential combination of artesunate followed by mefloquine was evaluated prospectively in 24 patients with acute recrudescent falciparum malaria. The sequential combination was used to minimize possible side effects and to take advantage of the ability of artesunate to rapidly clear parasitemia and the prolonged effect of mefloquine to clear residual parasites. All patients had experienced one or more treatment failures with one or more courses of the following drugs (administered alone or in combination): quinine, tetracycline, mefloquine, artesunate, and sulfadoxine/pyrimethamine. Sequential treatment with artesunate (600 mg over five days) followed by mefloquine (750 mg and 500 mg six hours apart) cured all 24 patients. Each patient was followed for 28 days and 10 were observed for at least 35 days without clinical or parasitologic evidence of recrudescence. Fever and parasite clearance times after treatment with the sequential combination were 32.8 +/- 19.3 hr (mean +/- SD) and 40.0 +/- 16.2 hr, respectively. Susceptibility testing of selected parasite isolates indicated that all of the isolates tested were resistant to one or more antimalarial drugs. These results suggest that sequential treatment with artesunate followed by mefloquine is effective and well-tolerated in patients with recrudescent falciparum malaria.     

Double blind randomised clinical trial of two different regimens of oral artesunate in falciparum malaria.

A double blind randomized comparative trial of the efficacy of 7-day and 5-day courses of oral artesunate at 600 mg was studied in 89 Thai patients with uncomplicated falciparum malaria. Eighty patients completed the 28-day follow-up period. Artesunate was found to be well tolerated in either regimen. There was an increase of 7% in the cure rate obtained from a 7-day regimen. In 43 patients with a 7-day regimen, the cure rate was 92.5% and 15 patients showed P. vivax in their peripheral blood between days 12 and 34. The mean fever and parasite clearance times were 20 and 40 hours, respectively. In 46 patients with a 5-day regimen, the cure rate was 85% and 8 patients showed P. vivax during days 13 and 24. The mean fever and parasite clearance times were 29 and 40 hours, respectively. Although the cure rates of oral artesunate were high in both regimens, the efficacy was considered unsatisfactory since the aim of the treatment is to achieve 100% cure rate. We suggest however that the extension of the duration of treatment to 7 days together with the increase in total dose may improve therapeutic efficacy of artesunate in falciparum malaria.     

Treatment of acute uncomplicated falciparum malaria with artemether-lumefantrine in nonimmune populations: a safety, efficacy, and pharmacokinetic study

The efficacy and safety of artemether-lumefantrine for the treatment of malaria in nonimmune populations are not well defined. In this study, 165 nonimmune patients from Europe and non-malarious areas of Colombia with acute, uncomplicated falciparum malaria or mixed infection including P. falciparum were treated with the six-dose regimen of artemether-lumefantrine. The parasitologic cure rate at 28 days was 96.0% for the per protocol population (119/124 patients). Median times to parasite clearance and fever clearance were 41.5 and 36.8 hours, respectively. No patient had gametocytes after Day 7. Treatment was well tolerated; most adverse events were mild to moderate and seemed to be related to malaria. There were few serious adverse events, none of which were considered to be drug-related. No significant effects on ECG or laboratory parameters were observed. In conclusion, the six-dose regimen of artemether-lumefantrine was effective and well tolerated in the treatment of acute uncomplicated falciparum malaria in nonimmune patients.