甲癣涂剂的制备及疗效观察

目的：研究甲癣涂剂的制备工艺、质量控制方法，观察甲癣涂剂的疗效。方法：以二甲基亚砜为溶剂制备高浓度的水杨酸溶液，采用酸碱滴定法测定水杨酸含量。结果：含量测定的平均回收率为100．02％，RSD为0．17％，临床用于治疗甲癣患8例(共17只病甲)，治愈病甲16只。结论：该制剂质量稳定，使用方便，疗效较好。     

Onychomycosis due to Achaetomium strumarium

Onychomycosis is the most common infection of the toe-nails or finger-nails and it may be caused by a large variety of fungal species. Achaetomium species which belong to the phylum Ascomycota (Family Chaetomiaceae), are usually soil saprophytes or endophytic fungi which have been rarely reported as human or animal pathogens. Here, we report a case of onychomycosis caused by Achaetomium strumarium in a healthy person who showed involvement of all fingers of both hands with yellowish brown discoloration. The causative agent isolated was identified as Achaetomium species by morphology, colony morphometry and growth at high temperature and as A. strumarium from DNA sequence of ITS region. Onychomycosis from this case responded satisfactorily with per os (P. O.; oral) and topical application of Terbinafine.     

Solubilización in vitro del aceite de árbol de té y primeros resultados de su efecto antifúngico en onicomicosis

IntroductionOnychomycosis is the main cause of nail alteration. Hepatotoxicity, interference and low adherence to pharmacological treatment are associated. Therefore, our objective was to assess the in vitro effectiveness of tea tree essential oil (less harmful) against main causative agents of these infections.Material and methodsTrichophyton rubrum and Trichophyton mentagrophytes were isolated and inoculated at a concentration of 3x10⁵ CFU / mL in potato agar dextrose and tea tree essential oil at different concentrations to assess its effect by counting colony forming units and radial growth.ResultsTrichophyton rubrum growth inhibition was obtained at concentrations higher than 0.04% of the essential tea tree oil (p = 0.004). In the case of Trichophyton mentagrophytes, inhibition was obtained at 0.02% (p = 0.017), and even complete inhibition at a final concentration of the oil at 0.07%.ConclusionsTea tree essential oil inhibits the in vitro growth of the fungus and may be a less harmful alternative to the onychomycosis treatment.     

Enhancement of tioconazole ungual delivery: Combining nanocapsule formulation and nail poration approaches

This work investigated the impact of formulation including in vitro release profile, repeated dosing, and nail poration on the ex vivo nail delivery performance of antifungal formulations. Chitosan coated and uncoated tioconazole-loaded nanocapsules and a nano-based film-forming vehicle were assessed via in vitro release and in vitro permeation tests using an artificial membrane and human nail clippings, respectively. The later involved single and daily dosing experiments with intact and porated nails. Additional experiments with Nile Red-loaded formulations evaluated the depth of penetration of the fluorescent marker into the nail by laser scanning confocal microscopy. The nanocapsule formulations prolonged release of tioconazole for longer than the control solutions and this ability was related to an enhanced nail penetration of the drug. Further, the new film-forming formulation delivered its drug payload more efficiently than a marketed product. Daily dosing of the formulations doubled the amount of drug recovered from the nails. Porating the nails enhanced tioconazole delivery in single dose experiments only. The depth of penetration of Nile Red into the nails clippings ranged between 90–160?μm. This research suggests that ensuring prolonged release of a drug is fundamental to develop efficacious topical nail formulations.     

伊曲康唑不同治疗方案对比特比萘芬治疗甲真菌病疗效和安全性的Meta分析

目的:系统评价伊曲康唑不同治疗方案对比特比萘芬治疗甲真菌病的临床疗效与安全性,以为临床治疗提供循证参考。方法:计算机检索Pub Med、EMBase、Medline、The Cochrane Library、中国期刊全文数据库、维普中文科技期刊全文数据库、万方数字化期刊全文库,收集伊曲康唑对比特比萘芬治疗甲真菌病的随机对照试验(RCT),提取资料并评价质量后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入11项RCT,合计1 886例患者。Meta分析结果显示,伊曲康唑连续治疗的临床治愈率[RR=0.94,95%CI(0.76,1.18),P=0.61]与特比萘芬比较差异无统计学意义,而真菌学治愈率[RR=0.80,95%CI(0.68,0.95),P=0.01]和总治愈率低于特比萘芬,两组比较差异有统计学意义;伊曲康唑冲击治疗的临床治愈率[RR=0.75,95%CI(0.65,0.87),P<0.000]和总治愈率[OR=0.39,95%CI(0.27,0.55),P<0.000]低于特比萘芬,而真菌学治愈率与特比萘芬比较差异无统计学意义[RR=0.82,95%CI(0.63,1.07),P=0.14];两组患者消化系统不良反应发生率比较,差异无统计学意义[OR=1.02,95%CI(0.83,1.25),P=0.86]。结论:伊曲康唑不同治疗方案治疗甲真菌病的疗效均低于特比萘芬,安全性相似。由于纳入研究数量较少、质量一般,该结论尚有待大样本、高质量的RCT进一步验证。