特比萘芬治疗伊曲康唑抵抗及复发或再感染的甲真菌病的疗效观察

目的 观察特比萘芬对伊曲康唑治疗甲真菌病抵抗及复发或再感染者的疗效，为难治性、复发性甲真菌病治疗提供临床经验。方法 我们选取伊曲康唑治疗甲真菌病抵抗4例及复发或者再感染13例，共17例门诊患者，特比萘芬口服，250mg，1／d，连续12周，观察治疗结束时和随访24周的疗效和不良反应。结果 治疗结束时真菌学疗效可达88．2％，其中指甲为100％，趾甲为85．7％，随访24周真菌学治愈率为100％。治疗结束时临床疗效有效率达84．2％，其中指甲为66．7％，趾甲为85．7％；随访至24周时有效率为94．1％，指甲100％，趾甲92．9％。仅2例出现了轻度的胃部不适、皮肤瘙痒及头痛。结论 特比萘芬对伊曲康唑治疗抵抗及复发或再感染的甲真菌病者疗效好，且耐受性好，不良反应少，安全性高。

Observation of the Efficacy of Terbinafine on Itraconazole-Resistant,Recurrent and Reinfected Onychomycosis

Objective To observe the efficacy of terbinafine on tr ea ting patients with itraconazole-resistant, recurrent and reinfected onychomycos is. Methods We selected 17 outpatients with itraconazole-resistant (4cases), resurrent and reinfected (13cases) onychomycosis, whom were treated w ith terbinafine, 250 mg, PO, qd, for 12 weeks consecutively. Then the efficacy a nd side effects of terbinafine were recorded at the end of treatment and 24-wee k follow-up. Results The fungal removal rate of terbinafine at the end of treatment was 88.2%, including 100% for nail, 85.7% for toenail, and t he fungal removal rate of 24-week follow-up was 100%. The effective rate of te rbinafine at the end of treatment was 84.2%, including 66.7% for nail, 85.7% for toenail, and the effective rate of 24-week follow-up was 94.1% (100 for n ail, 92.9% for toenail). 2 of the 17 cases had slight stomach uncomfort, skin itch and headache. Conclusion Terbinafine is efficient for itracona zole-resistant, recurrent and reinfected onychomycosis with good tolerability a nd high safety.