伊曲康唑间歇冲击疗法治疗甲真菌病临床追踪观察

目的 评价伊曲康唑间歇冲击疗法治疗由皮肤癣菌、酵母菌和霉菌引起的甲真菌病的有效性、安全性及停药2年内的复发率.方法 采用间歇冲击疗法,连续服用伊曲康唑(2次/d,200mg/次,国药准字H20020367)7d,停药21d为1个疗程.指甲真菌病服药2个疗程;趾甲真菌病服药3个疗程.观察疗程结束、停药3个月、6个月指(趾)甲真菌病的临床治愈率及2年内甲真菌病的复发率.结果 疗程结束时,停药后3个月、6个月时指甲真菌病的临床治愈率分别为23.17%、80.49%和91.46%;指(趾)甲同患真菌病的临床治愈率分别为13.56%、62.71%和81.36%.疗程结束后,经追踪观察,随时间延长治愈率不断提高,停药后6个月达到最高.指甲真菌病治愈率高于趾甲真菌病.停药2年内复发率为14%.结论 伊曲康唑间歇冲击疗法治疗甲真菌病具有疗效高、副作用小、安全性好、耐受性高、复发率低的特点.     

伊曲康唑短程间歇冲击疗法治疗甲真菌病

伊曲康唑短程间歇冲击疗法治疗甲真菌病３３例。服药后第１３周、停药后３个月、６个月其临床治疗率分别是１５．１％、６０．６％、９０．９％；真菌镜检转阴率分别为５６．６％、８２．８％、９６．３％。其临床治愈率，真菌镜检阴率经统计学处理均有非常显著性差异（Ｐ〈０．０１）。提示伊曲康唑治疗甲真菌病具有起效快，治愈率高等优点。     

伊曲康唑间歇冲击疗法治疗甲真菌病

用伊曲康唑短程间歇冲击疗法治疗甲真菌病５４例（指甲真菌病２６例,趾甲真菌病２８例）,并随访９个月。结果显示：患者指甲临床治愈率为８８５％,真菌学治愈率为９６１％;趾甲临床治愈率为８２１％,真菌学治愈率为９６１％;仅有７４％的患者出现恶心、胃肠道不适等轻微副作用。本疗法疗效高、副作用小和安全性好     

伊曲康唑间歇冲击疗法治疗甲真菌病80例分析

目的 观察伊曲康唑间歇冲击疗法治疗甲真菌临床疗效.方法 8o例甲真菌痛患者每天口服伊曲康唑胶囊2次,每次200mg,共7d,停药21d为1个疗程.指甲真菌病用药2个疗程,趾甲真菌病及指(趾)甲同患真菌病用药3个疗程.结果 35例指甲真菌病临床痊愈率为91.4%,45例趾甲真菌病及指(趾)甲同患真菌病临床痊愈率为84.4%,二者伴发皮肤真菌感染者真菌清除率分别为97%、96%.结论 伊曲康唑短期冲击疗法治疗甲真菌病疗程短,疗效高,不良反应小,安全性高,复发率底.     

伊曲康唑治疗甲真菌病52例疗效及后效应观察

目的 详细观察伊曲康唑对甲真菌病的效果及后效应，方法 用伊曲康唑间歇冲击疗效法治疗甲真菌病５２例，结果 治疗结束时指甲真菌病临床有效率为４５．５％，趾甲真菌临床有效率为４１．５％，用药第４０周指甲真菌病有效率为９０．９％，趾甲真菌病有效率为９０．２５％，治疗结束时疗效与用药第４０周疗效相比，其临床有效率在统计学上有非常显著差异，结论 伊曲康唑治疗甲真菌病有良好的“药物后效应”。     

伊曲康唑间歇冲击疗法治疗甲真菌病的多中心开放性研究

目的:观察伊曲康唑治疗甲真菌病的疗效、安全性及对甲生长速度的影响.方法:在全国15家医疗单位进行多中心开放性临床研究,患者采用口服伊曲康唑间歇冲击疗法,观察对靶甲(患甲)的临床疗效、真菌学疗效、不良反应及治疗后各期靶甲正常甲板的净增长长度.结果:该疗法对指甲真菌病及趾甲真菌病都有良好的疗效,对皮肤癣菌、酵母菌和非皮肤癣菌丝状真菌所致的甲真菌病都有很好的疗效,真菌清除率达97.86%,并在停药后有后续的治疗作用.停药后6个月和停药后9个月时,趾甲真菌病的靶甲正常甲板的净增长长度略高于指甲真菌病.未见严重不良反应发生.结论:该疗法对甲真菌病疗效确切,安全性好,对患甲尤其是趾甲真菌病有一定的促甲生长作用.     

伊曲康唑短程冲击加局部外用治疗甲真菌病的疗效观察

目的设计疗效确切且费用较低的治疗甲真菌病的方法。方法52例甲真菌病患者，每日早、晚饭后各服伊曲康唑200mg，连续服1周(为短程冲击疗法)，联合盐酸特比萘酚软膏封包病甲6个月。结果指甲真菌病临床和真菌学痊愈率均为100％。趾甲真菌病临床痊愈率为94.4％，显效率5.6％；真菌学痊愈率94.4％，未愈率5.6％。结论本法费用较伊曲康唑常规间歇冲击疗法明显减少（仅为其1／3～1／2）；不良反应发生率更低。     

伊曲康唑短程间歇冲击疗法治疗甲真菌病20例疗效观察

应用伊曲康唑短程间歇冲击疗法治疗甲真菌病２０例，其中指甲真菌病１２例，痊愈率８３．３％，显效率７．３％。趾甲真菌病８例，痊愈率６２．５％，显效率３７．５％。     

伊曲康唑与中药醋联合治疗甲真菌病疗效观察

目的 比较伊曲康唑口服与甲封包中药醋泡联合应用治疗近端甲真菌病的疗效.方法 共120例门诊患者分治疗组和对照组,治疗组伊曲康唑冲击疗法与甲封包加中药醋热泡联合应用,指甲3个月、趾甲6个月;对照组单纯口服伊曲康唑.结果 治疗组总有效率85%,对照组总有效率66.7%,治疗组明显优于对照组（P〈0.05）.结论 近端甲癣是疑难杂证,病程长、易复发,伊曲康唑冲击疗法与甲封包中药醋泡联合应用使治愈率明显提高,不失为治疗甲真菌病的好方法.     

伊曲康唑间歇冲击疗法治疗甲真菌病疗效观察

目的：应用伊曲康唑间歇冲击疗法治疗指、趾甲真菌病，观察第9周和13周疗效。方法：指甲真菌病患采用2周期疗法，即服药1周，休息3周，第5周再服药即可。趾甲真菌病患在2周期疗法基础上再服药1周，即第9周再服药1周。剂量为400mg/d。午餐及晚餐后立即服用200mg。结果：指、趾甲癣第9周治愈率分别为80．3％及67．9％，而第13周治愈率分别上升至94．6％及90．5％。尚未发现无效病例。不良反应发生率7．3％，3－9个月复发率为5．9％，复发后再以相同方法治疗仍然有效。结论：伊曲康唑不失为高效安全的抗甲真菌药。     

斯皮仁诺短程冲击间歇治疗老年甲真菌病

目的：观察斯皮仁诺短程冲击治疗老年人甲真菌病的临床疗效。方法：70例患者口服斯皮仁诺胶囊200 mg,2次/d,与餐同服-连用1周,停药3周为1个疗程。指甲真菌病患者用药2个疗程,趾甲真菌病及指趾甲真菌病患者用药3个疗程。结果：40例指甲真菌病患者痊愈率87.5%,显效率7.5%,总有效率95.0%;54例趾甲真菌病患者痊愈率77.8%,显效率11.1%,总有效率88.9%。结论：斯皮仁诺短程冲击治疗老年人甲真菌病疗程短、疗效高、副作用小、安全可行。     

Intermittent-pulse treatment of onychomycosis with orally administered itraconazole]

Fifty-four patients received an intermittent regimen of itraconazole (26 of them were finger onychomycosis and 28 toe onychomycosis) and were followed-up for nine months. The result showed that the clinical cure rate of fingernails was 88.5% and the mycologic cure rate was 96.4%, while the clinical cure rate of toes was 82.1% and the mycologic cure rate was 96.4%. Few adverse events were observed by 7.4%, just like nausea, gastric discomfort etc. It suggests that the pulse administration system is highly effective and has a few side-effects.     

特比奈芬治疗88例儿童甲真菌病临床观察

目的 观察特比奈芬治疗儿童甲真菌病的疗效及安全性。方法 应用特比奈芬治疗儿童指甲真菌病50例及趾甲真菌病38例，并作疗效、真菌清除率及安全性观察。结果 特比奈芬治疗儿童指甲真菌病的痊愈率及总有效率分别为92．1％和97-37％：趾甲真菌病则分别为86．36％和93．94％。真菌清除率均达到96．59％。在本临床研究中未发现特比奈芬有严重的毒副反应。结论 特比奈芬治疗儿童甲真菌病疗效显著、安全性高，是有效根治儿童甲真菌病的方法之一。     

特比奈芬治疗88例儿童甲真菌病临床观察

目的 观察特比奈芬治疗儿童甲真菌病的疗效及安全性.方法 应用特比奈芬治疗儿童指甲真菌病50例及趾甲真菌病38例,并作疗效、真菌清除率及安全性观察.结果 特比奈芬治疗儿童指甲真菌病的痊愈率及总有效率分别为9.1%和97.37%;趾甲真菌病则分别为86.36%和93.94%.真菌清除率均达到96.59%.在本临床研究中未发现特比奈芬有严重的毒副反应.结论 特比奈芬治疗儿童甲真菌病疗效显著、安全性高,是有效根治儿童甲真菌病的方法之一.     

Treatment of dermatophyte toenail onychomycosis in the United States. A pharmacoeconomic analysis

This study attempted to determine the cost-effectiveness of therapies for dermatophyte toenail onychomycosis in the United States in 2001. The antimycotic agents evaluated were ciclopirox 8% nail lacquer and the oral agents terbinafine, itraconazole (pulse), itraconazole (continuous), fluconazole, and griseofulvin. A treatment algorithm for the management of onychomycosis was developed, and a meta-analysis was carried out to determine the average mycologic and clinical response rates for the various agents. The cost of the regimen was figured as the sum of the costs of drug acquisition, medical management, and management of adverse effects. The expected cost of management and disease-free days were determined, and a sensitivity analysis was conducted. It was concluded that ciclopirox 8% nail lacquer, which has recently become available in the larger size of 6.6 mL, is a cost-effective agent for the management of toenail onychomycosis.     

Efficacy of terbinafine for toenail onychomycosis. A multicenter trial of various treatment durations

The efficacy of terbinafine (250 mg/day) in the treatment of toenail onychomycosis was evaluated in a large open-label, multicenter trial of 12, 18, and 24 weeks of therapy. All 1,534 patients had onychomycosis, confirmed by either positive potassium hydroxide (KOH) wet mount, positive fungal culture, or both, and all received at least 12 weeks of treatment. Treatment was continued for an additional 6 or 12 weeks, depending on the extent of the disease at follow-up. Mycologic cure rates (negative culture plus negative KOH) at week 72 were 72.1% in the 12-week treatment group, 72.5% in the 18-week group, and 77.0% in the 24-week group. In all groups, clinical cure rates were higher at week 72 than at week 48: 49.5% of the 12-week group, 49.2% of the 18-week group, and 44.6% of the 24-week group experienced clinical cure by the end of the study. Both mycologic and clinical recurrence rates were low in all treatment groups at the 72-week assessment. The results of this study confirm the efficacy of terbinafine in the treatment of toenail onychomycosis as demonstrated in previous registration and large-scale clinical trials.     

0.9 ms 1064 nm Nd：YAG激光联合伊曲康唑治疗趾甲真菌病

目的探究0.9 ms 1064 nm Nd：YAG激光联合伊曲康唑治疗趾甲真菌病的临床疗效及安全性。方法对37例（178个甲） 趾甲真菌病患者随机分为甲乙两组,再按甲真菌病临床评分指数（SCIO）和甲真菌病严重度指数（OSI）分值高低各分为不同亚 组。所有患者均使用激光治疗（1次/周,共8次）。乙组第1周口服伊曲康唑0.2 g,2/日。比较治疗前后的疗效、临床评分、外观变 化以及不良反应,并进行患者满意度调查。结果随访12个月,临床有效率甲组31.33%、乙组35.79%;真菌清除率甲组30.00%、 乙组41.18%;两组临床有效率、真菌清除率差异均无统计学意义（P>0.05）。SCIO/OSI变化,甲组均无统计学意义（P>0.05）、乙 组均有统计学意义（P<0.05）;SCIO<12、OSI<16时,不同亚组之间临床有效率无明显差异（P>0.05）;SCIO≥12、OSI≥16时,不同 亚组之间临床有效率有差异性（P<0.05）。分别有33.71%、74.72%、70.79%的病甲在面积、形状、颜色方面得到改善。62.16%患 者对治疗效果满意。所有患者无明显不良反应。结论0.9 ms 1064 nm Nd：YAG激光1年内有效改善甲真菌病病甲的外观,对 于较为严重的甲真菌病,联合伊曲康唑治疗是个更好的选择。     

Treatment of toenail onychomycosis with oral terbinafine plus aggressive debridement: IRON-CLAD, a large, randomized, open-label, multicenter trial

This study was conducted to investigate the efficacy of oral terbinafine with and without aggressive debridement for the treatment of toenail onychomycosis. Onychomycosis patients aged 18 to 75 years received 12 weeks of terbinafine, 250 mg/day, alone (n = 255) or with aggressive debridement (n = 249). Both groups showed marked improvement from baseline at all time points. At week 48, complete, mycologic, and clinical cure rates were higher in the terbinafine plus debridement group compared with the terbinafine alone group, although significance was reached only for clinical cure (59.8% versus 51.4%; P = .023). Although approximately 39% of the patients received at least one antidiabetic, antihypertensive, or cholesterol-lowering agent concomitantly, including statins, the incidence of treatment-emergent adverse events was low and the adverse events were generally mild to moderate in severity. No clinically significant changes in liver transaminase levels were observed 6 weeks after treatment or after 12 weeks in those tested. These results support the well-established safety and efficacy of terbinafine for treatment of onychomycosis.