伊曲康唑联合局部用药治疗外阴阴道念珠菌病的疗效分析

目的：探讨伊曲康唑联合局部用药治疗外阴阴道念珠菌病的疗效。方法：将400例患者随机分成2组，治疗组和对照组均口服伊曲康唑，每次0．2g，每日1次，连服1周，治疗组同时加用制苯合剂局部用药，每天1次，共1周。结果：治疗组与对照组总有效率分别为95％、65％，两组比较差异有显著性（P〈0．05）。结论：伊曲康唑联合局部用药治疗外阴阴道念珠菌病疗效确切。     

伊曲康唑改良法治疗花斑癣的临床观察

目的探讨伊曲康唑改良法治疗花斑癣的疗效和安全性。方法将97例患者随机分为2组,实验组采用伊曲康唑改良法治疗,即口服伊曲康唑0.2g,1次/d,共7天,7天后每月1次口服0.2g,共6个月;对照组口服伊曲康唑0.2g,1次/d,连续7天停药。结果实验组和对照组治疗6个月后有效率分别为92.00%和74.47%,两组差异有统计学意义(P<0.05)。结论伊曲康唑改良法治疗花斑癣可提高治愈率,降低复发率,安全可靠。     

伊曲康唑间歇冲击疗法治疗甲真菌病的血清及甲中药物水平的研究

目的 了解伊曲康唑间歇冲击疗法治疗甲真菌病的血清及甲中药物水平的变化,为该疗法提供药物动力学依据。方法 １５例趾甲真菌病患者经伊曲康唑间歇冲击疗法治疗;于服药前、服药后每月取患者血清（共３月）并收集远端甲标本,将指甲和趾甲分开;以高效液相色谱（ＨＰＬＣ）测定伊曲康唑的含量。结果 １．每次冲击后４周,血清中均未测得伊曲康唑;２．甲组织中伊曲康唑水平较高,在２或３月时达到高峰;３．停药后,伊曲康唑仍能以较高的水平在甲中存在至６月后;同一时间点,指甲和趾甲中的药物水平无统计学差异（Ｐ〉０．０５）。结论 伊曲康唑经口服吸收后从血液迅速向甲组织分布,停药后,以较高水平在甲组织中持续存在６月以上。     

伊曲康唑巩固疗法降低马拉色菌毛囊炎复发率的临床观察

目的：探讨伊曲康唑在降低马拉色菌毛囊炎复发率中的有效治疗方案及安全性。方法：将124例马拉色菌毛囊炎患者随机分为试验组和对照组，两组均口服伊曲康唑0．2g，每天1次，连服7天。7天后对照组停药观察，试验组继续服用伊曲康唑，每次0．2g，每月1次，共服6个月。两组患者皆每月复诊1次，观察疗效和不良反应，共6次。结果：试验组63例患者复发率为1．59％，治愈率为82．54％。对照组61例患者复发率为19．67％，治愈率为57．38％。两组患者的复发率及治愈率比较，有显著性差异（χ^2=10．80，P〈0．005和χ^2=9．37，P〈0．01）。结论：伊曲康唑巩固疗法治疗马拉色菌毛囊炎疗效确切，安全性好，该疗法能降低马拉色菌毛囊炎的复发率。     

伊曲康唑胶囊联合盐酸阿莫罗芬乳膏治疗马拉色菌毛囊炎临床疗效观察

目的观察伊曲康唑胶囊联合盐酸阿莫罗芬乳膏治疗马拉色菌毛囊炎的疗效,并评价其安全性。方法 114例马拉色菌毛囊炎患者随机分为研究组61例和对照组53例。研究组采用伊曲康唑胶囊口服联合盐酸阿莫罗芬乳膏;对照组给予盐酸阿莫罗芬乳膏。观察临床疗效。结果治疗组显效率、治愈率、总有效率分别为32.8%、59.0%、91.9%,对照组显效率、治愈率、总有效率分别为22.6%、39.6%、62.3%。结论伊曲康唑胶囊口服联合盐酸阿莫罗芬乳膏外用治疗马拉色菌毛囊炎比单纯外用盐酸阿莫罗芬乳膏疗效好。由于短期内小剂量口服伊曲康唑胶囊,临床上也未见明显不良反应出现。     

3种抗真菌药治疗甲真菌病疗效对比观察

应用伊曲康唑、特比萘芬、氟康唑３种不同抗真菌药物治疗１２０例甲真菌病患者,并作疗效对比观察,结果显示,３种药物均有较艰的抗真菌疗效,特比萘芬疗效优于伊曲康唑及氟康唑,伊曲康唑疗效优于所经康唑。３种药物近、中、远期临床治愈率及真菌学阴转率,复发率Ｐ值均〉０．０５,无统计学意义。     

伊曲康唑与特比萘芬治疗念珠菌性慢性前列腺炎附睾炎的疗效观察

目的 对性病治疗后有慢性前列腺炎附睾炎的673例患者做精液或前列腺液的真菌培养，发现45例念珠菌感染，占6．69％，给予伊曲康唑及特比萘芬治疗并进行临床观察。方法 采用科玛嘉定位显色真菌培养，对念珠菌阳性患者随机分为2组，1组口服伊曲康唑200mg，每日1次，连服14d，2组口服特比萘芬250mg，每日1次，连服14d。结果 45例念珠菌阳性者中，光滑念珠菌2l例，白念珠菌16例，热带念珠菌5例，克柔念珠菌3例。随机分组治疗后，1组临床总有效率为82．6l％，2组临床总有效率为86．36％，1组真菌学治愈率为78．26％，2组真菌学治愈率为72．73％，两组临床有效率及真菌学治愈率经卡方检验差异无显著性。结论 念珠菌是性病治疗后慢性前列腺炎附睾炎的致病原因之一，伊曲康唑和特比萘芬可作为治疗念珠菌性慢性前列腺炎附睾炎的有效和安全药物。     

伊曲康唑联合1％盐酸布替萘芬乳膏治疗念珠菌性包皮龟头炎的临床观察

目的探讨伊曲康唑联合1％盐酸布替萘芬乳膏治疗念珠茵性包皮龟头炎的疗效。方法口服伊曲康唑胶囊，外用1％盐酸布替萘芬乳膏治疗78例念珠茵性包皮龟头炎，1周后判定疗效，1个月后复查判定复发率。结果痊愈50例（64．10％），显效22例（28．21％），有效率92．31％；1个月后仅1例复发，复发率1．39％。且未见明显不良反应。结论伊曲康唑联合1％盐酸布替萘芬乳膏治疗念珠菌性包皮龟头炎安全、有效，值得临床推广应用。     

伊曲康唑治疗头癣的疗效观察

目的：了解伊曲康唑治疗儿童头癣的疗效和安全性。方法：头癣患儿每天晚饭后一次口服100mg伊曲康唑，连续6周。结果：治疗第7周，25例患中治愈2例，显效9例，临床总有效率84％。治疗第14周痊愈19例（76％），显效4例，总有效率92％。真菌学清除率为100％。未见明显的不良反应。结论：伊曲康唑治疗儿童头癣疗效高、安全。     

伊曲康唑治疗孢子丝菌病的疗效观察

目的观察伊曲康唑治疗孢子丝菌病的疗效。方法选择在本院皮肤科就诊的明确诊断为孢子丝菌病患者30例,随机分为两组,分别予单独服用伊曲康唑和伊曲康唑与碘化钾联合治疗。结果联合用药组3个月痊愈率为55.0%,6个月痊愈率为100.0%;伊曲康唑组分别为40.0%,100.0%。结论单独口服伊曲康唑治疗孢子丝菌病疗效确切。     

NB-UVB联合酮康唑洗剂、伊曲康唑治疗马拉色菌毛囊炎疗效评价

目的:评价NB-UVB联合酮康唑洗剂、伊曲康唑治疗中重度马拉色菌毛囊炎的疗效。方法:181例中重度马拉色菌毛囊炎患者,随机分为3组。A组58例,给予NB-UVB照射(每周3次)、2%酮康唑洗剂外洗(每天1次)及小剂量伊曲康唑口服(100 mg,日1次),治疗4周;B组60例,给予2%酮康唑洗剂外洗及小剂量伊曲康唑口服;C组63例,仅予小剂量伊曲康唑口服。结果:A、B、C组总有效率分别为91.38%、78.33%及61.90%,平均治愈时间分别为(27.80±3.15)天、(32.13±3.98)天及(35.83±3.42)天。结论:NB-UVB联合酮康唑洗剂在中重度马拉色菌毛囊炎治疗中能提高伊曲康唑疗效。     

The value of chronic suppressive therapy with itraconazole versus clotrimazole in women with recurrent vaginal candidiasis.

OBJECTIVE--To determine the comparative efficacy of oral itraconazole versus intravaginal clotrimazole in suppressing recurrent episodes of vulvovaginal candidiasis. DESIGN--Prospective randomised open study of women with recurrent vulvovaginal candidiasis. Clinical and microbiological assessments were made monthly for 12 months. SETTING--Women's Clinic of a University teaching hospital. SUBJECTS--Forty-four otherwise healthy, non-pregnant women, with at least four proven episodes of candida vaginitis in the last year were enrolled into the study. INTERVENTION--After an acute episode of candida vaginitis, 22 women received oral itraconazole 200 mg daily for five days, then 200 mg twice weekly for six months; and 22 women received intra-vaginal clotrimazole 200 mg ovules daily for five days, then 200 mg twice weekly for six months. MAIN OUTCOME MEASURES--Symptomatic recurrent clinical vulvovaginal candidiasis during the first six months of suppressive therapy was the major endpoint. A secondary endpoint was recurrent candida vaginitis within six months after completion of therapy. RESULTS--Six patients did not complete the study, one in the itraconazole group and five in the clotrimazole group. Of the evaluable patients, seven of 21 patients (33.3%) in the itraconazole group versus none (0%) of 17 patients on clotrimazole were failures on suppressive therapy, p = 0.02. Following discontinuation of suppressive therapy, recurrences of candida vaginitis were similar, 10 (47.6%) of patients on itraconazole (95% confidence interval (CI) 27-67%), versus 11 (64%) patients on clotrimazole (CI 41-87%), p = 0.15. CONCLUSION--Intermittent suppressive therapy with clotrimazole was more effective than itraconazole in preventing recurrent candida vaginitis, provided patients adhered to the regimen. Recurrence of vaginitis was common with both regimens after stopping suppressive therapy.     

外阴阴道假丝酵母菌病临床特征和抗真菌药物敏感性研究

目的：探讨外阴阴道假丝酵母菌病（VVC）的临床特征和抗真菌药物敏感性。方法：对1120例VVC患者进行临床特征分析,阴道分泌物标本采集、真菌培养及体外药敏实验。结果：单纯型VVC占36．79％,重度VVC占37．77％,RVVC占14．38％,非白假丝酵母菌VVC占11．07％。重度VVC的特征最为严重（P均=0．000）,以白假丝酵母菌最多见（P=0．000）。抗菌药物的敏感性依次为制霉菌素、克霉唑、氟康唑、伊曲康唑、益康唑、咪康唑及酮康唑,差异有统计学意义（P〈0．01）。结论：白假丝酵母菌是VVC主要的病原体,复杂型VVC临床较为常见且临床特征较单纯型VVC严重。白假丝酵母菌对唑类抗真菌药物仍有较高敏感性,制霉菌素、克霉唑抗真菌敏感性较高,可以供临床治疗选用。     

杭州地区220株外阴阴道念珠菌病的菌种鉴定及药敏试验分析

目的了解杭州地区外阴阴道念珠菌病的菌种类别及药物敏感性.方法采用常规念珠菌培养方法和API 20CAUX方法进行鉴定.药敏试验采用ATB FUNGUS方法.结果220例外阴阴道念珠菌病以白念珠菌为主,检出172例,占78.18%,其次光滑念珠菌17例,占7.73%.念珠菌对伊曲康唑、氟康唑、制霉菌素、两性霉素B、咪康唑、酮康唑、益康唑、5-氟胞嘧啶的敏感性分别为97.73%、96.82%、94.09%、88.64%、73.64%、66.82%、42.32%、23.64%.结论外阴阴道念珠菌病以白念珠菌感染为主,但与以往相比比率有所下降.检测的220株念珠菌对伊曲康唑、氟康唑、制霉菌素、两性霉素B敏感性高,对咪康唑、酮康唑、益康唑、5-氟胞嘧啶的耐药率高.     

Amorolfine and itraconazole combination for severe toenail onychomycosis; results of an open randomized trial in Spain

Objective In an open, randomized, clinical study of toenail onychomycosis with matrix area involvement, two alternative regimens of topical amorolfine/oral itraconazole therapy were compared with itraconazole monotherapy.
Patients/Methods A total of 131 patients were randomized to treatment. Patients in the combination groups were treated with amorolfine 5% nail lacquer (Loceryl®, Galderma Laboratories) once weekly for 24 weeks and 200 mg itraconazole once daily for 6 weeks (Group AI-6) or 12 weeks (Group AI-12). A control group received itraconazole monotherapy for 12 weeks (Group I-12). Strict inclusion criteria specified that subjects had to have onychomycosis of the toenails with matrix area involvement and/or > 80% total nail surface involvement. Mycological evaluations using both microscopic examination and culture of nail samples were performed at weeks 12 and 24. A stringent assessment of outcome at study end combined the results of mycological and clinical outcomes into a global cure rate. Safety was also assessed.
Results At week 12, mycological cure was attained in 42 of 45 patients (93·3%) in group AI-6, 29 of 35 patients (82·9%) in group AI-12, and 14 of 34 patients in group I-12. The difference between both combination groups and the control group were significant ( P  < 0·001). The global cure rate at week 24 was 83·7% (36 patients) in group AI-6, 93·9% (31 patients) in group AI-12, and 68·8% (22 patients) in group I-12. The difference between the AI-12 group and itraconazole monotherapy was significant ( P  < 0·05).
Conclusions These results indicate that amorolfine combination therapy represents an improved treatment strategy for patients with severe onychomycosis.     

慢性皮肤黏膜念珠菌病

报告1例白念珠菌引起的皮肤黏膜念珠菌病，患儿女，7岁，全身散在丘疹5年，加重伴指疣状增生1年，同时出现口腔黏膜，皮肤及甲板损害，双手掌疣状赘生物，手指末节残缺，变形。口腔黏膜白斑，北部皮损组织及粪便真菌培养均为白念珠菌生长。皮肤组织病理改变为表皮角化明显，角质层中查见大量真菌菌丝。经伊曲康唑，制霉菌素等药治疗后，皮损逐渐好转。     

口腔念珠菌病菌群分布及药敏试验和临床疗效分析

目的探讨口腔念珠菌病的菌群分布特点及体外抗真菌药敏试验和临床疗效情况。方法采用科玛嘉显色培养基鉴定78株分离自口腔念珠菌病的患者临床分离株的菌群分布;ROSCO纸片扩散法检测念珠菌对氟康唑和伊曲康唑的敏感性;用氟康唑和伊曲康唑进行治疗。结果白念珠菌占71.79%,热带念珠菌占11.54%,光滑念珠菌占7.69%,克柔念珠菌占5.13%,其他念珠菌占3.85%。氟康唑和伊曲康唑对念珠菌的敏感率分别为73.08%和65.38%。氟康唑治疗组有效率87.80%,真菌清除率为87.80%;伊曲康唑治疗组依次为91.89%和91.89%。结论口腔念珠菌病仍以白念珠菌为主要致病菌。氟康唑和伊曲康唑对念珠菌均有较好的敏感性。氟康唑体外药敏试验结果与临床疗效有较好的相关性,伊曲康唑体外药敏试验结果与临床疗效有一定的相关性,但不完全一致。ROSCO纸片扩散法有在临床实验室推广应用的前景。     

Management of persistent vulvo vaginal candidosis due to azole-resistant Candida glabrata.

CASE REPORT--SUBJECTS--Three cases are described of long-standing vaginal candidosis due to Candida glabrata. These had failed to respond to local and systemic antifungals. In each case the infecting strain appeared resistant to a range of azole drugs in vitro. CLINICAL COURSE--Case one--This patient recovered following prolonged treatment with oral itraconazole in combination with oral and vaginal nystatin. Case two. Yeasts were eradicated from this patient following cyclical treatment with oral dydrogesterone; prolonged vaginal treatment with nystatin may have helped. Case three. This patient did not respond to a prolonged course of oral itraconazole in combination with vaginal and oral nystatin, oral medroxyprogesterone or intravaginal boric acid. Eradication of C glabrata was finally achieved by local application of 1% gentian violet. Shortly after eradication of the C glabrata infection, both Case two and Case three developed infections with other Candida species responsive to azole antifungals.     

Antifungal Susceptibility Testing with Etest for Candida Species Isolated from Patients with Oral Candidiasis

BackgroundThe necessity of performing antifungal susceptibility tests is recently increasing because of frequent cases of oral candidiasis caused by antifungal-resistant Candida species. The Etest (BioMerieux, Marcy l''Etoile, France) is a rapid and easy-to-perform in vitro antifungal susceptibility test.ObjectiveThe purpose of this study was to determine the minimal inhibitory concentrations (MICs) of antifungal agents by using the Etest for Candida species isolated from patients with oral candidiasis.MethodsForty-seven clinical isolates of Candida species (39 isolates of Candida albicans, 5 isolates of C. glabrata, and 3 isolates of C. tropicalis) were tested along with a reference strain (C. albicans ATCC 90028). The MIC end points of the Etest for fluconazole, itraconazole, voriconazole, and amphotericin B susceptibility were read after the 24-hour incubation of each isolate on RPMI 1640 agar.ResultsAll Candida isolates were found susceptible to voriconazole and amphotericin B. However, all five isolates of C. glabrata were resistant to itraconazole, among which two isolates were also resistant to fluconazole.ConclusionThis study revealed that the Etest represented a simple and efficacious method for antifungal susceptibility testing of Candida species isolated from oral candidiasis patients. Therefore, voriconazole and amphotericin B should be recommended as effective alternatives for the treatment of oral candidiasis.     

山西省某三甲医院黏膜念珠菌病病原菌和耐药性分析

目的了解太原地区皮肤科门诊黏膜念珠菌病的构成情况和病原菌耐药性。方法收集山西白求恩医院皮肤科门诊2019—2020年期间真菌培养阳性的172例黏膜念珠菌病患者临床资料, 并对病原菌进行分子生物学鉴定和体外药敏实验。结果 172例黏膜念珠菌病患者中外阴阴道念珠菌病142例(82.6%), 念珠菌性包皮龟头炎24例(14.0%), 口腔念珠菌病6例(3.5%);≤ 18岁3例、19 ～ 59岁155例、≥ 60岁14例, 分别有2例、134例(86.45%)和6例外阴阴道念珠菌病患者, 各年龄组占比差异有统计学意义(χ2 = 14.29, P < 0.05)。分离的172株菌均为念珠菌属, 包括白念珠菌165株(95.9%), 光滑念珠菌5株(2.9%), 近平滑念珠菌2株(1.2%);对常用抗真菌药物氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑、伏立康唑的敏感性分别为95.9%、100.0%、62.2%、47.1%和56.4%。结论本院皮肤门诊黏膜念珠菌病以外阴阴道念珠菌病为主, 致病菌主要为白念珠菌;念珠菌分离株对氟胞嘧啶、两性霉素B敏感性较好。