氟康唑、伊曲康唑治疗马拉色菌毛囊炎的临床观察分析

目的观察分析氟康唑(FLU)、伊曲康唑(ICZ)对马拉色菌毛囊炎(MF)的治疗效果。方法按随机数字表法将99例马拉色菌毛囊炎病患分为两组,氟康唑组49例予以氟康唑胶囊0.15g/d,口服,连服2周,伊曲康唑组50例予以伊曲康唑胶囊0.2g/d,口服,连服2周。结果伊曲康唑组总有效率88.0%略高于氟康唑组83.7%,差异无显著性,P>0.05;伊曲康唑组不良反应发生率4.0%略低于氟康唑组6.1%,结果无明显差异,P>0.05。结论氟康唑、伊曲康唑对马拉色菌毛囊炎的治疗均有良好的疗效与较高的安全性,值得研究与应用。     

口服伊曲康唑与氟康唑治疗马拉色菌毛囊炎的疗效及费用情况分析

目的:探讨口服伊曲康唑与氟康唑治疗马拉色菌毛囊炎的临床疗效及费用情况。方法:整取抽样2015年1月~2016年2月门诊治疗的马拉色毛囊炎患者54例,按随机数字表法分为两组:对照组27例,给予氟康唑胶囊150mg/d,1次/d;观察组27例,给予伊曲康唑胶囊200mg/d,1次/d。两组均治疗4周后,比较两组用药效果及用药成本。结果:两组用药总有效率比较差异无统计学意义(P0.05),且两组均无严重不良反应发生;但观察组用药费用低于对照组(P0.05)。结论:对马拉色毛囊炎患者采取氟康唑和伊曲康唑治疗均安全、有效,但伊曲康唑用药成本相对较低,更经济实惠。     

评价口服伊曲康唑与氟康唑治疗马拉色菌毛囊炎的疗效

目的：探讨口服伊曲康唑与氟康唑治疗马拉色菌毛囊炎的临床疗效。方法马拉色菌毛囊炎患者中选取80例作为研究对象,随机分为观察组和对照组,各40例。观察组患者采用伊曲康唑进行治疗,对照组患者采用氟康唑进行治疗,观察两组患者的临床治疗效果。结果观察组患者治疗总有效率为97.5%,对照组患者治疗总有效率为85.0%,差异具有统计学意义（P＜0.05）。结论马拉色菌毛囊炎患者采用伊曲康唑进行治疗,有助于提高患者的治疗效果,降低并发症发生率,改善患者的生活质量,值得大力推广使用。     

2种方案治疗复发性外阴阴道念珠菌病成本-效果分析

目的:评价口服伊曲康唑胶囊与氟康唑胶囊治疗复发性外阴阴道念珠菌病(RVVC)的成本-效果分析.方法:将临床RVVC患者随机分为A、B两组,A组121例采用伊曲康唑胶囊0.2g/d,口服,连续7d,B组110例采用氟康唑胶囊0.15g/d,口服,连续7天.治疗后应用药物经济学成本-效果分析法进行评价.结果:伊曲康唑胶囊与氟康唑胶囊治疗RVVC的总有效率分别为85.12%(103/121)和87.27%(96/110).C/E分别为1.98和2.01.△C/△E为3.22.结论:伊曲康唑胶囊组治疗效果最佳.     

伊曲康唑胶囊治疗马拉色菌毛囊炎的临床疗效观察

目的分析探讨伊曲康唑配合使用复方酮康唑洗剂对马拉色菌毛囊炎的治疗效果。方法选取150例经真菌学检查被确诊为马拉色菌毛囊炎的患者为研究对象,随机将他们分为对照组和观察组,每组各75例患者。对照组使用2％复方酮康唑洗剂每天清洗3次,连续使用4周,对观察组患者则在对照组的基础上,同时服用伊曲康唑,200mg／d,每日一次,连服7d。结果观察组治疗总有效率为96％,对照组为72％,观察组治疗效果好于对照组。结论伊曲康唑配合使用复方酮康唑洗剂是治疗马拉色菌毛囊炎的有效手段,值得临床推广和应用。     

两种方案治疗甲真菌病的成本-效果分析

目的:探讨比较伊曲康唑胶囊与特比萘芬片治疗甲真菌病的成本-效果.方法:将临床甲真菌病患者分为A、B两组,A组82例采用伊曲康唑胶囊口服治疗,B组79例采用特比萘芬片口服治疗,应用药物经济学成本-效果分析法进行评价.结果:伊曲康唑胶囊与特比萘芬片治疗指/趾甲真菌病的总有效率分别为89.02%(73/82)和91.14%(72/79);成本分别为1039.92元和1 659.6元;C/E分别为11.68、18.21;△C/△E为292.3.结论:伊曲康唑胶囊具有更合理成本-效果优势.     

观察伊曲康唑胶囊联合液氮冷冻治疗马拉色菌毛囊炎的临床疗效

目的分析伊曲康唑胶囊联合液氮冷冻治疗马拉色菌毛囊炎的临床疗效。方法将我院收治的60例马拉色菌毛囊炎患者纳入本次实验,所有病例均选自2016年3月至2017年8月,采取随机双盲法将其分为治疗组(30例)与对照组(30例),对照组采取口服伊曲康唑胶囊+外用炉甘石治疗,治疗组在对照组的基础上应用液氮冷冻治疗,对两种治疗方案的疗效进行对比。结果两组患者在治疗2周后的总有效率无明显区别,组间比较P> 0.05;治疗组患者在治疗四周后的总有效率(86.7%)显著高于对照组(63.3%),组间比较P <0.05;两组患者不良反应发生情况无明显区别,组间比较P> 0.05。结论对马拉色菌毛囊炎患者给予伊曲康唑胶囊联合液氮冷冻治疗可获得理想的疗效,且不良反应少,药物安全性有保障,值得推广应用。     

伊曲康唑与氟康唑口服治疗念珠菌性阴道炎成本-效果分析

目的：评价口服伊曲康唑与氟康唑治疗念珠菌性阴道炎成本效果分析。方法：采用循证医学的方法收集临床资料，应用药物经济学的成本效果分析法对口服伊曲康唑与氟康唑口服治疗念珠菌性阴道炎进行评价。结果：伊曲康唑与氟康唑口服治疗念珠菌性阴道炙治愈率分别为77．96％（69．24％，86．68％）、67．61％（65．95％，89．97％），C／E分别为4．02、0．51，AC／AE为26．98。结论：虽然伊曲康唑疗效优于氟康唑，但成本-效果分析表明，氟康唑更具成本效果优势。     

三种给药方案治疗念珠菌性阴道炎的成本-效果分析

目的：评价三种给药方案治疗念珠菌性阴道炎的疗效与经济成本。方法：480例念珠菌性阴道炎患者随机分为盐酸特比萘酚片（A组）、氟康唑胶囊（B组）和伊曲康唑胶囊（C组）三组,分别给予口服盐酸特比萘酚片、氟康唑胶囊和伊曲康唑胶囊,三组均联合达克宁栓剂外用治疗,同时采用成本-效果分析法对三组进行评价。结果：A组、B组和C组三组的有效率分别为86.25%、88.75%和91.875%,成本分别为97.07、57.21和82.44元。结论：氟康唑胶囊组方案较经济。     

伊曲康唑与氟康唑口服治疗念珠菌性阴道炎成本－效果分析

目的探讨伊曲康唑与氟康唑口服治疗念珠菌性阴道炎的成本－效果分析。方法收集2013年9月～2014年12月我院诊断为念珠菌性阴道炎的患者作为本次研究对象,按随机号码表法分为两组,100例伊曲康唑组（0．2g,1日2次,总疗程为7d）和100例氟康唑组（150mg 1日1次,总疗程为3d）。对比①两组治疗疗效、治疗后6个月念珠菌性阴道炎复发率。②两组治疗念珠菌性阴道炎的成本－效果比。③两组治疗念珠菌性阴道炎的敏感度。结果①伊曲康唑组与氟康唑组治疗念珠菌性阴道炎的有效率分别为98％、96％,差异无统计学意义（ P＞0．05）。②伊曲康唑与氟康唑治疗念珠菌性阴道炎的成本－效果比分别为0．91、0．20,可以看出氟康唑治疗念珠菌性阴道炎具有明显的成本－效果比优势,而且氟康唑每加一个效果单位（△C／△E）所花费的成本也较伊曲康唑组低。③伊曲康唑组与氟康唑组治疗念珠菌性阴道炎的敏感度分别为88％、80％,基本无差异（ P＞0．05）。结论本次研究认为念珠菌性阴道炎的治疗方案中可以选择成本－效果具有优势的氟康唑口服。     

5种不同用药方案治疗念珠菌性阴道炎的经济学评价

目的：探讨不同给药方案治疗念珠菌性阴道炎的经济学效果。方法：将189例念珠菌性阴道炎患者以随机抽样法分为5组,分别给予氟康唑片（A组）、伊曲康唑胶囊（B组）、克霉唑阴道片（C组）、氟康唑片＋克霉唑阴道片（D组）、伊曲康唑胶囊＋克霉唑阴道片（E组）,运用药物经济学方法进行成本-效果分析。结果：5组成本分别为15.57、51.18、13.60、29.17、64.78元;有效率分别为80%、89.5%、80.6%、97.5%、97.5%;成本-效果比分别为19.46、57.18、16.87、29.18、66.44;A、B、D、E组方案相对于C组方案的增量成本-效果比分别为-3.28、4.22、0.92、3.03。结论：治疗念珠菌性阴道炎的5种方案中,氟康唑片＋克霉唑阴道片方案较佳。     

3种中成药治疗失眠症的成本-效果分析

目的:评价3种中成药治疗失眠症的药物经济学效果。方法:78例门诊失眠症患者随机接受舒眠胶囊(A组)、甜梦胶囊(B组)、复方枣仁胶囊(C组)治疗,以药物经济学方法进行成本-效果分析。结果:A、B、C组的总成本(C)分别为288.20、163.08、139.22元,匹兹堡睡眠质量指数(PSQI)总分减少量(E1)分别为5.15、8.88、11.84,有效率(E2)分别为26%、46%、64%;平均成本-效果比C/E1分别为55.96、18.36、11.76,C/E2分别为11.08、3.55、2.18;与C组比较,A组和B组增量成本-效果比ΔC/ΔE1分别为—22.27、—8.06,ΔC/ΔE2分别为—3.92、—1.33。结论:3种中成药中,复方枣仁胶囊治疗失眠症较经济。     

Involvement of phenobarbital and SKF 525A in the hepatotoxicity of antifungal drugs itraconazole and fluconazole in rats

Itraconazole and fluconazole are potent wide spectrum antifungal drugs. Both of these drugs induce hepatotoxicity clinically. The mechanism underlying the hepatotoxicity is unknown. The purpose of this study was to investigate the role of phenobarbital (PB), an inducer of cytochrome P450 (CYP), and SKF 525A, an inhibitor of CYP, in the mechanism of hepatotoxicity induced by these two drugs in vivo. Rats were pretreated with PB (75 mg/kg for 4 days) prior to itraconazole or fluconazole dosing (20 and 200 mg/kg for 4 days). In the inhibition study, for 4 consecutive days, rats were pretreated with SKF 525A (50 mg/kg) or saline followed by itraconazole or fluconazole (20 and 200 mg/kg) Dose-dependent increases in plasma alanine aminotransferase (ALT), gamma-glutamyl transferase (gamma-GT), and alkaline phosphatase (ALP) activities and in liver weight were detected in rats receiving itraconazole treatment. Interestingly, pretreatment with PB prior to itraconazole reduced the ALT and gamma-GT activities and the liver weight of rats. No changes were observed in rats treated with fluconazole. Pretreatment with SKF 525A induced more severe hepatotoxicity for both itraconazole and fluconazole. CYP 3A activity was inhibited dose-dependently by itraconazole treatment. Itraconazole had no effects on the activity of CYP 1A and 2E. Fluconazole potently inhibited all three isoenzymes of CYP. PB plays a role in hepatoprotection to itraconazole-induced but not fluconazole-induced hepatotoxicity. SKF 525A enhanced the hepatotoxicity of both antifungal drugs in vivo. Therefore, it can be concluded that inhibition of CYP may play a key role in the mechanism of hepatotoxicity induced by itraconazole and fluconazole.     

Involvement of Phenobarbital and SKF 525A in the Hepatotoxicity of Antifungal Drugs Itraconazole and Fluconazole in Rats

Itraconazole and fluconazole are potent wide spectrum antifungal drugs. Both of these drugs induce hepatotoxicity clinically. The mechanism underlying the hepatotoxicity is unknown. The purpose of this study was to investigate the role of phenobarbital (PB), an inducer of cytochrome P450 (CYP), and SKF 525A, an inhibitor of CYP, in the mechanism of hepatotoxicity induced by these two drugs in vivo. Rats were pretreated with PB (75 mg/kg for 4 days) prior to itraconazole or fluconazole dosing (20 and 200 mg/kg for 4 days). In the inhibition study, for 4 consecutive days, rats were pretreated with SKF 525A (50 mg/kg) or saline followed by itraconazole or fluconazole (20 and 200 mg/kg) Dose-dependent increases in plasma alanine aminotransferase (ALT), γ-glutamyl transferase (γ-GT), and alkaline phosphatase (ALP) activities and in liver weight were detected in rats receiving itraconazole treatment. Interestingly, pretreatment with PB prior to itraconazole reduced the ALT and γ-GT activities and the liver weight of rats. No changes were observed in rats treated with fluconazole. Pretreatment with SKF 525A induced more severe hepatotoxicity for both itraconazole and fluconazole. CYP 3A activity was inhibited dose-dependently by itraconazole treatment. Itraconazole had no effects on the activity of CYP 1A and 2E. Fluconazole potently inhibited all three isoenzymes of CYP. PB plays a role in hepatoprotection to itraconazole-induced but not fluconazole-induced hepatotoxicity. SKF 525A enhanced the hepatotoxicity of both antifungal drugs in vivo. Therefore, it can be concluded that inhibition of CYP may play a key role in the mechanism of hepatotoxicity induced by itraconazole and fluconazole.     

4种非甾体抗炎药治疗类风湿关节炎的成本-效果分析

目的 :探讨 4种口服非甾体抗炎药治疗类风湿性关节炎 6mo的成本和效果。方法 :4 6 1例病人随机分成 4组 ,双氯芬酸组 131例 ,服用双氯芬酸 75～ 10 0mg·d- 1,萘丁美酮组 131例 ,服用萘丁美酮 10 0 0mg·d- 1,美洛昔康组 14 4例 ,服用美洛昔康 15mg·d- 1,塞来昔布组 5 5例 ,服用塞来昔布 2 0 0mg·d- 1,疗程均为 6mo。运用成本 -效果分析对 4组病人进行分析评价。结果 :双氯芬酸、萘丁美酮、美洛昔康、塞来昔布 4组完成疗程病例数分别为12 5 ,12 7,139和 5 5例。在疗程结束时 ,4组间疗效无显著差异 (P >0 .0 5 ) ,塞来昔布组不良反应率明显低于其他 3组 (P <0 .0 1)。 4组总成本分别为(14 0 0±s 32 6 ) ,(15 31± 36 ) ,(2 0 18± 5 2 7) ,(32 2 5±76 7)元 ;成本 -效果比为 (2 0 4 1± 6 12 ) ,(2 5 6 0±6 81) ,(2 985± 70 6 ) ,(4 6 6 7± 1389)元·例 - 1;经敏感度分析后的成本 -效果比为 (1896± 4 5 5 ) ,(2 36 6±6 38) ,(2 6 6 9± 5 89) ,(3978± 96 3)元·例 - 1。结论 :双氯芬酸为治疗类风湿性关节炎的较佳方案 ,在经济许可的情况下 ,偏重考虑药物安全性 ,塞来昔布也是一个较佳选择。     

Influence of concomitant food intake on the oral absorption of two triazole antifungal agents,itraconazole and fluconazole

The influence of food on the pharmacokinetics of the triazole antimycotics fluconazole and itraconazole was investigated in a randomised, parallel group, single dose study in 24 healthy subjects. Each group took either a 100 mg capsule of fluconazole or a 100 mg capsule of itraconazole, pre-prandially or after a light meal or a full meal, in a three-way crossover design. Gastric and intestinal pH were measured with a co-administered radio-telemetric pH capsule, and gastric emptying time of the capsule (GET) was taken as the maximum gastric residence time of drug and food.The plasma AUC and C_max of itraconazole were significantly different under the various conditions and the mean AUC was greatest after the full meal. The bioavailability (90% confidence intervals) of itraconazole relative to that after the full meal, was 54% (41–77%) on an empty stomach and 86% (65–102%) after a light meal. The criteria for bioequivalence were not attained. In contrast, the bioavailability (90% CI) of fluconazole relative to the full meal was 110% pre-prandially (100–115%) and 102% after the light meal (88–103%), and the criteria for bioequivalence were attained.Itraconazole absorption was promoted by low stomach pH, long gastric retention time and a high fat content of the coadministered meal, whereas the pharmacokinetics of fluconazole was relatively insensitive to physiological changes in the gastrointestinal tract.     

伊曲康唑注射液治疗老年人侵袭性肺曲霉病

目的:研究伊曲康唑注射液治疗老年人侵袭性肺曲霉病的临床疗效及安全性。方法:对15例60 a以上应用伊曲康唑治疗的侵袭性肺曲霉病病人的资料进行分析。其中男性11例,女性4例,年龄(72±s 7)a;确诊病例3例,临床诊断很可能病例8例,临床诊断可能病例4例。伊曲康唑注射液d 1～2,每日400mg,分2次静脉滴注,以后200 mg·d-1静脉滴注。观察临床疗效、用药时间、预后及不良反应。结果:总有效率60％(9／15)。3例确诊病例中显效1例,进步1例,无效1例。临床诊断很可能病例中痊愈2例,显效2例,无效4例。临床诊断可能病例中痊愈3例,显效1例。曲霉菌完全清除9例,真菌交替3例,未清除3例。不良反应为头痛1例。结论:早期、足量、足疗程应用伊曲康唑注射液治疗老年人侵袭性肺曲菌病疗效好,安全。     

缺血性卒中病人CYP2C19基因多态性与个体化抗血小板治疗的临床观察

目的 研究小样本缺血性卒中病人的CYP2C19基因型,根据其CYP2C19基因型指导个体化抗血小板治疗并观察其临床预后.方法 入选急性缺血卒中病人300例,对入选病人采用随机数字表法分为个体化治疗组150例和常规治疗组150例.个体化治疗组在入选后立即检测CYP2C19基因,按照不同的基因型采用个体化的抗血小板治疗方案,即快代谢型按照氯吡格雷负荷量300 mg、维持量50 mg·d-1口服;中间代谢型按照氯吡格雷负荷量300 mg、维持量75 mg·d-1口服;慢代谢型按照氯吡格雷负荷量300 mg、维持量75 mg·d-1,联合阿司匹林100 mg·d-1口服.常规治疗组直接按照氯吡格雷负荷量300 mg、维持量75 mg·d-1口服治疗,不检测CYP2C19基因.通过随访观察两组病人治疗30 d及180 d不良事件发生率之间的差异.结果 随访6个月,再发缺血性卒中的发生率在个体化治疗组显著降低(P<0.05),出血事件的发生率在个体化治疗组明显低于常规治疗组(P<0.05).结论 根据CYP2C19基因型采取不同的治疗方案可以及时发现慢代谢病人,进而调整抗血小板聚集治疗方案,降低不良事件发生率并可以减少药物的不良反应.     

伊曲康唑治疗念珠菌性阴道炎40例疗效观察

目的: 评价伊曲康唑对念珠菌性阴道炎的疗效.方法: 80例念珠菌阴道炎患者,随机分为2组,治疗组40例,用伊曲康唑200 mg,po,bid×1 d,对照组40例,用氟康唑150 mg 顿服,并进行临床及真菌学疗效观察.结果: 治疗组临床总有效率90.0%,对照组总有效率87.5%,差异无显著性(P>0.05).治疗组与对照组的真菌清除率分别为90.0%和85.0%,差异无显著性(P>0.05).结论: 伊曲康唑一日疗法可治愈绝大部分念珠菌阴道炎病人.     

脑梗死4种药物治疗方案的成本-效果分析

目的:评价4种药物治疗方案治疗脑梗死的成本-效果。方法:231例脑梗死患者随机分为A(银杏达莫)、B(葛根素)、C(血塞通)、D(复方丹参)4组,分别观察其疗效和不良反应,并运用药物经济学成本-效果法进行分析。结果:A、B、C、D组成本分别为3 648.51、3 320.91、3 003.81、2 438.91元;有效率分别为91.67%、84.21%、86.44%、65.45%;成本-效果比(C/E)分别为39.80、39.44、34.75、37.26;A、B、C组相对于D组的增量成本-效果比(ΔC/ΔE)分别为46.13、47.01、26.91。结论:C组血塞通方案为较佳治疗方案。