万乃洛韦不同疗程治疗复发性生殖吕疱疹的临床研究

本试验采用随机对照方法，评价了万乃洛韦治疗复发性生殖器疱疹的有效性、安全性及适宜疗程。共治疗１０１例患者，其中万乃洛韦一周组３６例（３００ｍｇ，每天２次），万乃洛韦一月组３５例（３００ｍｇ，每天２次），阿昔洛韦一月组３０例（２００ｍｇ，每天５次）。结果显示，万乃洛韦一周和一月组起效时间均比阿昔洛韦组明显加快（Ｐ〈０．０１）。并能缩短疗程，但三组 显著性差异（Ｐ〉０．０５）。万乃洛韦一月组能显著降低患者复发频率（Ｐ〈０．０１）。另两组则否，结果表明，万乃洛韦一月疗法治疗复发性生殖器疱疹安全有效，能显著降低复发频率，患者依从性好。是治疗该病较好的药物和较适宜疗程。     

万乃洛韦和阿昔洛韦治疗生殖器疱疹疗效对比

目的比较万乃洛韦和阿昔洛韦治疗生殖器疱疹的疗效。方法生殖器疱疹58例,随机分组。治疗组28例,口服万乃洛韦300mg,bid;对照组30例,口服阿昔洛韦200mg,每日5次。疗程均6d。结果万乃洛韦起效时间短于阿昔洛韦(P＜0.01),两者疗效相当(P＞0.05)。结论万乃洛韦服药方便,起效迅速,治疗生殖器疱疹较理想。     

阿昔洛韦联合斯奇康治疗复发性生殖器疱疹的临床观察

目的探讨阿昔洛韦联合斯奇康注射液治疗生殖器疱疹复发的疗效。方法对35例生殖器疱疹患者予阿昔洛韦口服,加用斯奇康注射0.5mg肌肉注射,隔日1次,3个月为一疗程;对照组单用阿昔洛韦治疗。观察两组复发情况及不良反应。结果治疗组复发率明显低于单用阿昔洛韦组(P<0.05),且无明显不良反应。结论斯奇康注射液治疗复发性生殖器疱疹可有一定疗效。     

万乃洛韦口服治疗复发性生殖器疱疹

为治疗和防止阴部疱疹的复发,用万乃洛韦（３００ｍ ｇ 一日２次,７ｄ）治疗生殖器疱疹４８ 例,并与阿昔洛韦（２００ｍｇ 一日５ 次,７ｄ）进行了对比观察。结果,万乃洛韦疗效优于阿昔洛韦（Ｐ＜ ０．０５）,且无明显副作用。因此,万乃洛韦是预防和治疗阴部疱疹的良药。     

胸腺五肽联合盐酸伐昔洛韦治疗复发性生殖器疱疹的疗效观察

目的:观察胸腺五肽联合盐酸伐昔洛韦治疗复发性生殖器疱疹的疗效。方法:选取复发性生殖器疱疹患者62例,随机分为治疗组、对照组,2组患者的年龄、性别、病史、临床表现等方面比较,差异无显著性。治疗组口服盐酸伐昔洛韦分散片,300 mg/次,bid,同时给予胸腺五肽注射液10 mg皮下注射,隔日一次;对照组口服盐酸伐昔洛韦分散片,300 mg/次,bid。2组治疗时间均为3个月。结果:治疗后随访6个月,与对照组相比,治疗组复发间隔时间非常显著长于对照组(P<0.01),复发皮损面积显著小于对照组(P<0.05),皮损痊愈时间非常显著短于对照组(P<0.01),复发频率非常显著小于对照组(P<0.01)。结论:盐酸伐昔洛韦联合胸腺五肽治疗复发性生殖器疱疹疗效好,复发率低,无明显不良反应。     

万乃洛韦与阿昔洛韦治疗生殖器疱疹的成本－效果分析

目的 :比较万乃洛韦与阿昔洛韦治疗生殖器疱疹疗效及经济学成本。方法 :运用药物经济学原理对万乃洛韦和阿昔洛韦的成本 -效果进行最小成本比较分析。结果 :2种药物治疗生殖器疱疹的有效率分别为 92 86 %和 86 6 7% ,两者无显著性差异 (P>0 0 5 ) ,但费用的差别有统计学意义 ,阿昔洛韦费用较低。结论 :阿昔洛韦是治疗生殖器疱疹的首选药物。     

卡介菌多糖核酸联合阿昔洛韦片治疗复发性生殖器疱疹的效果观察

目的探讨肌内注射卡介菌多糖核酸联合口服阿昔洛韦片治疗频繁复发的生殖器疱疹的效果。方法选择无卡介菌多糖核酸肌内注射禁忌证的频繁复发的生殖器疱疹患者(每年复发次数6次以上)186例,分成3组(A组,B组,C组),分别给予卡介菌多糖核酸联合阿昔洛韦片、单独阿昔洛韦片抑制疗法和单独肌内注射卡介菌多糖核酸疗法。疗程均为1年,期间定期复诊,记录患者的生殖器疱疹复发情况及药物不良反应情况。结果各组患者治疗前的平均复发频率为9~10次/年,经过1年的连续性治疗后,年均复发频率分别减少了75%,62.4%,33.3%。结论卡介菌多糖核酸肌内注射联合口服阿昔洛韦片是治疗复发性生殖器疱疹的有效方法,可以明显减少其复发频率。     

3种抗病毒药物治疗复发性生殖器疱疹的疗效观察

［摘要］目的比较膦甲酸（DEV）钠氯化钠注射液、更昔洛韦（GCV）注射液和阿昔洛韦（ACV）注射液治疗复发性生殖器疱疹的疗效。方法复发性生殖器疱疹患者99例，随机分为3组，各33例，PFA 组给予膦甲酸钠氯化钠注射液3 g；GCV组给予更昔洛韦注射液250 mg，加入5%葡萄糖注射液或0.9%氯化钠溶液250 mL中；ACV组给予阿昔洛韦注射液500 mg加入5%葡萄糖注射液或0.9%氯化钠溶液250 mL中。3组用法均为静脉滴注，qd，连用10 d为1个疗程。结果治疗复发性生殖器疱疹，膦甲酸钠氯化钠注射液、更昔洛韦注射液疗效均优于阿昔洛韦注射液，膦甲酸钠氯化钠注射液优于更昔洛韦注射液。结论膦甲酸钠氯化钠注射液治疗复发性生殖器疱疹疗效好，复发率低。     

阿昔洛韦治疗单纯性疱疹的效果

阿昔洛韦能阻止病毒DNA的复制,具有很强的抑制单纯疱疹病毒繁殖的作用。用5%阿昔洛韦软膏治疗生殖器复发性单纯性疱疹23例(第1组),皮肤复发性单纯性疱疹25例(第2组),刚复发即开始用软膏涂患处,每日5次,每次隔4h,疗程10d。作为对照组,用0.5%bonafton软膏治疗生殖器复发性单纯性疱疹19例(第3组),皮肤复发性单纯性疱疹20例(第4组)。各组的病情、性别和年龄结构有可比性,中、青年女性占多数,每年复发3～15次,半数以上病例每次复发需2周才能康复(发疹期平均5.7～6.7d,上皮形成期平均7.9～9.6d)。此次复发,发疹均伴有水肿、疼痛,65%充血,30%瘙痒…     

中西医结合治疗复发性生殖器疱疹58例

［摘要］目的观察中西医结合治疗复发性生殖器疱疹的临床疗效及复发率。方法将168例复发性生殖器疱疹患者分为3组:中西医结合组58例,西药组56例,中药组54例。中西医结合组用中药自拟方口服结合西药万乃洛韦（0.3 g,bid,po,共20 d）与卡介菌多糖核酸（1 mg,im,隔日1次,共10次）进行治疗；西药组用万乃洛韦与卡介菌多糖核酸治疗；中药组用中药自拟方口服治疗。结果中西医结合组有效率比其他两组高，复发率比其他两组低(均P＜0.05),西药组与中药组疗效及复发率比较,差异无显著性(P＞0.05)。结论中西医结合综合治疗复发性生殖器疱疹,不但临床疗效较好,并且能明显降低复发率,值得临床进一步研究探讨。［关键词］ 疱疹，生殖器；中西医结合；复发     

阿昔洛韦联合胸腺肽肠溶片对生殖器疱疹患者复发的影响

目的观察阿昔洛韦联合胸腺肽肠溶片治疗生殖器疱疹的临床效果。方法选取50例生殖器疱疹患者并采用信封法随机分为2组,对照组患者口服阿昔洛韦,连续服用1周,观察组在对照组基础上加服胸腺肽肠溶片,3次/d,每月连续2周。两组患者疗程均为4个月,治疗结束后随访半年,观察两组患者随访半年期间复发情况,同时根据患者临床症状、体征及血清学检查结果对患者进行疗效评定。结果观察组治疗总有效率为92.00%,对照组为68.00%,观察组疗效明显优于对照组(P<0.05)。观察组3例(12.00%)复发,对照组9例(36.00%)复发,观察组复发率明显低于对照组,且观察组复发≥3次者仅占4.00%,而对照组≥3次者占28.00%,两组≥3次者比例差异有统计学意义(P<0.05)。结论采用阿昔洛韦联合胸腺肽肠溶片治疗生殖器疱疹可取得显著的疗效,明显降低患者复发率。     

伐昔洛韦与阿昔洛韦治疗带状疱疹152例的比较

目的：比较伐昔洛韦与阿昔洛韦对带状疱疹的治疗作用和安全性。方法：伐昔洛韦开放组９２ 例（ 男性４９ 例,女性４３ 例,年龄４２ ａ ±ｓ １４ ａ） , 用伐昔洛韦３００ ｍｇ , ｐｏ , ｂｉｄ 。对照试验６０ 例,其中用伐昔洛韦治疗的试验组３０ 例（ 男性１７ 例,女性１３例,年龄４６ ａ ±１２ ａ） , 用阿昔洛韦的对照组３０ 例（ 男性１４ 例, 女性１６ 例, 年龄４６ ａ ±１６ ａ） , ２００ｍｇ , ｐｏ ,ｑ ４ ｈ（ 总量为１０００ ｍｇ／ｄ） 。疗程均为９ ｄ 。 结果：伐昔洛韦治疗后ｄ ３ 及ｄ ９ ,症状、体征均较治疗前及阿昔洛韦组有显著和非常显著差异（ Ｐ＜０ ．０５ , Ｐ＜ ０ ．０１） , 总显效率达９０ ％ ,不良反应轻。结论：伐昔洛韦治疗带状疱疹疗效显著且安全。     

生殖器疱疹无症状排毒与血清抗体及药物干预的研究

目的 分析生殖器疱疹无症状排毒和血清抗体、药物干预的相关性.方法 根据患者荧光PCR、ELISA测定结果、病程和发病次数以及药物干预措施,将患者分为阳性组和阴性组,阿昔洛韦组、伐昔洛韦组和对照组,病程＞3年组和病程≤3年组,频发组和少发组.测定各组患者血清学抗体分泌,并记录患者药物干预后排毒情况和复发情况.结果 本组共294例患者排毒阳性（57.31％）.病程＞3年组和病程≤3年组、少发组和频发组排毒阳性率差异有统计学意义（P＜0.05）.阴性组和阳性组HSV-Ⅰ和ⅡIgG以及HSV-Ⅰ IgG差异有统计学意义（P＜0.05）,而两组HSV-ⅡIgM差异无统计学意义（P＞0.05）.伐昔洛韦组和阿昔洛韦组与对照组相比,除在停药4月后,均与对照组差异有统计学意义（P＜0.05）.排毒检测阳性DNA质粒数为3200拷贝/ml.阿昔洛韦组年复发次数为（1.16±0.77）次,伐昔洛韦组年复发次数为（1.22±0.7）次,对照组年复发次数为（2.68±1.13）次,阿昔洛韦组和伐昔洛韦组与对照组年复发次数差异有统计学意义（P＜0.05）.结论 生殖器疱疹阳性率较高.生殖器疱疹无症状排毒常存在混合感染.患者病程越长、发作越频繁,阳性率越高.通过及时的药物干预,可以降低生殖器疱疹复发率.     

伐昔洛韦与紫外线联合治疗带状疱疹40例

［摘要］目的观察伐昔洛韦与紫外线联合治疗带状疱疹的疗效。方法带状疱疹患者80例，随机分为治疗组和对照组各40例。治疗组给予伐昔洛韦0.3 g， bid，po,紫外线隔日照射1次，共治疗10 d;对照组单用阿昔洛韦0.2 g， 每天5次，po ，10 d。结果治疗组患者症状、体征消退时间明显短于对照组。结论伐昔洛韦与紫外线联合治疗带状疱疹的疗效较单用阿昔洛韦显著。     

泛昔洛韦联合卡介苗多糖核酸治疗复发性生殖器疱疹疗效观察

目的探讨研究泛昔洛韦联合卡介苗多糖核酸治疗复发性生殖器疱疹的临床疗效。方法收集本院80例复发性生殖器疱疹患者,随机分为观察组和对照组,每组40例,观察组用泛昔洛韦联合卡介苗多糖核酸进行治疗,对照组用泛昔洛韦进行治疗,比较两组的临床治疗效果。结果随访1年后,观察组的复发率明显低于对照组,两组比较差异有统计学意义（P〈0．05）;且两组均未出现明显的不良反应。结论泛昔洛韦联合卡介苗多糖核酸可以有效地降低复发性生殖器疱疹的复发率,值得在临床上推广使用。     

中西药结合治疗复发性生殖器疱疹42例

目的:观察中西药结合治疗复发性生殖器疱疹的临床疗效及复发率。方法:将120例复发性生殖器疱疹患者随机分为3组,中西药结合组给予口服中药自拟方+西药伐昔洛韦胶囊+重组人干扰素治疗;西药组给予伐昔洛韦+重组人干扰素治疗;中药组给予口服中药自拟方治疗。结果:中西药结合组有效率比其他2组高,复发率比其他2组低(均P<0.05)。结论:中西药结合治疗复发性生殖器疱疹,疗效好,复发率低。     

Valaciclovir: a review of its long term utility in the management of genital herpes simplex virus and cytomegalovirus infections

Valaciclovir is an aciclovir prodrug used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus, and for prophylaxis against cytomegalovirus (CMV). Oral valaciclovir provides significantly better oral bioavailability than oral aciclovir itself, contributing to the need for less frequent administration. Several studies have demonstrated the efficacy of long term (> 90 days) therapy with valaciclovir for the suppression of genital HSV disease in otherwise healthy individuals with HSV infection. In 1 randomised, double-blind trial, once daily valaciclovir (1000 mg, 500 mg and 250 mg) produced statistically significant suppression of disease recurrence, as did twice daily valaciclovir 250 mg and aciclovir 400 mg. Valaciclovir dosages of > or = 500 mg daily are recommended for suppression of genital herpes recurrences in immunocompetent individuals. This disease occurs frequently in patients with human immunodeficiency virus (HIV) infection and, in a single randomised double-blind trial, prophylactic valaciclovir (1000 mg once daily or 500 mg twice daily) and aciclovir (400 mg twice daily) were found to be of similar efficacy in the suppression of genital herpes. However, a higher than expected dropout rate indicated that more studies of valaciclovir in patients with HIV are required. In a randomised trial of patients undergoing renal transplant, valaciclovir 2 g 4 times daily for 90 days significantly reduced the incidence and delayed the onset of CMV disease: the incidence in valaciclovir-treated patients who were CMV-seronegative at baseline, and recieived a kidney from a CMV-seropositive donor, was 3% versus 45% for placebo after 90 days of treatment. Acute graft rejection was also reduced in the valaciclovir-treated group. A small study in heart transplant patients compared valaciclovir (2 g 4 times daily) with aciclovir (200 mg 4 times daily) and found a significant reduction in CMV antigenaemia favouring valacilovir at the end of the treatment period. Additional reductions in other indices of CMV in those given valaciclovir compared with aciclovir were also noted. In a preliminary study of prophylaxis for CMV disease in bone marrow transplant recipients valaciclovir (2 g 4 times daily) was superior to aciclovir (800 mg 4 times daily) in terms of time to CMV viraemia or viruria. Although valaciclovir (8 g/day for approximately 30 weeks) reduced the incidence and time to CMV disease compared with aciclovir (3.2 g/day) in patients with advanced HIV disease, valaciclovir was associated with more gastrointestinal complaints and an increased risk of death, leading to premature termination of the study. As yet, no trials comparing the efficacy of valaciclovir with famciclovir (the oral prodrug for penciclovir) in the suppression of recurrent episodes of genital herpes have been published, nor have direct comparisons been made, between valaciclovir with ganciclovir in patients with CMV disease. Valaciclovir is well tolerated at dosages used to suppress recurrent episodes of genital herpes (500 to 1000 mg/day) in immunocompetent and HIV seropositive individuals, with headache being reported most often. However, a potentially fatal thrombotic microangiopathy (TMA)-like syndrome has been reported in some immunocompromised patients receiving high-dose prophylactic valaciclovir therapy (8 g/day) for CMV disease for prolonged periods, and the risk of this syndrome appears to be higher in patients with advanced HIV disease. While the clinical benefits of valaciclovir in some immunocompromised patients may outweigh the risk of TMA, close monitoring for symptoms of TMA is indicated in all immunocompromised patients receiving high-dose valaciclovir. Conclusion: Oral valaciclovir is an effective drug for the suppression of recurrent episodes of genital herpes in immunocompetent and immunocompromised individuals. (ABSTRACT TRUNCATED)     

两种伐昔洛韦抑制疗法方案预防生殖器疱疹复发作用比较

目的:比较两种伐昔洛韦抑制疗法方案预防生殖器疱疹复发的临床效果。方法:将87例频发性生殖器疱疹患者(>3次/半年)随机分成2组,Ⅰ组42例患者口服万乃洛韦,300mg每日1次,。连续服用6个月。Ⅱ组45例患者口服万乃洛韦300mg,隔日1次,连续服用6个月。分别对用药前及用药6个月后的复发情况进行观察。结果:两种方案治疗后平均复发次数明显减少,但两组间平均复发次数差异无显著性(P>0.05)。结论:两种治疗方案对预防频发性生殖器疱疹复发疗效相同。     

Double-blind comparison of weekend and daily regimens of oral acyclovir for suppression of recurrent genital herpes

The potential utility of intermittent regimens of oral acyclovir for suppression of recurrent genital herpes depends on how long the suppressive effect of the drug persists during pauses in treatment. To study this question, we admitted 38 patients in a double-blind controlled trial comparing the results of daily acyclovir treatment (200 mg t.i.d.) with treatment on weekend days only (400 mg t.i.d. on Saturday and Sunday) for suppression of recurrent genital herpes. Of the 35 patients completing the study, significantly more failures occurred in the weekend group (13/17) than in the daily group (3/18, P less than 0.001). Failures on the weekend regimen were more frequent as the week progressed (P = 0.005). The findings suggest a short-term persistence of suppression by acyclovir and hence that intermittent regimens with more closely spaced periods of treatment may be more effective than the regimen we studied. Most virus isolates studied, including all of those isolated from the patients during treatment, were sensitive to acyclovir.