人体蠕形螨感染的中西医治疗现状

蠕形螨（Demodex）俗称毛囊虫（follicle mite），是一类永久性专性寄生螨，能寄生于人体的蠕形螨目前已知的仅有2种，即毛囊蠕形螨（Demodex folliculorum）和皮脂蠕形螨（Demodex brevis）。毛囊蠕形螨主要寄生于毛囊根部，常见于面部的鼻周围、颊部、颏部、额部和眼睑。而皮脂蠕形螨主要寄生于皮脂腺里，亦可寄生于毛囊中。蠕形螨是一种条件致病性螨类，随着数量、虫种、人体反应性的不同，临床表现也多样。在寄生部位合并细菌感染的情况下还可继发痤疮、酒渣鼻、睑缘炎、外耳道瘙痒症等疾病。目前人体蠕形螨病的治疗药物多达数百种，现将其治疗情况综述如下。     

自制灭螨液体外杀螨及治疗人体面部蠕形螨病的临床研究

目的观察灭螨液的体外杀螨效果、治疗蠕形螨病的疗效及其安全性。方法将离体活螨成虫分别置于灭螨液、2%甲硝唑溶液及空白基质组中;将面部蠕形螨病患者(168例)随机分为灭螨液组(107例)和2%甲硝唑溶液对照组(61例),两组均于每天早、晚各1次分别将灭螨液及2%甲硝唑溶液涂于整个面部,连续用药3周后观察临床疗效。结果体外用药4 h后,灭螨液组螨虫全部死亡,与2%甲硝唑组(杀螨率62.26%)和空白基质组(杀螨率12.28%)比较,差异均有统计学意义(χ2=91.50,P<0.001);灭螨液组临床治疗的愈显率为63.55%,2%甲硝唑组的愈显率为42.62%。两组比较差异有统计学意义(χ2=6.91,P<0.01)。结论灭螨液具有较强的体外杀螨作用,治疗蠕形螨病安全有效。     

甲硝唑凝胶对兔疥螨和人体蠕形螨的实验治疗和体外杀虫作用

 目的：观察甲硝唑凝胶对兔疥螨和人体蠕形螨的治疗作用和体外杀虫作用。方法：采用家兔感染疥螨和离体试验评价甲硝唑凝胶的杀虫作用。结果：甲硝唑凝胶能杀灭兔体的疥螨，对兔疥螨感染后溃烂、皮疹具有明显的疗效。对离体疥螨和人体蠕形螨也具有显著的杀灭作用，48h内能全部杀灭虫体。结论：甲硝唑凝胶是一种杀灭疥螨和蠕形螨的有效药物。     

复方大黄膏对面部蠕形螨杀灭作用26例分析

目的:寻找治疗人体蠕形螨所致的痤疮、酒渣鼻等皮肤疾患的药物。方法:用大黄、硫黄等四味中药调制成纯中药膏剂,受试者每日晚涂抹于面部,治疗1疗程(3周)后观察受试者面部蠕形螨检出与治前的差别,以此判定疗效。结果:治疗后螨虫消除有效率达95％,其中痊愈者占47％,显效率85％。结论:复方大黄膏杀灭人体皮肤蠕形螨效果良好,可用于治疗由于皮肤蠕形螨所致的各种皮肤疾患。     

茶树油眼用凝胶和甲硝唑滴眼液体外抗螨作用比较

目的:探讨5%茶树油凝胶、2%甲硝唑滴眼液2种制剂对毛囊蠕形螨的体外杀灭作用,为选择有效的灭螨方法提供依据。方法:在本院眼科门诊用睫毛拔取法采集眼部毛囊蠕形螨,置于细胞板中,滴加5%茶树油凝胶、2%甲硝唑滴眼液,利用倒置显微镜观察其存活情况,生理盐水为空白对照。结果:5%的茶树油凝胶对毛囊蠕形螨有较好的杀灭作用,虫体形态及活动度均发生了兴奋-痉挛-松弛-死亡的典型变化。毛囊蠕形螨在5%茶树油凝胶中的存活时间平均为(1.43±0.62)h,与2%甲硝唑滴眼液组的平均存活时间(27.65±5.14)h比较差异有统计学意义(P<0.01)。毛囊蠕形螨在3组间的存活时间经H检验,差异有统计学意义(P<0.01)。其中,毛囊蠕形螨在2%甲硝唑滴眼液中的存活时间与空白对照组的平均存活时间(23.33±3.98)h比较差异无统计学意义。毛囊蠕形螨在5%茶树油凝胶与空白对照组的存活时间比较差异有统计学意义(P<0.01)。在5%茶树油凝胶、2%甲硝唑滴眼液和空白对照组间,毛囊蠕形螨24 h死亡率分别为100%,20%,50%,差异具有统计学意义(P<0.01)。结论:2%甲硝唑滴眼液对毛囊蠕形螨无体外杀灭作用;5%茶树油凝胶对毛囊蠕形螨有体外杀灭作用。茶树油凝胶制剂可作为一种天然高效的杀螨药物。     

复方百部乳液的制备及杀灭人体蠕形螨的效果观察

复方百部乳液的制备及杀灭人体蠕形螨的效果观察王福兴,米献淼,马印图(解放军北京医学高等专科学校100071)蠕形螨亦称毛囊虫。其寄生在人体毛囊或皮脂腺内,流行广泛。国外报道,成人感染率为27%～100%[1]。国内已知25个省、市、自治区有人体蠕形螨感染或病例报道,人群感染率为16.98%～99.5%[2,3]。蠕形螨感染一般无症状,但严重者可引起面部痤疮、丘疹、色素沉着、酒渣鼻等皮肤病。现有治疗药物多为硫磺、灭滴灵、白降汞等化学药?...     

中西医结合治疗面部人蠕型螨病56例疗效观察

目的：观察中西医结合治疗面部人蠕形螨病的临床疗效。方法：对56例患者给予甲硝唑芬布芬0．2Tid结合枇杷清肺饮舍导赤散加减进行治疗。结果：治疗56例,痊愈31例,显效17例,有效8例,总有效率85．71％。结论：甲硝唑芬布芬结合枇杷清肺饮合导赤散加减治疗面部人蠕型螨病疗效较好。     

克螨护肤灵的实验研究

克螨护肤灵是笔者多年来研制的纯中药外用制剂,主治酒渣鼻、痤疮等皮肤病,临床观察,疗效良好。对于该药的研究,笔者做了四项动物实验及对人体蠕形螨的药敏实验、抗菌实验等。结果表明,该药有杀螨、抑菌作用,对皮肤无损害。     

杀灭人体蠕形螨的中药筛选

目的：从中药中筛选杀灭人体蠕形螨的有效药物。方法：选用百部、丁香等１１种具有杀虫灭菌作用的中药煎剂,以３种不同浓度进行体外杀螨实验,并以已知有效杀螨药物甲硝唑作对比。结果：浓度为１００％的百部、丁香和花椒组蠕形螨全部死亡的时间分别是５ｈ,７ｈ,９ｈ,而其他中药组均在１１ｈ以上;甲硝唑对照组为９ｈ结论：浓度为１００％的百部、丁香和花椒煎剂都具有较好的杀螨作用;百部的杀螨效果优于２％甲硝唑水剂。     

八宝眼膏治疗蠕形螨睑缘炎临床观察

目的 探讨纯中药眼用制剂八宝眼膏治疗蠕形螨睑缘炎的疗效。方法 选取蠕形螨睑缘炎患者60例，随机分为2组，试验组患侧眼睑缘先用婴儿沐浴乳清洁、眼部用湿巾擦拭处理，再予八宝眼膏治疗；对照组患侧眼睑缘先用婴儿沐浴乳清洁、眼部除螨湿巾擦拭处理，再予妥布霉素地塞米松眼膏治疗，治疗30 d后，对患者进行镜检蠕形螨计数、症状评分及裂隙灯下观察临床体征评分。比较2组治疗前后数据。结果 2组治疗前后镜检蠕形螨计数差异均有统计学意义(P<0.05)。治疗后，2组蠕形螨计数差异无统计学意义(P>0.05)。2组治疗前后症状、体征总评分差值差异均有统计学意义(P<0.05)。结论 八宝眼膏治疗蠕形螨睑缘炎疗效显著，不仅能杀灭蠕形螨，更能减轻患眼症状和体征。     

薄荷油乳剂经皮给药对小鼠耳肿胀的保护作用

目的:研究薄荷油乳剂经皮给药对小鼠耳肿胀的保护作用。方法:40只雄性小白鼠随机分为正常对照组、阳性对照组、薄荷油乳剂高剂量组、薄荷油乳剂中剂量组、薄荷油乳剂低剂量组。正常对照组耳部涂抹生理盐水,阳性对照组耳部涂抹石灰搽剂,其余均涂抹薄荷油乳剂。以肿胀度和肿胀率为指标区分消炎效果。结果:阳性对照组、薄荷油乳剂高剂量组、薄荷油乳剂中剂量组、薄荷油乳剂低剂量组较正常对照组肿胀度和肿胀率均有降低。结论:石灰搽剂、薄荷油乳剂均具有一定的消炎效果。薄荷油乳剂高剂量组较石灰搽剂组消炎效果明显。     

薄荷油致小鼠肝毒性时-量关系及其机理研究

目的研究薄荷油致小鼠肝毒性的量效、时效关系及自由基损伤机制。方法小鼠口服不同剂量薄荷油,测定其LD50。另取小鼠按不同剂量或不同时间点分组,检查血清ALT等肝功能指标和肝组织形态变化,测定肝组织SOD,MDA。结果小鼠口服薄荷油的LD50为3.0 ml/kg。ALT等肝功能指标在给药后24~48 h达到高峰,72 h可恢复近正常值。与正常组相比,薄荷油中、高剂量组对肝组织损伤显著,随着剂量增大,ALT等肝功能指标升高显著(P<0.05或P<0.01)。薄荷油组与正常组比较,小鼠肝组织中SOD降低而MDA升高(P<0.05),与四氯化碳相似。结论小鼠一次性口服大剂量薄荷油可造成急性肝损伤甚至死亡,并显示有毒性时-效、量-效关系;自由基损伤可能是其肝毒性机制之一。     

不同促渗剂对蒿甲醚软膏体外透皮吸收的影响

目的:考察促渗剂氮酮、冰片、薄荷油对蒿甲醚软膏体外透皮吸收的影响。方法:使用智能透皮试验仪,选择小鼠腹皮为渗透屏障,对含3种促渗剂及其复配体系的软膏进行体外经皮扩散实验,HPLC测定蒿甲醚的累积透过量和经皮扩散速率。结果:2%氮酮、2%冰片、2%薄荷油,2%氮酮+2%冰片、2%氮酮+2%薄荷油均可以不同程度地促进蒿甲醚软膏的透皮吸收,其促渗效果顺序为2%氮酮+2%薄荷油2%氮酮+2%冰片2%薄荷油2%冰片2%氮酮。结论:薄荷油单用和复配使用对蒿甲醚的体外透皮吸收均有良好的促进作用,复配使用促透效果更佳。     

A review of the bioactivity and potential health benefits of peppermint tea (Mentha piperita L.)

Peppermint (Mentha piperita L.) is one of the most widely consumed single ingredient herbal teas, or tisanes. Peppermint tea, brewed from the plant leaves, and the essential oil of peppermint are used in traditional medicines. Evidence-based research regarding the bioactivity of this herb is reviewed. The phenolic constituents of the leaves include rosmarinic acid and several flavonoids, primarily eriocitrin, luteolin and hesperidin. The main volatile components of the essential oil are menthol and menthone. In vitro, peppermint has significant antimicrobial and antiviral activities, strong antioxidant and antitumor actions, and some antiallergenic potential. Animal model studies demonstrate a relaxation effect on gastrointestinal (GI) tissue, analgesic and anesthetic effects in the central and peripheral nervous system, immunomodulating actions and chemopreventive potential. Human studies on the GI, respiratory tract and analgesic effects of peppermint oil and its constituents have been reported. Several clinical trials examining the effects of peppermint oil on irritable bowel syndrome (IBS) symptoms have been conducted. However, human studies of peppermint leaf are limited and clinical trials of peppermint tea are absent. Adverse reactions to peppermint tea have not been reported, although caution has been urged for peppermint oil therapy in patients with GI reflux, hiatal hernia or kidney stones.     

Effects of peppermint oil and caraway oil on gastroduodenal motility

The effect of enteric-coated (Enteroplant) and non-enteric-coated preparations containing a peppermint-caraway oil combination with 90 mg peppermint oil and 50 mg caraway oil was studied on gastroduodenal motility with stationary manometry in six healthy volunteers. The results showed that: (1) both enteric-coated and non-enteric-coated preparations have effects on the migrating motor complex (MMC); (2) mainly a decrease in the number of contractions and contraction amplitudes is seen during the various phases of the MMC; (3) non-enteric-coated preparations have their effects mainly during the first MMC after administration; (4) enteric-coated preparations have their effects temporally delayed during the second MMC after administration. In conclusion, enteric-coated and non-enteric-coated peppermint-caraway oil combinations are safe preparations, acting locally to cause smooth muscle relaxation.     

Cholertic activity of Thapsia chem I,II, and III in rats: Comparison with terpenoid constituents and peppermint oil

The influence on bile flow of the fruit essence from three chemotypes of the genus Thapsia and their major components has been investigated. For comparative purposes menthol and peppermint oil were also included in the assay. All the drugs tested showed toa different extent choleretic activity calculated on the increase of the bile amount in male adbult Wistar rats. Thapsia Chem I (50 mg/kg) containing 88% geranylacetate was found to indued choleresis in treated rats to a level as high as peppermint oil containing 42% menthol. A similar activity was confirmed when pure geranylacetate was assayed.     

麦冬多糖口服吸收促进剂的研究

目的:研究适用于麦冬多糖(OJP)的口服吸收促进剂,为寻求利用吸收促进剂来实现OJP口服给药提供依据.方法:通过Caeo-2细胞模型,对薄荷油、丁香油、冰片、三七花皂苷、麦冬皂苷、人参皂苷Rg_1、三七皂苷R_1和癸酸钠的吸收促进作用和细胞毒性进行评价.通过大鼠在体肠段试验,对OJP在各肠段的吸收情况以及癸酸钠对吸收的促进作用进行研究.结果:癸酸钠是既有效又安全的吸收促进剂,而丁香油、薄荷油、麦冬皂苷的吸收促进作用与细胞毒性高度相关.OJP在十二指肠、回肠和结肠段中均有少量吸收,其中在十二指肠中的吸收情况最好,回肠次之,而在结肠段最差.在使用癸酸钠之后,各肠段对OJP的吸收均有显著提高,尤以结肠段最为明显.结论:吸收促进剂的吸收促进作用往往与其细胞毒作用相关,选用安全而有效的吸收促进剂来增加麦冬多糖的口服吸收是有效且具有应用价值的一种方法.     

Mode of action of peppermint oil and (-)-menthol with respect to 5-HT3 receptor subtypes: binding studies, cation uptake by receptor channels and contraction of isolated rat ileum

Peppermint oil (Mentha × piperita L. (Lamiaceae) has been shown to exert potent antiemetic properties, but its mode of action has not yet been elucidated. Among its active constituents (-)-menthol is the most important. Three different in vitro models were used to investigate the effects on 5-HT(3) receptors (serotonin receptor subtype): [(14)C]guanidinium influx into N1E-115 cells which express 5-HT(3) receptors, isotonic contractions of the isolated rat ileum and equilibrium competition binding studies using a radioactively labelled 5-HT(3) receptor antagonist ([(3)H]GR65630) (3-(5-methyl-1H-imidazol-4-yl)-1-(1-methyl-1H-indol-3-yl)-1-propanone). Both peppermint oil and (-)-menthol inhibited [(14)C]guanidinium influx through 5-HT(3) receptor channels as well as contractions of the ileum induced by serotonin. Neither the peppermint oil nor (-)-menthol, however, was able to displace [(3)H]GR65630 from 5-HT(3) binding sites. It may be concluded that peppermint oil and (-)-menthol exert their antiemetic effect at least partly by acting on the 5-HT(3) receptor ion-channel complex, probably by binding to a modulatory site distinct from the serotonin binding site.     

Acute and chronic pretreatment with essential oil of peppermint (Mentha × piperita L., Lamiaceae) influences drug effects

The appearance of common and self‐initiative usage of various herbal preparations in everyday practice and life imposes the question of possible interactions with drugs. This survey examined the influence of acute and chronic peppermint oil (PO – Mentha × piperita L., Lamiaceae; prepared as emulsion for oral use) on pentobarbitone‐induced sleeping time, analgesic effect of codeine and impairment of motor coordination caused by midazolam in mice. The chemical profile of essential oil was determined by GC‐MS. Applied doses of PO were 0.1 and 0.2 mL/kg. Chronic PO intake (in both doses) led to significant decrease of analgesic effect of codeine, while acute intake of PO did not change this effect. Acute PO pretreatment in higher dose caused significant prolongation of pentobarbitone‐induced sleeping time, while it was significantly shortened by chronic PO pretreatment at the same dose. Midazolam effect was enhanced and prolonged significantly by chronic PO intake at higher dose, while acute intake of PO did not change this effect. Gut motility was increased only by acute intake of higher PO dose. Regarding the fact that PO produces changes in tested drug effects, the interaction between drugs and phytopreparations containing PO should be additionally followed/confirmed in humans. Copyright © 2011 John Wiley & Sons, Ltd.