CO2激光联合5%咪喹莫特乳膏或卡介菌多糖核酸预防尖锐湿疣复发的临床观察

目的:观察CO2激光术后局部外用5%咪喹莫特乳膏与卡介菌多糖核酸注射(BCG-PSN)预防尖锐湿疣(CA)复发情况.方法:90例CA患者经CO2激光清除术后的患者分为咪喹莫特组(46例)和BCG-PSN组(44例),咪喹莫特乳膏组每周外用5%的咪喹莫特乳膏3次,BCG-PSN组隔日肌注1次,疗程均为8周.结果:咪喹莫特组治愈率为89.13%,复发率为10.87%.BCG-PSN组治愈率为65.9%,复发率为34.1%.咪喹莫特组的复发率明显低于BCG-PSN组,差异有统计学意义.结论:CO2激光术后,局部外用咪喹莫特乳膏疗效较满意.     

二氧化碳激光联合祛疣洗剂治疗尖锐湿疣的疗效观察及护理

[目的]探讨二氧化碳（CO2）激光联合祛疣洗剂治疗尖锐湿疣的疗效。[方法]将127例尖锐湿疣病人随机分为3组：A组采用CO2激光联合祛疣洗剂治疗,B组采用CO2激光联合咪喹莫特乳膏治疗,C组单用CO2激光治疗,同时3组给予相同的护理干预措施。观察3组病人的治愈、复发及不良反应情况。[结果]A组治愈率和复发率分别为88．37％和11．63％,B组为81.40％和18．60％,C组为53．66％和46．34％;A组与B组相比,治愈率和复发率差异均无统计学意义（P〉0．05）;A组与C组相比,治愈率和复发率差异均有统计学意义（P〈0．01）。A组有3例病人发生不良反应,其发生率低于B组（P〈0．01）。[结论]CO2激光联合祛疣洗剂治疗尖锐湿疣疗效明显。     

激光联合5%咪喹莫特乳膏治疗尖锐湿疣的疗效

目的:观察CO2激光联合5%咪喹莫特乳膏治疗尖锐湿疣的疗效及副反应.方法:选择2007年8月至2009年7月来门诊接受尖锐湿疣治疗的患者286例;采用随机对照试验研究的方法,观察治疗8周后实验组与对照组尖锐湿疣疗效及副反应;运用多元Logistic回归分析CO2激光治疗后局部外用5%咪喹莫特乳膏的疗效及副反应的关系.结果:激光联合5%咪喹莫特乳膏较激光联合干扰素治疗的痊愈率高、副反应大(P<0.001).疣体数量及病程与痊愈呈负相关而与副反应呈正相关(P<0.01).结论:激光联合5%咪喹莫特乳膏较联合干扰素效果好;疣体数量多、病程长的患者复发率及副反应都较高.     

HIV/AIDS患者伴尖锐湿疣的治疗

目的观察CO2激光联合咪喹莫特乳膏治疗不同CD4+T淋巴细胞水平的HIV/AIDS患者伴尖锐湿疣的疗效。方法采用病例对照研究,普通尖锐湿疣患者为对照组、HIV/AIDS患者且CD4+T淋巴细胞计数在200 cells/μL以上为试验A组、HIV/AIDS患者且CD4+T淋巴细胞计数在200 cells/μL以下者为试验B组。3组患者均给予CO2激光联合咪喹莫特乳膏治疗。结果 CO2激光联合咪喹莫特乳膏治疗HIV/AIDS患者伴尖锐湿疣对试验A组疗效较试验B组好。试验A组患者治疗时间不低于12周,试验B组患者治疗时间大于12周;3组患者治愈率和复发率差异有统计学意义。结论对于CD4+T淋巴细胞小于200 cells/μL的HIV/AIDS患者尽快进行高效抗反转录病毒治疗(HAART),可待CD4+T淋巴细胞上升至大于200 cells/μL时,再进行治疗,可以降低尖锐湿疣的复发率,减少治疗次数。该类患者进行HAART是必要的。     

CO_2激光联合保妇康栓治疗宫颈尖锐湿疣临床观察

目的：观察CO2激光联合保妇康栓治疗宫颈尖锐湿疣的疗效。方法：对60例宫颈尖锐湿疣患者随机分为观察组30例,用CO2激光联合保妇康栓治疗;对照组单用CO2激光治疗,比较两组的治疗效果。结果：两组治愈后复发率分别为观察组10%,对照组30%,两组比较差异有统计学意义（P〈0.05）。结论：CO2激光联合保妇康栓治疗宫颈尖锐湿疣能明显降低复发率。     

5％咪喹莫特软膏联合CO2激光治疗尖锐湿癍的疗效观察

目的 探讨尖锐湿疣患者激光治疗后外用5％咪喹莫特软膏的疗效。方法 回顾性分析我院60例尖锐湿疣患者的临床资料，比较使用激光治疗后外用5％咪喹莫特软膏组（治疗组）与单用激光治疗组（对照组）的疗效，并观察其复发情况。结果 治疗组中仅复发4例，复发率13．3％，治愈率达86．7％，而对照组复发12例，复发率40％，治愈率60％。两组差异有显著性意义（P〈0．05）。结论 联用5％咪喹莫特软膏能降低尖锐湿疣的复发率。     

CO2激光联合乌体林斯和中药外洗治疗尖锐湿疣112例临床分析

目的探讨CO2激光联合乌体林斯、中药外洗治疗尖锐湿疣的临床疗效。方法112例尖锐湿疣患者随机分成两组：治疗组62例,采用CO2激光联合乌体林斯、中药外洗治疗;对照组50例,单一使用CO2激光治疗,对比观察两组患者的临床治疗效果。结果CO2激光联合乌体林斯、中药外洗治疗组的痊愈率是82．3％（51／62）、复发率是4．8％（3／62）,对照组的痊愈率是60％（30／50）、复发率是34％（17／50）,两组比较有显著性差异（P〈0．05）。结论采用CO2激光、乌体林斯及中药外洗联合治疗尖锐湿疣,疗效显著,复发率低,值得临床推广应用。     

微波联合咪喹莫特乳膏治疗尖锐湿疣疗效观察

目的：探讨微波联合咪喹莫特乳膏治疗尖锐湿疣（CA）的临床疗效。方法：将60例患者随机分为2组，治疗组在微波术后局部外用咪喹莫特乳膏8周，对照组单纯用微波治疗，随访6个月，观察2组患者复发情况。结果：治疗组和对照组的复发率分别为6．67％和63．33％（P〈0．01）。结论：微波联合咪喹莫特乳膏治疗CA有较好的临床疗效。     

外用咪喹莫特预防尖锐湿疣复发的疗效及其机制

目的：评价外用咪喹莫特预防尖锐湿疣复发的疗效并探讨其机制。方法：将62例尖锐湿疣患者分为3组：（1）二氧化碳（CO2）激光治疗组（A组）16例;（2）CO2激光加明欣利迪外用组（B组）27例,以CO2激光去除疣体,等创面愈合后,再外用5%咪喹莫特乳膏（明欣利迪）,每周3次,最长连用16周;（3）明欣利迪外用组（C组）19例,患者仅外用明欣利迪,每周3次,最长连用16周。患者均随访6个月。同时用酶联免疫吸附试验（ELISA）方法检测37例患者的血清中细胞因子肿瘤坏死因子-α（TNF-α）、白介素-3（IL-3）、白介素-6（IL-6）、白介素-8（IL-8）和白介素-10（IL-10）的水平。结果：A组清除率为31.25%,复发率为68.75%;B组清除率为66.67%,复发率为33.33%;C组为清除率为47.37%,复发率为52.63%。B组复发率明显低于A组（P=0.024）,A组与B组、B组与C组无显著差异。在B组、C组的46例患者中,仅少部分患者出现的主要不良反应为用药局部的刺激反应,患者都能忍受,经简单处理后都能坚持治疗。37例患者血清中细胞因子TNF-α、IL-3、IL-6、IL-8和IL-10的水平,治疗前后均在正常范围,并且与正常人对照组相比均无显著差异。结论：CO2激光结合外用5%咪喹莫特乳膏（明欣利迪）能明显降低尖锐湿疣的复发率,且不良反应少。明欣利迪外用不能改变患者血清中细胞因子TNF-α、IL-3、IL-6、IL-8和IL-10的水平。     

5%咪喹莫特软膏联合CO2激光治疗尖锐湿疣的疗效观察

目的探讨尖锐湿疣患者激光治疗后外用5%咪喹莫特软膏的疗效.方法回顾性分析我院60例尖锐湿疣患者的临床资料,比较使用激光治疗后外用5%咪喹莫特软膏组(治疗组)与单用激光治疗组(对照组)的疗效,并观察其复发情况.结果治疗组中仅复发4例,复发率13.3%,治愈率达86.7%,而对照组复发12例,复发率40%,治愈率60%.两组差异有显著性意义(P<0.05).结论联用5%咪喹莫特软膏能降低尖锐湿疣的复发率.     

Treatment of extramammary Paget disease with topical imiquimod cream: case report and literature review

Extramammary Paget disease is an uncommon cutaneous neoplasm that presents as erythematous plaques most frequently located in the anogenital region. Management of patients with extramammary Paget disease involves evaluation of the individual for: (1) a disease-associated, unsuspected, visceral malignancy and (2) secondary adenocarcinoma in the underlying dermis or regional lymph nodes. Several modalities, each with variable effectiveness, are available to treat the cutaneous component of the disease: electrodesiccation and curettage, laser surgery, aminolevulinic acid photodynamic therapy, radiotherapy, topical chemotherapy, and wide surgical excision. However, surgical excision using the Mohs micrographic technique is currently the modality of choice for treating the cutaneous lesions of extramammary Paget disease. Recently, a topical imidazoquinoline immunomodulator that induces cytokine production and stimulates the innate and cellular immune responses--imiquimod cream-has been used for the management of primary or relapsing extramammary Paget disease. Complete healing, without recurrence, of extramammary Paget disease in patients whose cutaneous lesions were treated topically with imiquimod 5% cream was observed. We describe a man with suprapubic extramammary Paget disease whose condition was primary and limited to his skin. Biopsy-confirmed complete resolution of his disease was observed after the topical application of imiquimod 5% cream 3 times per week (on alternate days) for 16 weeks. After reviewing the published reports of other patients with extramammary Paget disease whose disease was successfully treated with imiquimod cream, we suggest that topical imiquimod 5% cream-at least 3 times per week (with 1-2 d of nontreatment in between) for a minimum of 8 to 16 weeks--be considered as an initial treatment for primary cutaneous extramammary Paget disease. Surgical excision or an alternative therapeutic modality is recommended for patients whose extramammary Paget disease persists or recurs after treatment with topical imiquimod.     

复方卡力孜然酊联合点阵二氧化碳激光治疗稳定期肢端白癜风疗效观察

目的分析复方卡力孜然酊联合点阵二氧化碳激光治疗稳定期肢端白癜风的疗效。方法研究随机取常熟市第一人民医院皮肤科收治的80例稳定期肢端白癜风患者进行观察,患者在2016年6月~2019年4月期间入院,采用数字随机分组方式对患者进行以下分组:对照组(40例)采用点阵二氧化碳激光治疗,观察组(40例)在此基础上联合复方卡力孜然酊治疗,对比两组患者的疗效和不良反应。结果观察组治疗的总有效率数据是87.50%(35例),较之于对照组的65.00%(26例)更低,数据差异性显著,P<0.05;两组患者均未见显著不良反应。结论复方卡力孜然酊联合点阵二氧化碳激光治疗稳定期肢端白癜风疗效显著,治疗安全,值得使用。     

脉冲染料激光治疗浅表性婴幼儿血管瘤的效果

目的分析脉冲染料激光(PDL)治疗浅表性婴幼儿血管瘤(IH)的效果。方法将我院2018年8月至2019年5月收治的93例浅表型IH患儿根据治疗方式不同分为观察组(n=58,使用PDL治疗)和对照组(n=35,使用5%咪喹莫特乳膏治疗)。比较两组治疗效果。结果观察组的治疗总有效率明显高于对照组,不良反应总发生率明显低于对照组(P<0.05)。观察组患儿家属满意度明显高于对照组(P<0.05)。结论 PDL治疗浅表性IH疗效确切,可有效促进皮损消退,安全性高。     

双波长脉冲染料激光联合绽妍透明质酸保湿乳治疗玫瑰痤疮的临床疗效观察

目的 分析对玫瑰痤疮患者采用双波长脉冲染料激光联合绽妍透明质酸保湿乳治疗的临床效果.方法 选择2018年3月至2020年9月收治的50例玫瑰痤疮患者作为研究对象,随机分为观察组(25例,采用双波长脉冲染料激光联合绽妍透明质酸保湿乳治疗)和对照组(25例,采用绽妍透明质酸保湿乳治疗).治疗前后分别对两组患者临床症状进行积...     

Imiquimod, a Patient-Applied Immune-Response Modifier for Treatment of External Genital Warts

Genital human papillomavirus infection is one of the most common sexually transmitted diseases. Imiquimod is a new agent, an immune-response modifier, that has been demonstrated to have potent in vivo antiviral and antitumor effects in animal models. The present prospective, multicenter, double-blind, randomized, vehicle-controlled trial evaluated the efficacy and safety of daily patient-applied imiquimod for up to 16 weeks for the treatment of external genital warts. Wart recurrence was investigated during a 12-week treatment-free follow-up period. In the intent-to-treat analysis, baseline warts cleared from 49 of 94 (52%) patients treated with 5% imiquimod cream, 13 of 90 (14%) patients treated with 1% imiquimod cream, and 3 of 95 (4%) vehicle-treated patients; the differences between the groups treated with vehicle and imiquimod were significant (P < 0.0001). For subjects who completed the follow-up period, recurrence rates after a complete response were 19% (9 of 48 patients) in the 5% imiquimod cream group, 17% (2 of 12) in the 1% imiquimod cream group, and 0% (0 of 3) in the vehicle-treated group. There were no systemic reactions, although local skin reactions (generally of mild or moderate severity) were common, particularly in the 5% imiquimod cream group. Local reactions caused two patients to discontinue treatment. The most frequently reported local skin reactions were erythema, excoriation or flaking, and erosion. Patient-applied 5% imiquimod cream is effective for the treatment of external genital warts and has a favorable safety profile.     

Imiquimod 5-percent cream does not alter the natural history of recurrent herpes genitalis: a phase II,randomized, double-blind,placebo-controlled study

Present strategies for control of herpes genitalis recurrences require multiple daily doses of antiviral medication. Imiquimod, an immune response modifier, induces alpha interferon and interleukin-12; application in the presence of local herpes antigens during a recurrence may augment herpes simplex virus (HSV)-specific cell-mediated immunity. To test this theory, we performed a randomized, double-blind, placebo-controlled study of imiquimod 5% cream to assess safety and efficacy for decreasing recurrences. Patients with six or more recurrences of herpes genitalis per year applied study cream (imiquimod or placebo) to lesions one, two, or three times per week for 3 weeks for each recurrence during a 16-week treatment period. This was followed by a 16-week observation period. Of 124 patients randomized to the study, 103 completed the treatment period and 93 completed the observation period. The median times to first genital herpes recurrence were 53 days for those receiving placebo (n = 30) and 54, 60, and 64 days for those receiving imiquimod one time per week (n = 34), two times per week (n = 32), and three times per week (n = 28), respectively. The median annualized recurrence rates during the treatment period were 3.8, 4.9, 3.2, and 3.1, respectively. There were no statistically significant differences in the time to first recurrence or in the annualized recurrence rate between the imiquimod and placebo groups in either the treatment or the observation period. A trend in increased rates of local adverse events at the application site and a delay in lesion healing with more frequent dosing suggested a pharmacologic effect. Although clinical efficacy has been observed for imiquimod in other conditions in which a TH1-type immune response may be beneficial, including other viral infections such as those caused by human papillomavirus, no apparent effect on the short-term natural history of herpes genitalis recurrences was observed.     

复方利多卡因乳膏在超脉冲CO2激光祛除面部色素痣的应用和效果评价

目的探讨复方利多卡因乳膏局部浅表麻醉对超脉冲CO2激光祛除面部色素痣患者疼痛的影响。方法选取120例面部色素痣患者,随机分为复方利多卡因乳膏试验组与对照组,每组60例。以视觉模拟评分法（VAS）观察复方利多卡因浅袁麻醉后超脉冲CO2激光治疗过程患者的疼痛程度,并作出比较分析。结果使用复方利多卡因乳膏试验组患者VAS评分为（3．800±0．917）分,明显低于对照组患者的疼痛评分（7．317±0．892）分,差异具有统计学意义（P〈0．05）。结论复方利多卡因乳膏术前局部浅表麻醉可明显减轻超脉冲CO2激光祛除色素痣时的疼痛感,该方法安全可靠,值得临床应用推广。     

The effect of topical wheatgrass cream on chronic plantar fasciitis: a randomized, double-blind, placebo-controlled trial

OBJECTIVES: To investigate the efficacy of a topical wheatgrass cream for improving pain and function in patients with chronic plantar fasciitis. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Eighty participants with chronic plantar fasciitis were randomly assigned to a treatment group (wheatgrass cream) or a control group (placebo cream). All participants applied a cream twice daily for 6 weeks. Follow up was conducted at 6 and 12 weeks. MAIN OUTCOME MEASURES: Visual Analogue Scale (VAS) for daily first-step pain and the Foot Health Status Questionnaire (FHSQ) for overall foot function. Secondary measures of foot posture, calf muscle strength and range of ankle dorsiflexion were also assessed. RESULTS: No significant differences were found between groups with respect to main outcomes of first-step pain or foot function at any time. Both groups improved significantly from baseline to 6 weeks, and these improvements were maintained at 12 weeks. CONCLUSIONS: The topical application of wheatgrass cream is no more effective than a placebo cream for the treatment of chronic plantar fasciitis.