抗真菌新药特比萘芬对家兔皮肤慢性毒性研究

用特比萘芬对青紫蓝家兔连续进行一个月皮肤敷药毒性试验，观察动物所产生的毒性反应情况，为临床局部用药提供安全方面依据，试验分设基质对照，５％，１０％和２０％四组，结果敷药局部皮肤２０％组呈明显充血红斑，并伴以轻度水肿，组织学检查见皮肤角化层略增厚；１０％组出现明显红斑；５％组１．３兔出现轻度红斑；全身情况、血液学参数，血液生化指标，组织检查与对照组相比均未见明显差别。     

布替萘芬霜剂局部给药对家兔慢性毒性实验研究

目的：观察布替萘芬霜剂长期大剂量皮肤局部使用对家兔的慢性毒性作用。方法：将24只家兔随机分成4组：对照组、布替萘芬高（20％）、中（10％）、低（5％）剂量组，连续皮肤局部使用1个月后，进行全身情况、血液学、血液生化、组织学检查。结果：除敷药的局部皮肤有些异常外，实验组家兔全身情况、血液学参数、血液生化指标、组织学检查与对照组相比均无明显差异。结论：布替萘芬局部给药安全，临床应用可靠。     

羊毛状小孢子菌引起泛发性体癣1例报道

患者刘某，女，２２岁，１月前替朋友代养猫咪，数日后全身多处出现红斑，自觉痒，曾就诊为“荨麻疹”，医治无效。于１９９９年５月１６日来我所就诊，经检查面部、躯干、双上肢有７２处大小不等（约０－５～２ｃｍ）环状或圆形的皮肤损害，边缘略高于正常皮肤，且炎性表现较重，同时伴有少许鳞屑，中心有自愈区域。实验室检查：皮肤损害主要集中在面、颈及双上肢。经局部消毒，取标本用１０％ＫＯＨ镜检，见大量原浆很丰满的菌丝，同时接种于沙氏培养基中，置２５℃～２７℃生物培养箱中，培养观察１５日，隔日观察一次生长情况。菌落生长…     

维胺酯、替硝唑治疗酒渣鼻的疗效观察

酒渣鼻是一种好发于颜面中部的慢性皮肤损害。临床发现甲硝唑治疗治愈后复发率较高。我们观察了口服替硝唑和维胺酯治疗红斑期及丘疹脓疱酒渣鼻的疗效，文献未见报道。１材料和方法１．１临床资料选择６０例门诊常见的红斑期酒渣鼻和丘疹脓疱期酒渣鼻纳入本研究。纳入标准 :鼻及其周围皮肤的持久性红斑 ,伴或不伴毛细血管扩张 ;上述部位尤其是鼻尖部丘疹、脓疱、红斑 ,伴或不伴毛细血管扩张。皮疹严重性的判断 :丘疹和脓疱按数量计分：无 :０ ,＜５个 :１ ,５～１０个 :２,１０～２０个 :３,＞２０个 :４ ;红斑 :无红斑 :０ ,轻度 :１,中度 …     

中药头皮脂溢搽剂的动物实验研究

目的：研究中药头皮脂溢搽剂对皮肤的急性毒性、过敏性及刺激性。方法：日本大耳白兔35只，雌雄各半，体重2．5-3．0kg；急性毒性试验用15只，刺激性试验用20只，两者均随机分组。将动物背部用去毛剂脱毛，敷药后观察大耳白兔全身中毒、局部表现以及死亡情况，判断中药头皮脂溢搽剂对皮肤的急性毒性和刺激性。豚鼠30只，雌雄兼用，随机分组；动物背部用去毛剂脱毛，致敏接触受试药观察豚鼠机体免疫系统在皮肤上的反应，评分、计算致敏率，评估中药头皮脂溢搽剂的过敏性。结果：用药各组大耳白兔全身及敷药区皮肤未见红斑和水肿，以及采食、体重、眼结膜和口腔黏膜，呼吸、循环、中枢神经系统、四肢活动等均未见明显异常，证实中药头皮脂溢搽剂对实验动物皮肤急性毒性很小，无刺激性；豚鼠敷药区皮肤未见红斑和水肿，表明中药头皮脂溢搽剂对实验动物免疫系统影响很小，无过敏性。结论：中药头皮脂溢搽剂对皮肤的急性毒性很小、无过敏性及刺激性，提示临床用药安全。     

肺癌低氧放疗的临床观察

２０例肺癌患者配对分为低氧组（１０例）和单照组（１０例）。低氧组患者吸入含氧体积分数为１０５％的低氧混合气２ｍｉｎ后开始接受放疗，５ｍｉｎ内完成治疗，单照组只单独使用６０Ｃｏ照射。结果：①发生Ⅰ度皮肤放射反应时的平均剂量低氧组为（４０７５±３３４）Ｇｙ，单照组为（３０４２±５６９）Ｇｙ（Ｐ＜００５）。②下咽痛时平均剂量低氧组为（４１５２±４３４）Ｇｙ，单照组为（３０５６±４７５）Ｇｙ（Ｐ＜００５）。③近期疗效评定２组患者均为部分缓解（ＰＲ）。④０５ａ，１ａ，３ａ，５ａ生存率低氧组分别为８０％，６０％，１０％，１０％；单照组分别为８０％，２０％，０％，０％（Ｐ＞００５）。⑤死因分析低氧组死于局部复发６例，脑转移３例；单照组分别为８例，２例。结果提示：肺癌低氧放疗能够有效减轻放射反应，对近期疗效及生存率没有明显影响     

异丙酚辅助硬膜外麻醉的临床观察

腹盆腔手术２００例行硬膜外阻滞，局部药为２％利多卡因１０ｍｌ＋０．３％地卡因１０ｍｌ＋１：２０万Ｕ肾上腺素，麻醉平面出现后，随机分组，异丙酚组１００例，术前５ｍｉｎ静滴异丙酚稀释（５％ＧＳ４份＋异丙酚１份），负荷量为１０ｍｇ／ｋｇ，维持量２￣４ｍｇ／ｋｇ。氟芬合剂组１００例，术前５ｍｉｎ静注氟芬合剂２￣３ｍｌ作为对照组。结果两组均能满足手术要求，术中Ｐ、Ｒ、ＭＢＰ、ＳＰＯ２、ＥＴＣＯ２等指标两组无     

荧光素钠眼底血管造影过敏反应3例报告

例１：女，１９岁，于１９９２年５月就诊，因左眼高度近视眼底出血行眼底血管造影检查，既往无药物过敏史，用双星明散瞳后静脉注射１０％荧光素钠５ｍｌ，５分钟后造影完毕，患者颜面部皮肤中度黄染，其它无明显不适回病房，半小时后患者自感喉部轻度异物感，观察双眼眼...     

氯葡栓毒理学试验研究

目的 :测试氯葡栓的皮肤刺激性和慢性毒性。方法 :采用豚鼠皮肤致敏试验和家兔阴道接触药物的慢性毒性实验。结果 :皮肤致敏试验用药部位未见红斑、水肿等皮肤致敏反应。慢性毒性实验用药组家兔一般行为活动、体重增长、血液学、血液生化、主要器官脏器指数等指标与对照组比较差异均无显著性 (P >0 .0 5 ) ;病理学切片检查 ,各主要组织器官均未见中毒性病理改变。结论 :氯葡栓无明显皮肤刺激性和慢性毒性作用 ,局部用药较为安全     

重组人粒细胞—巨噬细胞集落刺激因子I期临床耐受性试验与疗效 …

应用重组人粒细胞－巨噬细胞集落刺激因子对９例肿瘤患者分３种剂量进行了Ｉ期临床的耐受性试验，同时观察了用药剂量与促进白细胞增殖作用的关系。观察结果：２．５、５．０、７．５μｇ／ｋｇ剂量皮下给药，虽可出现骨肌肉痛、寒战、发热等轻度反应，注射部位局部皮肤可出现红斑、皮下硬结、肿胀、疼痛反应，但病人均可耐受。上述反应无需处理，均可自行缓解；重组人粒细胞－巨噬细胞集落刺激因子对肝功能、肾功能、心功能无影响；     

特比萘芬与萘替芬酮康唑联合治疗外耳道真菌病的疗效分析

目的观察口服特比萘芬联合外用萘替芬酮康唑治疗外耳道真菌病的疗效、安全性。方法将66例外耳道真菌病患者随机分为两组：治疗组34例,口服特比萘芬联合外用萘替芬酮康唑,疗程1月;对照组32例,局部外用萘替芬酮康唑,疗程1月。结果治疗组1月后有效率为94.1%,高于对照组的53.1%,有显著性差异。结论联合疗法和单一外用药物治疗外耳道真菌病均有效,但联合疗法起效快、疗程短、效果好。     

Comparative evaluation of the efficacy of itraconazole with terbinafine cream versus itraconazole with sertaconazole cream in dermatophytosis: A within person pilot study

BackgroundCurrent trend of rising drug-resistant dermatophyte infection is alarming and fretted by dermatologists. Dilemma prevails regarding use of the same or different class of antifungal agents topically and systemically. The aim was to study the efficacy of oral itraconazole 200 mg with 1% terbinafine cream versus oral itraconazole 200 mg with 2% sertaconazole cream in dermatophytosis.MethodsThis within-person open-label pilot study enrolled 50 patients with dermatophytosis. Two lesions of comparable size within each patient were randomly allotted to group A and B and treated with 2% sertaconazole and 1% terbinafine cream, respectively. Both groups received itraconazole 200 mg once daily for 4 weeks. The remaining lesions received 1% terbinafine cream. Response and adverse effects were assessed at 2 and 4 weeks. Reduction in erythema, scaling, pruritus and clinical, and mycological cure constituted efficacy outcomes.ResultsThe mean duration of lesions was 2.82 ± 1.35 months. Complete clinical cure was observed in 50% and 48%, whereas mycological cure was attained in 56% and 52% patients in groups A and B, respectively, after 4 weeks, which was statistically insignificant. Reduction in erythema, scaling, and pruritus after 4 weeks when compared between the two groups, was also statistically insignificant.ConclusionSame class of oral and topical antifungal agents has comparable efficacy with different classes of oral and topical antifungal agents in dermatophyte infection.     

Effect of topical application of terbinafine on fungal keratitis

Background Fungal keratitis is a rare but serious corneal disease that may result in loss of vision. The poor prognosis might be due to limited treatment option. This study aimed to evaluate the clinical efficacy of 0.25% terbinafine eye drops comparing with 5% natamycin suspension on fungal keratitis. Methods A retrospective clinical trial was performed on 90 patients presenting with direct smear and/or culture positive fungal keratitis at Beijing Tongren Hospital, Beijing, China from January 2006 to May 2008. Corneal ulcers were categorized as mild or severe. Forty-five patients were treated with topical terbinafine and the next 45 cases received topical natamycin hourly. Results Filamentous fungi were found in corneal scrapings among all 90 cases. Fungal cultures were positive in 64 patients （71%）. Species of Fusarium and Aspergillus were the principal isolates. Forty （89%） patients showed favorable response to terbinafine, while forty-two （93%） patients exhibited favorable response to natamycin （P 〉0.05）. The mean course of treatment was significantly showed in the terbinafine treatment group than natamycin group （（26.5±11.2） days versus （19.3±6.4） days; P 〈0.05）. In terbinafine group, twenty patients with ulcers smaller than 4 mm had favorable outcome, while 20 of 25 patients with ulcers more than 4 mm in diameter had favorable response （P 〈0.05）. Twenty-seven patients with depth of infiltration less than half of stroma thickness had favorable response to terbinafine, while 13 of 18 patients with depth of infiltration more than half of stroma responded to terbinafine. This difference was statistically significant （P 〈0.05）. Conclusions Our findings suggest that topical terbinafine is an effective antifungal drug for the management of filamentous mycotic keratitis, particularly in cases with smaller and shallower ulcers. Its mean duration of treatment was longer than natamycin.     

口服特比萘芬加外用益康唑短程联合疗法治疗足癣的临床对照研究

目的评价口服特比萘芬片加外用益康唑乳膏短程联合疗法治疗足癣的疗效和安全性。方法采用随机数字表法将124名患者分为两组：试验组予特比萘芬片250mg口服,1次／d,联合盎康唑乳膏外用,2次／d,共7d;对照组予益康唑乳膏外用,2次／d,同时口服维生索C片0．1g,1次／d,共28d。于停药时和停药后4周时观察临床疗效和真蔺学疗效,停药后4同时观察复发情况。结果共有113例患者完成临床观察．脱落7例（试验组1例,对照组6例）,剔除4例（对照组4例）。停药时两组相比试验组治愈率明显低于对照组（χ^2=23．03,P〈0．01）,有效率及真菌清除率差异无统计学意义（χ^2=0．33,P〉0．05;χ^2=0．03,P〉0．05）;停药后4周时两组相比试验组治愈率、有效率及真菌清除率均显著高于对照组（χ^2=17．21,P〈0．01;χ^2=14．56,P〈0．01;）（χ^2=23．03,P〈0．01）;停药后4周时两组相比试验组复发率明显低于对照组（χ^2=14．04,P〈0．01）;两组不良反应发生率相比差异无统计学意义（χ^2=3．27,P〉0．05）。结论口服特比萘芬片加外用益康唑乳膏短程联合疗法治疗足癣依从性和安全性高、疗效好。     

5%恩纳乳膏用于成人静脉穿刺时皮层局部麻醉的临床研究

目的 研究5％恩纳乳膏应用于成人静脉穿刺时皮层局部麻醉的最佳起效时间和局部反应。方法 随机选取33例无急、慢性疼痛的择期手术患者,均分为3组,A组不用恩纳乳膏,B组在静脉穿刺前1h手背部涂用5％恩纳乳膏0．6g／4cm^2,C组在静脉穿刺前2h手背部作同样准备。静脉穿刺前、后测视觉摸拟评分(VAS0～10cm),观察局部反应。结果 3组静脉穿刺后VAS评分均较穿刺前显著增加。A、B两组穿刺后VAS评分的差异无显著性。穿刺后C组VAS评分较A组和B组明显降低。所有患者均未发现明显的局部皮肤苍白、红斑和水肿。结论 5％恩纳乳膏用于静脉穿刺时皮层局部麻醉的镇痛效果约以2h为佳,能显著减轻疼痛,但不能完全消除患者的不适或疼痛,局部反应不明显,是一种有效、安全的局部麻醉药物。     

氯苯吩嗪治疗多形性日光疹的临床疗效观察

45例多形性日光疹病人，32例（男22例，女10例）口服氯苯吩氯片50mg／次，3次／日，13例（男8例，女5例）作为对照口服反应停片50mg/次，3次／日，两组局部外擦10％氧化锌软膏2次／日，连续观察1月，结果氯苯吩嗪治疗多形性日光的总有效率90．62％，对照组53．8％，P＜0．01，有显著性差异，氯苯吩嗪治疗多形性日光疹的疗效是肯定的。     

Study of oral itraconazole and terbinafine pulse therapy in onychomycosis

In this open, randomized and comparative study, the safety and efficacy of systemic intermittent itraconazole and terbinafine was examined in 30 patients with onychomycosis. The patient with positive mycological culture and also the patients with positive microscopy and negative culture were investigated. Patients were randomly assigned: 15 patients in each group received either 200mg itraconazole or 250 mg terbinafine twice daily during the first week of a 4 weeks cycle. The treatment duration was 16 weeks and was followed-up for 36 weeks. Both the treatment regimen showed significant reduction in onychomycosis affected areas after 8 weeks and maximum reduction was observed at the end of 36 weeks. At the end point of the follow-up period, the clinical cure rates (no residual deformity or with some deformity) were 86.7% in the itraconazole group and 100% in the terbinafine group. The mycological cure rates were 86.7% and 100% respectively. However, no statistically significant differences between the treatment groups were seen in clinical, mycological (P= 0.864) and severity assessment (P= 0.220). Nausea, abdominal cramp, headache, back pain and flu like syndrome are the adverse effects more frequently reported. At least one adverse effect was reported by 17 patients, of them 12 belonged to itraconazole group and 5 to terbinafine group and the difference was statistically significant (P= 0.027). The overall therapeutic effectiveness, safety and cost affectivity were in favor of Terbinafine pulse therapy.     

ROSCO药片扩散法对白色念珠菌体外抑菌研究

目的了解抗真菌药物的体外活性现状,为选择药敏试验方法和合理使用抗真菌药物提供依据。方法临床送检标本用TTC-沙保罗琼脂平板分离培养,常规法或API20CAUX酵母样真菌鉴定试条进行鉴定；ROSCO酵母样真菌药敏药片扩散法进行药敏试验。结果196株白色念珠菌对特比奈酚、伊曲霉素、氟胞嘧啶、益康唑、咪康唑、克霉唑、酮康唑、氟康唑、两性霉素B、游霉素的耐药率分别为71．4％、47．9％、34．6％、38．7％、39．7％、27．5％、29．5％、29．5％、10．2％、2．0％。结论白色念珠菌对游霉素和两性霉素B敏感性高,对特比奈酚和伊曲霉素耐药性高,咪唑组和三唑组吡咯类近30％～40％耐药程度；提示临床不能再靠经验用药,要参考药敏试验结果合理用药。     

纳米含氟高强度树脂氟释放与再吸收及氟再充效果评价

目的: 测定不同含氟量的纳米含氟高强度树脂的氟释放与再吸收能力,初步探讨临床氟再充方法。方法: 含氟量为10%、20%和30%的纳米含氟高强度树脂作为3个实验组,Fuji Ⅸ型玻璃离子水门汀作为阳性对照组,将材料做成直径5 mm、厚度2 mm各18个样本浸入10 mL去离子水中。每组样本随机抽取5个,采用氟离子选择性电极法测量每24 h氟离子释放量,连续测量30 d并计算氟释放累积量。随后将不含氟的Tetric N-Ceram、通用型、Neofil、Spectrum TPH光固化复合树脂作为阴性对照组,同样各制作18个样本。分别采用多乐氟、FLUORX氟保护漆、柯伯脂氟保护漆、氟化泡沫C型、氟化泡沫A型和1%NaF溶液共6种含氟制剂对各组样本进行氟再充处理并以同样方法测定氟释放累积量。对各组样本氟释放累积量采用单因素方差分析方法进行统计分析。结果: 10%、20%和30%的纳米含氟高强度树脂组及Fuji Ⅸ组均在第1天氟释放量最高,第2天降至较低水平,随后5~30 d氟离子释放趋于平稳。30d氟释放累积量,FujiⅨ组>30%纳米含氟高强度树脂组>20%纳米含氟高强度树脂组>10%纳米含氟高强度树脂组,10%和20%纳米含氟高强度树脂组之间比较差异无统计学意义(P>0.05),其余各组材料之间比较差异均有统计学意义(P<0.05)。经6种含氟制剂氟再充处理后的氟释放累积量,FujiⅨ组明显高于其他树脂组(P<0.01);30%纳米含氟高强度树脂组高于各不含氟树脂组即阴性对照组(P<0.05)。氟化泡沫A型处理所有样本后的氟释放累积量高于其他含氟制剂组(P<0.05)。结论: 3种含氟量纳米含氟高强度树脂均可在一定时间内向周围环境持续地释放及再吸收氟离子,含氟量为30%的纳米含氟高强度树脂氟释放及氟再吸收能力更强,氟化泡沫A型具有较好的氟再充效果。