封包削甲后外用必亮乳膏联合CO_2激光治疗Ⅰ型甲真菌病的疗效观察

目的观察封包削甲后外用奈替芬酮康唑乳膏联合每周照射1次CO_2点阵激光治疗Ⅰ型甲真菌病的疗效。Ⅰ型:是指远端甲板受损≤50%,且无甲母质受累,且受累指趾甲数目≤4个。方法将55例符合Ⅰ型的患者,按照就诊的顺序随机分为治疗组27例和对照组28例,治疗组采用封包削甲后外用奈替芬酮康唑乳膏联合每周照射1次CO_2点阵激光的方法,对照组采用封包削甲后仅外用奈替芬酮康唑乳膏的方法,对比2组12周时的治疗效果。结果治疗组27例,治愈26例,显效1例,有效率为100%。对照组28例,治愈17例,显效5例,好转5例,无效1例,有效率为78.57%。经统计学分析,2组疗效差异有统计学意义。治疗组病甲58个,治愈55个,显效3个,有效率100%。对照组病甲61个,治愈39个,显效11个,好转9个,无效2个,有效率81.97%。经统计学分析,2组疗效比较差异有统计学意义。结论封包削甲后外用奈替芬酮康唑乳膏联合每周照射1次CO_2点阵激光的方法治疗Ⅰ型甲真菌病临床效果显著。     

CO2点阵激光联合萘替芬酮康唑乳膏治疗甲真菌病疗效评价

目的：评价CO₂点阵激光联合萘替芬酮康唑乳膏外用治疗甲真菌病的临床疗效。方法：对2017年1月至2018年8月我科门诊甲真菌病患者患甲进行CO₂点阵激光照射（2周1次）,每日外涂萘替芬酮康唑乳膏治疗,共治疗16周。观察临床疗效、真菌学检查结果及不良反应发生情况。结果：共治疗35例患者,35个靶甲,其中指甲5个,趾甲30个;白色浅表型8个,远端侧位甲下型18个,近端甲下型9个。在第4次治疗后有效率为54.29%,真菌清除率为74.29%;疗程结束3个月后有效率为82.89%,真菌清除率为88.57%。结论：CO₂点阵激光联合萘替芬酮康唑乳膏治疗甲真菌病安全有效。     

超脉冲CO2激光联合布替萘芬软膏治疗甲真菌病的自身对照研究

目的：评价超脉冲CO2激光联合布替萘芬软膏治疗甲真菌病的疗效和安全性。方法：从同一甲真菌病患者中随机挑选一个或多个病甲分别作为治疗组和对照组,治疗组采用超脉冲CO2激光联合布替萘芬软膏外用治疗,激光每周治疗一次,4次后,每4周一次,布替萘芬软膏每日2次,指甲治疗12～16周,趾甲治疗20～24周。对照组仅外用布替萘芬软膏。结果：共治疗19例甲真菌病患者131个病甲,其中治疗组为66个病甲,对照组为65个病甲。治疗组有效率为51.52%高于对照组的18.46%,两者差异有显著性(P＜0.05);治疗组真菌镜检阴性率为66.67%高于对照组的26.15%,差异有显著性(P＜0.05)。结论：超脉冲CO2激光联合布替萘芬软膏治疗甲真菌病优于单用布替萘芬软膏。     

盐酸布替萘芬乳膏联合30%的冰醋酸治疗80例甲真菌病临床观察

目的观察盐酸布替萘芬乳膏治疗趾甲真菌病的疗效。方法治疗组30％冰醋酸联合盐酸布替萘芬乳膏外用病甲表面，2次／d；对照组30％冰醋酸联合复方苯甲酸软膏外用病甲表面，2次／d，两组共治疗3个疗程。并进行临床和真菌学评价。结果治疗组治愈率为73．68％，有效率为89.47％，真菌学清除率为78．94％；时照组治愈率为27．77％，有效率为61．11％，真菌清除率为66．66％。治疗组与对照组治愈率、总有效率比较差异均有显著性（P〈0．05），治疗组与对照组真菌清除率比较无统计学意义（P〉0．05）。结论盐酸布替萘芬乳膏联合30％的冰醋酸治疗趾甲真菌病临床治愈率高，经济实用。     

复方地肤子洗剂联合萘替芬酮康唑乳膏治疗足癣疗效观察1秦建平,徐杰,黄丽蓉,杨登科

目的 观察我院自制复方地肤子洗剂联合萘替芬酮康唑乳膏治疗足癣的临床疗效。方法 将2019年5月至2019年10月皮肤科门诊接诊确诊为足癣符合纳入标准的患者61例,随机分为2组,对照组单纯外用萘替芬酮康唑乳膏(必亮,重庆华邦制药有限公司),2次/d,每次适量;治疗组在对照组的基础上加用复方地肤子洗剂外泡足,每晚一次。结果 治疗组30例,总有效率90%;对照组31例,总有效率77.4%。结论 自制复方地肤子洗剂联合萘替芬酮康唑乳膏治疗足癣疗效优于单纯外用萘替芬酮康唑乳膏。     

萘替芬酮康唑乳膏治疗花斑癣的疗效观察

目的观察萘替芬酮康唑乳膏治疗花斑癣的疗效。方法将63例患者随机分为治疗组和对照组,治疗组外用萘替芬酮康唑乳膏,对照组外用硝酸咪康唑乳膏,根据疗效指数和真菌镜检结果判定疗效。结果治疗组治疗2周及4周时的疗效(2周时为65.63%和4周时为96.88%)和治疗2周时真菌清除率(治疗组78.13%,对照组51.61%)均明显高于对照组(2周时为38.71%和4周时为80.65%),差异均有统计学意义(P0.05)。结论萘替芬酮康唑乳膏治疗花斑癣安全而有效。     

窄谱中波紫外线联合萘替芬酮康唑乳膏治疗股癣49例

目的观察窄谱中波紫外线(NB-UVB)联合萘替芬酮康唑乳膏治疗股癣的临床疗效。方法将100患者随机分为两组,治疗组给予NB-UVB联合萘替芬酮康唑乳膏治疗,对照组单用萘替芬酮康唑乳膏,每周观测1次,治疗3周后判断疗效。结果两组真菌清除率各周比较均无统计学意义。治疗组有效率为91.8%,对照组有效率为85.1%,两组比较差异有统计学意义(P0.05)。两组均无明显不良反应。结论 NB-UVB联合萘替芬酮康唑乳膏治疗股癣疗效肯定,临床上值得应用。     

奈替芬酮康唑乳膏治疗马拉色茵毛囊炎123例疗效观察

目的 观察萘替芬酮康唑乳膏治疗马拉色茵毛囊炎的临床疗效和安全性.方法 将245例马拉色菌毛囊炎患者随机分为试验组和对照组:试验组采用萘替芬酮康唑乳膏外用,对照组采用酮康唑乳膏外用,均早晚各1次,疗程4周.结果 试验组和对照组的有效率分别是81.30％和47.54％(P＜0.01);试验组无不良反应出现.结论 萘替芬酮康唑乳膏治疗马拉色茵毛囊炎的疗效优于酮康唑乳膏,且安全可靠.     

奈替芬酮康唑乳膏治疗马拉色菌毛囊炎123例疗效观察

目的观察萘替芬酮康唑乳膏治疗马拉色菌毛囊炎的临床疗效和安全性。方法将245例马拉色菌毛囊炎患者随机分为试验组和对照组:试验组采用萘替芬酮康唑乳膏外用,对照组采用酮康唑乳膏外用,均早晚各1次,疗程4周。结果试验组和对照组的有效率分别是81.30%和47.54%(P<0.01);试验组无不良反应出现。结论萘替芬酮康唑乳膏治疗马拉色菌毛囊炎的疗效优于酮康唑乳膏,且安全可靠。     

萘替芬酮康唑乳膏与两种中药制剂合用治疗角化过度型足癣临床观察

目的观察萘替芬酮康唑乳膏分别联合中药复方香莲外洗液、抗真菌颗粒剂治疗角化过度型足癣的临床疗效。方法将120例角化过度型足癣患者随机分为A组40例(萘替芬酮康唑乳膏外用联合温水外洗)、B组40例(萘替芬酮康唑乳膏外用联合中药抗真菌颗粒剂口服)和C组40例(萘替芬酮康唑乳膏联合中药复方香莲外洗液外用),观察3组患者的临床疗效和真菌学疗效。结果停药后2周时,A,B和C三组的痊愈率分别是34.21%,57.89%和82.50%,有效率分别是68.42%,89.47%和97.50%,真菌清除率分别是89.47%,92.11%和100.00%。C组和B组的痊愈率、有效率均明显高于A组(P均<0.05);C组的痊愈率明显高于B组(P<0.05),有效率则略高于B组,但两者相比无明显差异(P>0.05)。C组的真菌清除率明显高于A组(P<0.05);C组与B组、B组与A组的真菌清除率比较均无明显差异(P均>0.05)。结论萘替芬酮康唑乳膏分别与中药复方香莲外洗液、抗真菌颗粒剂联合治疗角化过度型足癣均取得较好的疗效和安全性。     

Epidemiology and control and curable sexually transmitted diseases: opportunities and problems

BACKGROUND: Despite the availability of safe and effective treatment, infection with bacterial sexually transmitted diseases persists at a high prevalence in many populations. GOAL: To review the difficulties of parameter estimation when a cure is readily available and to explore the impact of different treatment and screening strategies that might maximize the benefits of using available treatments. STUDY DESIGN: A standard deterministic model for the spread of a bacterial sexually transmitted disease that causes symptomatic and asymptomatic infections, in which the population is stratified according to sex and sexual activity, is further stratified into two host groups to enable the modeling of different treatment and screening strategies. RESULTS: In the presence of a core group, if an infection has a high transmission probability, then screening for asymptomatic infections has a short-lived benefit. Repeated screening is slightly better if it is not restricted to a fraction of the at-risk population, but targeting of high-risk groups should be effective. Screening to treat asymptomatic infections in men could be beneficial if a substantial fraction of cases remain asymptomatic. CONCLUSIONS: After the initial gains achieved through treating symptomatic infections, further reductions in the prevalence of infections can be achieved by finding asymptomatic infections. However, these gains are difficult to achieve, especially in the case of gonorrhea. Because men are likely to have an asymptomatic chlamydial infection, screening of men for chlamydia should be worthwhile.     

Understanding and Evaluating Systematic Reviews and Meta-analyses

A systematic review is a summary of existing evidence that answers a specific clinical question, contains a thorough, unbiased search of the relevant literature, explicit criteria for assessing studies and structured presentation of the results. A systematic review that incorporates quantitative pooling of similar studies to produce an overall summary of treatment effects is a meta-analysis. A systematic review should have clear, focused clinical objectives containing four elements expressed through the acronym PICO (Patient, group of patients, or problem, an Intervention, a Comparison intervention and specific Outcomes). Explicit and thorough search of the literature is a pre-requisite of any good systematic review. Reviews should have pre-defined explicit criteria for what studies would be included and the analysis should include only those studies that fit the inclusion criteria. The quality (risk of bias) of the primary studies should be critically appraised. Particularly the role of publication and language bias should be acknowledged and addressed by the review, whenever possible. Structured reporting of the results with quantitative pooling of the data must be attempted, whenever appropriate. The review should include interpretation of the data, including implications for clinical practice and further research. Overall, the current quality of reporting of systematic reviews remains highly variable.