排水法观察慢性丝虫病下肢象皮肿的疗效

目的观察乙胺嗪、消肿乳糜清和自我照料3种方法对慢性丝虫病患者下肢象皮肿的疗效,探索有效控制发病的措施。方法选择浙江省桐乡市350名下肢象皮肿患者作为观察对象,按村随机分为4组:A组89例,每人口服乙胺嗪片剂100mg/d;B组91例,口服消肿乳糜清胶囊21粒/d(基质9g);C组86例,口服安慰剂胶囊6粒/d;D组84例,实施自我照料。各组均持续3个月。双盲法在治疗后3个月、1年随访患者,并测量患肢排水量,观察比较疗效。结果完成全程观察324人,感觉好转的171人(52.78%),无变化的153人(47.22%),经χ2检验,差异有统计学意义(χ2=63.67,P0.0001)。患肢排水容积均值差值经秩和检验、重复测量资料的方差分析,表明乙胺嗪、乳糜清组的近期疗效均优于安慰剂、照料组;远期:乙胺嗪和乳糜清组均优于安慰剂组、乙胺嗪组优于乳糜清组、照料组优于乳糜清组和安慰剂组,且乙胺嗪组与照料组之间的差别无统计学意义。结论乙胺嗪在治疗慢性丝虫性淋巴水肿、象皮肿患者中无论是近期或远期疗效均显著;乳糜清近期显效,远期则不明显;远期观察,照料也是一种有效的治疗手段。

Observation of curative effect on chronic filariasis patients with elephantiasis in lower limbs by drainage method

Objective To observe the curative effect of diethylcarbamazine,herbal medicine of xiaozhongrumiqing and self care on chronic filariasis patients with elephantiasis in lower limbs,and explore the effective measures to control the disease.Methods A total of 350 patients with elephantiasis in lower limbs selected from Tongxiang were randomly divided into 4 groups by villages.Group A （89 patients） were orally given diethylcarbamazine （100 mg/d）;Group B （91 patients） were orally given herbal medicine of xiaozhongrumiqing （21 capsules/d）;Group C （86 patients） were orally given placebo capsule （6 capsules/d）;Group D （84 patients） took self care.The treatment in all groups lasted for 3 months.The patients were followed up by double blind method at 3 months and 1 year after treatment and drainage volume of affected limbs were measured to observe the curative effect.Results Totally 324 patients completed the entire observation,of which 171 felt better （52.78%）,153 felt no improvement （47.22%）.By χ2 test,the difference was significant （χ2 = 63.67,P0.0001）.The rank sum test on difference of mean drainage volume of affected limbs and variance analysis of repeated measures indicated that the short-term effect of Group A and B were better than Group C and D,as for long-term effect,Group A and B were better than Group D,Group A were better than Group B,Group D were better than Group B and C.Moreover,The effect of Group A and D had no significant difference.ConclusionTreatment with diethylcarbamazine on chronic filariasis patients with lymphedema or elephantiasis had marked effects both in short term and in long-term.The short term effect of herbal medicine of xiaozhongrumiqing was marked,but the long term effect was not marked.By long term observation,self care was also an effective treatment method.