本文選題：特比萘酚　切入點：氟康唑　出處：《青島大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的：特比萘酚為新型丙烯胺類抗真菌藥,抗菌譜較廣,其片劑、膏劑在皮膚科已得到廣泛應用,效果較好,在眼科的應用研究較少。而另一種抗真菌藥氟康唑,因眼內(nèi)滲透性好,半衰期較長,副作用少,在眼科治療真菌性角膜炎有廣泛的應用,對曲霉菌、念珠菌、青霉菌等療效較好,而對鐮刀菌屬的敏感性降低。據(jù)統(tǒng)計,真菌性角膜炎的發(fā)病率逐年升高,且致病菌種已發(fā)生改變,以鐮刀菌屬及曲霉菌屬為主,臨床用于治療真菌性角膜炎的藥物數(shù)量有限,且部分藥物價格昂貴,在廣大基層醫(yī)院并未得到普及。特比萘酚與氟康唑兩藥聯(lián)合有協(xié)同作用。研究兩藥聯(lián)用治療真菌性角膜炎的方法及療效,并進行統(tǒng)計學分析,為臨床應用提供參考 方法：1.臨床病例的采集：收集我院門診及住院真菌性角膜炎病人,根據(jù)病史及臨床表現(xiàn)對懷疑真菌性角膜眼的病人,進行刮片鏡檢及真菌培養(yǎng),明確診斷。2.病人的分組：根據(jù)兩組平衡及隨機的原則,把所選病人,依據(jù)所制定的輕、中、重的分類標準,使兩組病人的病變程度基本平衡。3.治療方案的選擇：將特比萘酚粉末配制成0.5%的特比萘酚眼藥水,頻繁點眼,同時應用氟康唑眼水(靜達),與前者交叉點眼。并靜點氟康唑,口服特比萘酚,同時全身及局部應用消炎、促修復類藥物。單用組未用特比荼酚眼藥水及口服藥,余用藥兩組相同。觀察療效,并記錄療程。4.數(shù)據(jù)處理：將觀察所得數(shù)據(jù)進行統(tǒng)計學分析,比較兩組用藥療效及療程上是否有統(tǒng)計學差異 結(jié)果：觀察期間共收集到真菌性角膜炎病人27人,均做了刮片鏡檢及細菌培養(yǎng),且至少有一項陽性,才能確診。此27例病人聯(lián)合組分得14例,輕、中、重病人數(shù)分別為8,5,1,單用組分得13例,輕、中、重病人數(shù)分別為8,4,1。聯(lián)合組治愈率71.43%,治愈周期平均為21.4天,單用組治愈率30.77%,治愈周期平均為23.1天。兩組比較進行統(tǒng)計學分析。 結(jié)論：特比萘酚聯(lián)合氟康唑治療真菌性角膜炎療效優(yōu)于單用氟康唑治療組,尤其是角膜炎屬于輕、中組的病人,聯(lián)合用藥治療效果明顯好于單用氟康唑治療組的病人。治愈病人的治療周期聯(lián)合用藥組較單用藥組略短。
[Abstract]:Objective: terbinaphthol is a new antifungal agent with broad antibacterial spectrum. Its tablets and plasters have been widely used in dermatology with good results and less research in ophthalmology, while fluconazole, another antifungal drug, has been widely used in dermatology. Because of its good permeability, long half-life and less side effects, it has been widely used in the treatment of fungal keratitis in ophthalmology, and has a better effect on Aspergillus, Candida and Penicillium, but its sensitivity to Fusarium is reduced. According to statistics, The incidence of fungal keratitis has increased year by year, and the pathogenic species have changed, mainly in Fusarium and Aspergillus. The number of drugs used in clinical treatment of fungal keratitis is limited, and some drugs are expensive. The combination of terbinaphthol and fluconazole has synergistic effect. To study the method and curative effect of the two drugs in the treatment of fungal keratitis, and to carry on the statistical analysis, to provide the reference for the clinical application. Methods: the collection of clinical cases: the patients with fungal keratitis were collected from outpatients and inpatients in our hospital. According to the history and clinical manifestations, the patients suspected of fungal keratoderma were examined by scrape microscopy and fungal culture. Categorization of patients: according to the principles of balance and randomness in two groups, the selected patients are classified according to the established criteria of light, medium and heavy, The degree of lesion in the two groups was basically balanced .3. the choice of treatment plan: terbinol powder was prepared into 0.5% terbinol eye drops, frequent eye drops, and fluconazole eye water (Jingda, intersecting point eye with the former), and intravenous fluconazole, Oral terbinol, systemic and local use of anti-inflammatory, pro-repair drugs. Single use of terbiol eye drops and oral medicine, the rest of the two groups were the same. And record the course of treatment .4. data processing: observe the data for statistical analysis, to compare the efficacy of the two groups and whether there is statistical difference in course of treatment. Results: a total of 27 patients with fungal keratitis were collected during the observation period, all of whom were examined by scraping and bacterial culture, and there was at least one positive test before the diagnosis could be confirmed. The combined group of 27 patients was divided into 14 cases, mild and moderate. The number of patients with severe diseases was 80.13 cases were divided into two groups: mild, moderate and severe. The cure rate of the combined group was 71.433.The average cure period was 21.4 days, the cure rate was 30.77 and the average cure period was 23.1 days in the single use group. Statistical analysis was carried out between the two groups. Conclusion: terbinol combined with fluconazole is more effective than fluconazole alone in the treatment of fungal keratitis, especially in patients with mild and moderate keratitis. The effect of combination therapy was better than that of fluconazole group, and the treatment cycle of cured patients was shorter than that of single drug group.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R772.21

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