甲真菌病患者口服抗真菌药治疗的依从性和安全性研究  

Study on the compliance and safety of the oral antifungal agents for the treatment of onychomycosis

作　　者：胡燕[1] 杨莉佳[1] 魏聆[1] 戴迅毅[1] 华海康[1] 戚稼[1] 孙慧[1] 郑渊[1] 

机构地区：[1]南京医科大学附属无锡市第二人民医院皮肤科,214002

出　　处：《中华流行病学杂志》2005年第12期988-991,共4页Chinese Journal of Epidemiology

基　　金：南京医科大学科技发展基金(NY2002059)

摘　　要：目的 了解甲真菌病患者口服抗真菌药治疗的依从率、影响依从性的因素及服药的安全性。方法 根据甲真菌病临床评分指数(SCIO)，对330例甲真菌病患者的靶甲进行SCIO评分，按SCIO积分范围随机分成3组，分别给予伊曲康唑间歇冲击治疗(A组)、特比萘芬连续治疗(B组)和特比萘芬隔日间歇治疗(C组)。采用自编问卷对每例患者进行凋查。结果 平均服药依从率为55.15%。依从者治愈率达89.01%，不依从者仅为30.41%。服药不依从率为44.85%，其中29.73%的患者不依从是因为担心副作用，22.30%是认为已治愈而自行停止服药，15.54%是经济原因，12.16%是药物的不良反应。依从率和年龄、靶甲部位、SCIO积分及治疗方案显著性相关(P<0.05)，与性别、文化程度及病程无显著性关系(P>0.1)。A、B、C组不良事件的发生率分别为22.73%、21.43%、23.15%，差异无统计学意义(P>0.1)。不良事件大多发生于治疗的第一个月且多为轻度和可逆的。结论 甲真菌病患者口服抗真菌药治疗的依从性较低且其对疗效影响显著。年龄、靶甲部位、SCIO积分和治疗方案对依从性有影响。口服伊曲康唑和特比萘芬治疗甲真菌病均有良好的安全性和耐受性。Objective To explore the rate of compliance, influencing factors and the safety of patients with onychornycosis under treatment of oral antifungal agents. Methods According to the scoring clinical index of onychornycosis（SCIO）, 330 patients with onychornycosis, their target nail＇s integral of the SCIO were calculated and randomly divided into three groups under the baseline of the SCIO integral range. Patients were treated with intermittent pulse itraconazole （ A group）, continuous terbinafine （ B group） and intermittent terbinafine（C group） respectively. Self-adrninistered questionnaire was applied in the survey on every onychornycosis patient. Results The average rate of compliance was 55.15 %. The cure rate for those compliance with doctors＇ order was 89.01%, while it was only 30.41% for those noncompliant patients. The overall non-compliant rate was 44.85%. Among the noncompliant ones, 29.73 % were worried about the side effects of rnedicine,22.30 % thought that they had already been cured, 15.54 % was due to economic reasons and 12.16% could not bear the side effects of medicine. It was found that the compliant rates were significantly correlated to ageing,position of the target nails, the integral of the SCIO and the therapy scherne（P〈0.05）, while no significant correlations were seen between male and female, culture degree and course（ P 〉 0,1 ）. The frequency of adverse incident of A, B, C groups were 22.73 % , 21.43 % ,23.15 % respectively, but without statistical significance （ P 〉 0.1 ）. Majority of the adverse incidents happened during the first month of therapy but were mild and reversible. Conclusion Our results showecl that the oveall compliance was low which exerted a significant influence on the curative effect of onychomycosis patients. Factors as ageing, position of the target nail, integral of the SCIO and the therapy scheme had an influence on the compliant rate. When treating onychornycosis with oral itraconazole, the results seemed to be just as safe as

关 键 词：甲真菌病 口服抗真菌药 依从性 安全性 

分 类 号：R756[医药卫生—皮肤病学与性病学]