不同疗程5%咪喹莫特乳膏预防尖锐湿疣的复发  

Preventing the recurrence of condyloma acuminatum with different treatment courses of imiquimod cream

作　　者：胡东艳[1] 陈蕾[1] 李明[1] 

机构地区：[1]复旦大学附属中山医院皮肤科,复旦大学上海医学院皮肤性病学系,上海200032

出　　处：《中华皮肤科杂志》2006年第5期257-259,共3页Chinese Journal of Dermatology

摘　　要：目的探讨应用不同疗程5％咪喹莫特乳膏预防尖锐湿疣复发的疗效和安全性。方法采用随机、对照的方法,将患者分成3组：A组单用CO_2激光治疗：B组用CO_2激光祛除疣体后外用5％咪喹莫特乳膏4周,每周3次；C组用CO_2激光祛除疣体后外用5％咪喹莫特乳膏8周,每周3次。所有患者均随访6个月。结果共有90例外生殖器及肛周尖锐湿疣患者完成临床研究,6个月后,3组的复发率分别为64．29％、50％及21．88％,3组复发率比较,差异有统计学意义(P=0．0033)。外用咪喹莫特乳膏8周组复发率低于前两组；外用4周组与8周组复发率比较,差异有统计学意义(P=0．0207)。激光治疗后外用5％咪喹莫特乳膏4周组与8周组出现的不良反应率分别为73．33％,84．38％。不良反应包括：红斑、瘙痒、疼痛、灼热、糜烂、溃疡,以及流感样症状,两组差异无统计学意义(P＞0．05)。结论激光治疗后外用5％咪喹莫特乳膏8周,皮损的复发率比外用4周明显下降。两组安全性无明显差异。Objective To evaluate the efficacy and safety of imiquimod 5% cream applied with different treatment courses for preventing the recurrence of condyloma acuminatum lesions. Methods A randomized, controlled clinical trial was conducted. Patients with condyloma acuminatum were divided into 3 groups （ Group A, B and C ）. Group A was treated with CO2 laser only. Group B was given topical imiquimod 5% cream three times a week over 4 weeks after laser treatment of visible warts. Group C was given topical imiquimod 5% cream three times a week over 8 weeks after laser treatment of visible warts. All patients were followed up for 6 months. Restdts A total of 90 patients with anogenital warts were enrolled in, and finished the study. The recurrence rates of the Group A, B, and C were 64.29%, 50%, 21.88%, respectively, in 6 months of follow-up. The recurrence rate was statistically lower in Group C than in Group A and B （ P = 0.0033 ）, and in Group C than in Group B （ P = 0.0457 ）. Adverse reactions occurred in 73.33% and 84.38% of patients in Group B and C, respectively, which included erythema, itching, pain, burning, erosion, ulceration and flu-like symptoms. There was no significant difference of the frequencies of adverse reactions between Group B and C （ P 〉 0.05 ）. Conclusion The recurrence rate of anogenital warts declines significantly in patients treated with imiquimod 5% cream for 8 weeks, but not in the 4 weeks group, after laser therapy. The frequencies of adverse reactions are not significantly different in both groups.

关 键 词：尖锐湿疣 复发 化学预防 咪喹莫特 

分 类 号：R752.53[医药卫生—皮肤病学与性病学] R512.62[医药卫生—临床医学]