三苯双脒、青蒿琥酯和吡喹酮单药或联合用药治疗华支睾吸虫病的疗效观察  

Effectiveness observation of treating the patients infected with Clonorchis Sienensis by oral administration of single tribendimidine ,artesunate and praziquantel or combined drug

作　　者：蒋智华[1] 张鸿满[1] 黎学铭[1] 江河[1] 谭裕光[1] 阮廷清[1] 黄福明[1] 张陆娟[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁530028

出　　处：《应用预防医学》2012年第5期264-268,共5页Applied Preventive Medicine

摘　　要：目的明确三苯双脒、青蒿琥酯和吡喹酮在治疗华支睾吸虫病人的效果和副作用。方法在华支睾吸虫病流行区,经改良加藤涂片法粪检和体检,选择合适的病例随机分配于青蒿琥酯组、三苯双脒双倍剂量组、三苯双脒单倍剂量组、吡喹酮组、青蒿琥酯-三苯双脒组和青蒿琥酯-吡喹酮组6个药物组进行疗效观察。结果选择128人为治疗观察对象,各组分别为18、18、21、29、22和20人,最终失访16人。各治疗组的虫卵转阴率分别为0.00%、75.00%、68.42%、57.69%、75.00%和78.95%,其中青蒿琥酯组与各组的疗效均有统计学差异,其余各组间疗效的差异无统计学意义。各组虫卵减少率分别为0.45%、99.20%、99.68%、93.19%、95.73%和69.46%。药物副反应较轻微,主要包括头晕、头痛、呕吐等,各组发生率分别为11.11%、11.11%、0.00%、6.90%、4.55%和15.00%,各组差异无统计学意义。结论三苯双脒对华支睾吸虫病人的治疗效果与吡喹酮相当,且副作用较小;但青蒿琥酯则几乎无效。三苯双脒有希望用于华支睾吸虫病的临床治疗。Objective To assess the efficacy and safety of tribendimidine and artesunate compared with that of praziquantel in treating the patients with Clonorchis sinensis（C.sinensis） infection. Methods In the endemic area of C.sinensis, lhe cases were screened by Kato-Katz technique and physical examination and randomly assigned into 6 groups which were treated with artesunate, tribendimidine （doubling dose）, tribendimidine （single dose）, praziquantel, artesunate- tribendimidine and artesunate- praziquantel and clinical observation was done.. Results 128 patients were randomly assigned： 18 received artesunate, 18 tribendimidine （doubling dose）, 21 tribendimidine （single dose） ,29 praziquantel, 22 artesunate- tribendimidine and 20 artesunate- praziquantel. At last ,19 patients were lost to follow-up. The cured ratios of the treatment groups were 0.00%,75.00%,68.42%,57.69%,75.00% and 78.95%,respectively.Of the total, the difference of cured ratio was statistical significance between a^esunate and other groups, but for other groups ,the difference of cured ratio lacked statistical significance. The egg reduction ratio of the treatment groups was 0.45%, 99.20% ,99.68%,93.19% ,95.73% and 69.46%, respectively. But the difference of cured ratio lacked statistical significance each other. Most adverse events, including dizziness, headache, vomiting and so on were mild.The incidence of the treatment groups were 11.11%,11.11%,0.00%,6.90%, 4.55% and 15.00% respectively. But the difference of their incidence lacked statistical significance. Conclusion Tribendimidine seems to be at least as efficacious As the drug of choice, praziquantel, for the treatment of C.sinensis infections; both drugs were well tolerated. Artesunate did not show an effect. Tribendimidine may be used in the therapy of clonorchiasis in future.

关 键 词：三苯双脒 青蒿琥酯 吡喹酮 华支睾吸虫 临床观察 

分 类 号：R532.235[医药卫生—内科学]