四种常用驱梅药物治疗早期梅毒的对比分析  

Comparative Analysis of Benzylpenicillin, Ceftriaxone, Doxycycline and Azithromycin in the Treatment of Early Syphilis

作　　者：陆星显[1] 李锁[1] 常红芹[1] 王葆青[1] 郭盛华[1] 

机构地区：[1]江苏省常州市第二人民医院皮肤性病科,江苏常州213003

出　　处：《中国皮肤性病学杂志》2013年第7期692-693,695,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的研究苄星青霉素、头孢曲松钠、多西环素和阿奇霉素四种药物治疗早期梅毒的疗效,为临床提供可选择的治疗方案。方法 662例早期梅毒患者随机分为四组:苄星青霉素组(A组)308例,予苄星青霉素240万U,每周肌注1次,连续3周;头孢曲松钠组(B组)182例,予头孢曲松钠1g肌注,1次/d,共10d;多西环素组(C组)90例,予多西环素0.1g2次/d口服,共14d;阿奇霉素组(D组)82例,予阿奇霉素第1天1g一次口服,第2天开始0.5g,1次/d口服,共14d,并进行两年的随访,复查RPR。结果苄星青霉素、头孢曲松钠、多西环素和阿奇霉素治愈率分别为94.48%,97.25%,81.11%和67.07%。苄星青霉素和头孢曲松钠疗效优于多西环素和阿奇霉素,差异有统计学意义(P<0.05)。结论苄星青霉素作为治疗梅毒的首选药物仍然值得信赖;头孢曲松钠具有同样高效、安全的优点也可广泛使用;多西环素和阿奇霉素疗效相对较低,仅作为替代方案。Objective To evaluate the efficacy of the four commonly used antibiotics （benzylpenicillin, ceftriaxone, doxycycline, azithromycin） in treating early syphilis（phase I , phase II ）. Methods Six hundred and sixty-two cases of early syphilis were divided into 4 groups： group A（308 cases） using benzylpenicillin, group B（ 182 cases） using ceftriaxone, group C（90 cases） using doxycycline, group D（82 cases） using azithromycin. After therapy, a two-year follow-up with RPR test were taken. Results The curative rate of group A, group B, group C, group D were 94.48%, 97.25 %, 81.11% and 67.07%, respectively. Conclusion The standard benzylpenicilin therapy is still valid. With a higher curative rate and minimal side effects, tetracycline is recommened for the treatment of early syphilis. Compared with benzylpenicilin and ceftriaxone, the curative rate of doxycycline, azithromycin are less lower, which can be used as replacement treatment for early syphilis.

关 键 词：梅毒 治疗 对比 苄星青霉素 头孢曲松钠 多西环素 阿奇霉素 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]