恙虫病临床抗病原的药物治疗研究  

The therapeutic effects of anticscrub typhus drugs

作　　者：彭琳[1] 张亮[2] 黄文权[1] 李松[1] 何日东[3] 陈彩兰[3] 马燕妮[3] 

机构地区：[1]广东省湛江中心人民医院药学部,524037 [2]中山大学孙逸仙纪念医院药学部 [3]广东省湛江中心人民医院感染疾病科,524037

出　　处：《山西医药杂志》2014年第14期1615-1617,共3页Shanxi Medical Journal

基　　金：广东省湛江市科技攻关计划项目(2010C3105010)

摘　　要：目的：探讨抗恙虫病药物的治疗效果。方法将84例恙虫病患者分为3组均治疗7～10 d：多西环素治疗组（D组，30例）给予多西环素治疗，首次剂量200 mg ，以后每12 h给予100 mg ，口服；8～18岁的患者首次剂量为4 mg/kg ，以后每12 h给予2 mg/kg ，口服；阿奇霉素治疗组（A组，28例）给予阿奇霉素500 mg ，儿童10mg·kg -1·d-1，静脉滴注，每日1次；氯霉素治疗组（C组，26例）给予氯霉素1.5～2g/d，儿童30mg·kg -1·d-1，静脉滴注，每日2次。观察3组患者退热时间和比较临床症状体征消失时间、临床耐药性及治愈情况。结果3组退热时间比较差异无统计学意义（ P＞0．05），A组临床症状体征消失时间、治愈率明显优于D组和C组，差异均有统计学意义（均 P ＜0．05），D组和C组比较差异均无统计学意义（均 P ＞0．05）。A组未出现临床耐药性，D组有8例（24％）出现临床耐药性，C组有5例（28％）出现临床耐药性（ P ＜0．05）。结论阿奇霉素对恙虫病病原治疗的临床效果明显优于多西环素和氯霉素，无临床耐药病例出现。Objective To determine and analyze the therapeutic effects of anti-scrub typhus drugs .Methods Eighty-four patients with scrub typhus were divided into 3 groups randomly .Each group was treated to relieve fever and the other symptoms .Supportive treatment was also implemented .In doxycycline group（D group ,n =30） ,doxycycline was used with the first dose 200 mg ,and 100 mg per 12 hour orally ;the patients between 8-18 years were given the first dose 4 mg/kg and then 2 mg/kg per 12 hour orally ;in azithromycin group （A group ,n=28） ,the patients took azithromycin 500 mg while children 10 mg · kg -1 ·d-1 ,intravenously one a day ;in chloramphenicol group （C group ,n=26） ,the patients were given chloramphenicol 1 .5-2 g/d ,while the dose for children was 30 mg · kg -1· d-1 ,intravenously twice a day .All groups were treated for 7-10 d .The time for fever relief ,the disappearance of the symptoms ,drug resistance and recovery were compared.Results The time for fe-ver relief had no statistical significance in all groups （ P〉0 .05） .In A group ,the time for the disappearance of the symptoms was shorter than that in the other two groups ,with higher recovery rate .The comparison had statistical significance（ P 〈0 .05） .The comparison between D group and C group had no statistical significance （ P 〉0.05） .In A group ,drug resistance was not discovered while 8 cases with drug resistance（24% ）were observed in D group and another 5 cases（28% ）in C group ,respectively （ P 〈0 .05） .Conclusion The therapeutic effects of azithromycin have more advantages than those doxycycline and chloramphenicol for the fighting against Rickettsita orientalis .Meanwhile ,it doesn′t cause drug resistance.

关 键 词：丛林斑疹伤寒 药物疗法 抗菌药 

分 类 号：R513.2[医药卫生—内科学]