点阵CO_2激光联合1%卢立康唑乳膏外用封包治疗甲真菌病疗效观察  

Efficacy and safety of superpulse-mode fractional carbon-dioxide laser combined with 1% luliconazole in the treatment of onychomycosis

作　　者：黄荷[1] 李锦[1] 刘娟[1] 张家安[1] 许阳[1] 吴迪[1] 骆丹[1] 周炳荣[1] 

机构地区：[1]南京医科大学第一附属医院皮肤科,南京210029

出　　处：《中国真菌学杂志》2016年第5期298-303,297,共7页Chinese Journal of Mycology

基　　金：中国中西医结合学会皮肤性病专业委员会卢立康唑临床研究专项基金

摘　　要：目的观察超脉冲点阵CO_2激光联合1%卢立康唑乳膏外用封包治疗甲真菌病的疗效及安全性。方法共募集甲真菌病患者60名,总计223个病甲。患者随机分为A、B两组。其中A组患者病甲予超脉冲点阵CO_2激光治疗,每两周1次,共6个月;B组患者病甲予每两周1次超脉冲点阵CO_2激光治疗,联合每日1%卢立康唑乳膏外用封包于病甲8h,共持续治疗6个月。在治疗结束后3个月进行临床及真菌学评价。结果 60例患者均完成治疗及随访,A组31例患者共计108个病甲,治疗结束后3个月临床有效率为50.9%,真菌清除率为38.9%;B组29例患者共计115个病甲,治疗结束后3个月临床有效率为69.6%,真菌学清除率为57.4%。B组临床有效率及真菌清除率均显著高于A组,差异有统计学意义(P<0.05)。治疗结束后3个月,A、B两组患者满意度评价分别为87.1%和93.1%。两组治疗中,除激光治疗时出现轻微可耐受疼痛外,均无其他不良反应出现。结论超脉冲点阵CO_2激光联合1%卢立康唑乳膏外用封包治疗甲真菌病是一种安全有效的方法,其疗效优于单纯点阵CO_2激光治疗。Objective To evaluate the efficacy and safety of superpulse-mode fractional carbon-dioxide（CO2）laser combined with1%luliconazole in the treatment of onychomycosis.Method A total of sixty patients with 223 onychomycotic nails were enrolled in this study and then randomly divided into two groups.The affected nails in group A were treated by superpulse-mode fractional carbon-dioxide（CO2）laser at 2-week intervals.The affected nails in group B were treated by superpulse-mode fractional carbon-dioxide（CO2）laser at 2-week intervals combined with daily topical application of 1%luliconazole cream under occlusion.The course of treatment is 6-month long for each group.Clinical efficacy and mycological clearance were evaluated at 3months after the completion of treatment.Results Sixty patients completed the treatment and follow-up.In group A,among the 31 patients with 108 affected nails,the clinical efficacy was about 50.9% whereas the mycological clearance rate was about 38.9%.In group B,among the 29 patients with 115 affected nails,the clinical efficacy was about 69.6%and mycological clearance rate was about 57.4%.There were significant differences in the clinical efficacy and mycological clearance rates between both groups（P〈0.05）.The comprehensive satisfactory rate was about 87.1%in group A while it was about 93.1%in group B.In addition to slight tolerable pain,there were no obvious side effects noticed in both groups.Conclusions Superpulse-mode fractional carbon-dioxide（CO2）laser combined with 1%luliconazole cream was a safe and effective method for the treatment of onychomycosis,and the clinical efficacy was much better than the laser treatment only.

关 键 词：甲真菌病 点阵激光 卢立康唑 外用治疗 

分 类 号：R756.4[医药卫生—皮肤病学与性病学]