长脉宽Nd:YAG 1064nm激光联合特比萘芬治疗甲母质受累的中重度甲真菌病疗效观察  

Long pulsed 1064nm Nd:YAG laser combined with terbinafine in the treatment of moderate to severe onychomycosis with parent nail matrix involvement

作　　者：王玲[1] 刘俊[1] 曹月清 景东云[1] 王学军[1] 占城[1] 马洁浩[1] 李明鑫[1] WANG Ling;LIU Jun;CAO Yue-qing(Department of Dermatology,Dermatology Hospital of Dalian,Dalian 116021,China)

机构地区：[1]大连市皮肤病医院皮肤科,116021

出　　处：《实用皮肤病学杂志》2021年第1期4-7,共4页Journal of Practical Dermatology

基　　金：大连市科技计划项目(2015E12SF136)。

摘　　要：目的观察长脉宽Nd:YAG 1064nm激光与短疗程口服特比萘芬联合治疗甲母质受累的中重度甲真菌病的临床疗效.方法临床入组甲母质受累的中重度甲真菌病靶甲,观察组接受12周长脉宽Nd:YAG 1064nm激光及4周口服特比萘芬联合治疗,对照组接受12周口服特比萘芬治疗.进行甲真菌病严重度指数(OSI)评估,比较两组治疗前、治疗结束和疗后12周的临床评分变化,评估临床有效率和真菌学清除率.结果观察组入组114个靶甲,对照组入组109个靶甲.治疗结束、疗后12周与治疗前相比,观察组OSI(t=7.481、12.141,P=0.000、0.000)、对照组OSI(t=11.406、22.797,P=0.000、0.000),差异均有统计学意义.疗后12周观察组与对照组真菌学清除率差异有统计学意义(χ^(2)=5.347,P=0.021).结论对于不能足疗程口服药物治疗的甲母质受累的中重度甲真菌病患者,长脉宽Nd:YAG 1064nm激光联合短疗程口服特比萘芬治疗是更好的选择.Objective To observe the clinical efficacy of long pulsed 1064nm Nd:YAG laser combined with short course oral terbinafine in the treatment of moderate to severe onychom ycosis with parent nail matrix involvement.Methods The patients with moderate to severe onychomycosis complicated with nail matrix involvement were randomly divided into 2 groups(observation group:30 patients with 114 target nails;control group:30 patients with 109 target nails).The patients in observation group were treated with long pulsed 1064nm Nd:YAG laser for 12 weeks and oral terbinafine for 4 weeks,while the patients in control group were only treated with oral terbinafine for 12 weeks.The onychomycosis severity index(OSI)was evaluated and compared between the two groups before,at the end,and 12 weeks after the treatment,and the clinical effective rate and mycological clearance rate were statistically analyzed.Results The difference of the value of OSI between before treatment,at the end of treatment and 12 weeks after treatment,was statistically significant in the both two groups(observation group:t=7.481,12.141,P=0.000,0.000;control group:t=11.406,22.797,P=0.000,0.000).Twelve weeks after treatment,the difference of mycological clearance rate between the two groups was statistically significant(x^(2)=5.347,P=0.021).Conclusion For the patients with moderate to severe onychomycosis complicated with nail matrix involvement who could not accept full course treatment of oral medicine,long pulse 1064nm Nd:YAG laser combined with short course of oral terbinafine may be a better choice.

关 键 词：甲真菌病 激光 长脉宽Nd:YAG1064nm 特比萘芬 联合治疗 

分 类 号：R756.4[医药卫生—皮肤病学与性病学] R454.2[医药卫生—临床医学]