CO2点阵激光联合萘替芬酮康唑乳膏治疗68例甲真菌病疗效观察(1)
[摘要]目的：探讨CO2点阵激光联合萘替芬酮康唑乳膏治疗甲真菌病的临床疗效。方法：选取笔者科室门诊具有甲真菌病典型临床表现且真菌镜检阳性的患者，随机分为激光组和对照组。激光组：对患甲进行激光治疗后，再外用萘替芬酮康唑乳膏治疗；对照组：对病甲进行锉甲处理后直接外用萘替芬酮康唑乳膏治疗。治疗前后均进行真菌学检查，并做临床疗效评分，比较两组的真菌学检查结果和临床评分差。结果：疗程结束4个月后观察疗效，激光组痊愈率70.58%，有效率85.29%，真菌清除率为55.88%；对照组痊愈率、有效率及真菌清除率分别为47.05%，61.76%，44.11%。两组治愈率、有效率比较，差异有统计学意义(P<0.05)，但激光组与对照组的真菌清除率比较，差异无统计学意义(P>0.05)。结论：治疗甲真菌病运用CO2点阵激光联合萘替芬酮康唑乳膏是目前一种安全、有效的治疗措施，特别是对老年人、儿童、有肝肾疾病等无法口服药物的特殊人群有重要的治疗意义。
[关键词]CO2点阵激光；萘替芬酮康唑乳膏；甲真菌病； 真菌清除率；SCIO分级
, http://www.100md.com
[中图分类号]R758.72 [文献标志码]A [文章编号]1008-6455(2018)11-0046-03
Abstract： Objective To explore the clinical efficacy of fractional CO2 laser combined with Naftifine Hydrochloride and Ketoconazole Cream for the treatment of onychomycosis. Methods Patients with typical clinical manifestations of onychomycosis and positive fungal microscopy were randomly divided into laser group and control group. Laser group： After laser treatment of the nail， the topical treatment with naftifine ketoconazole cream； control group： after treatment of the diseased armor，the topical treatment with naftifine ketoconazole cream. Mycological examinations were performed before and after treatment， and the clinical efficacy scores were scored. The mycological examination results and clinical scores of the two groups were compared. Results After 4 months of treatment， the curative effect was observed. The recovery rate of laser group was 70.58%， the effective rate was 85.29%， and the fungal clearance rate was 55.88%. The cure rate， effective rate and fungal clearance rate of the control group were 47.05%， 61.76%， 44.11% ， respectively. There were significant differences in the cure rate and effective rate between the two groups (P<0.05). However， there was no significant difference in the rate of fungal clearance between the laser group and the control group (P<0.05). Conclusion Fractional CO2 laser combined with Naftifine Hydrochloride and Ketoconazole Cream is currently a safe and effective therapeutic option for the treatment of onychomycosis， which is of important therapeutic significance for the special populations contraindicated for oral medications， including the elderly， children and patients with hepatic or renal diseases.
, 百拇医药
Key words： CO2 laser； Naftifine and ketoconazole Cream； onychomycosis； fungal clearance； SCIO classification
甲真菌病是由皮膚癣菌、酵母菌或霉菌引起的甲感染性疾病，是甲最常患的疾病，全球患病率2%～26.9%，其中仅由皮肤癣菌感染引起者称为甲癣[1]。指甲、趾甲均可发病，趾甲更容易被累及， 患者症状表现为甲板变色、增厚、表面变形、易碎、脱屑、缺损等，且具有传染性，常从单侧一两个甲板产生病变，若不采取及时治疗，可逐步累及邻甲与全甲[2]。甲真菌病在临床中，虽然无明显瘙痒及疼痛等症状，但是由于该病严重影响患者的美观，会对患者心理造成伤害，甚至影响日常生活及社会交往[3-4]。目前，有多项研究显示，CO2点阵激光在治疗甲真菌病方面疗效显著，不仅能促使病甲的局部组织产生气化、分解，一定程度上杀灭病菌，且能促进外用抗真菌药物透甲吸收，利于增强治疗效果[5]。2016年10月-2017年5月，笔者科室采用CO2点阵激光联合萘替芬酮康唑乳膏治疗甲真菌病，并与单纯外用萘替芬酮康唑乳膏治疗进行疗效比较，现将结果报道如下。, http://www.100md.com(景文文 梁永辉 周永安)
[关键词]CO2点阵激光；萘替芬酮康唑乳膏；甲真菌病； 真菌清除率；SCIO分级
, http://www.100md.com
[中图分类号]R758.72 [文献标志码]A [文章编号]1008-6455(2018)11-0046-03
Abstract： Objective To explore the clinical efficacy of fractional CO2 laser combined with Naftifine Hydrochloride and Ketoconazole Cream for the treatment of onychomycosis. Methods Patients with typical clinical manifestations of onychomycosis and positive fungal microscopy were randomly divided into laser group and control group. Laser group： After laser treatment of the nail， the topical treatment with naftifine ketoconazole cream； control group： after treatment of the diseased armor，the topical treatment with naftifine ketoconazole cream. Mycological examinations were performed before and after treatment， and the clinical efficacy scores were scored. The mycological examination results and clinical scores of the two groups were compared. Results After 4 months of treatment， the curative effect was observed. The recovery rate of laser group was 70.58%， the effective rate was 85.29%， and the fungal clearance rate was 55.88%. The cure rate， effective rate and fungal clearance rate of the control group were 47.05%， 61.76%， 44.11% ， respectively. There were significant differences in the cure rate and effective rate between the two groups (P<0.05). However， there was no significant difference in the rate of fungal clearance between the laser group and the control group (P<0.05). Conclusion Fractional CO2 laser combined with Naftifine Hydrochloride and Ketoconazole Cream is currently a safe and effective therapeutic option for the treatment of onychomycosis， which is of important therapeutic significance for the special populations contraindicated for oral medications， including the elderly， children and patients with hepatic or renal diseases.
, 百拇医药
Key words： CO2 laser； Naftifine and ketoconazole Cream； onychomycosis； fungal clearance； SCIO classification
甲真菌病是由皮膚癣菌、酵母菌或霉菌引起的甲感染性疾病，是甲最常患的疾病，全球患病率2%～26.9%，其中仅由皮肤癣菌感染引起者称为甲癣[1]。指甲、趾甲均可发病，趾甲更容易被累及， 患者症状表现为甲板变色、增厚、表面变形、易碎、脱屑、缺损等，且具有传染性，常从单侧一两个甲板产生病变，若不采取及时治疗，可逐步累及邻甲与全甲[2]。甲真菌病在临床中，虽然无明显瘙痒及疼痛等症状，但是由于该病严重影响患者的美观，会对患者心理造成伤害，甚至影响日常生活及社会交往[3-4]。目前，有多项研究显示，CO2点阵激光在治疗甲真菌病方面疗效显著，不仅能促使病甲的局部组织产生气化、分解，一定程度上杀灭病菌，且能促进外用抗真菌药物透甲吸收，利于增强治疗效果[5]。2016年10月-2017年5月，笔者科室采用CO2点阵激光联合萘替芬酮康唑乳膏治疗甲真菌病，并与单纯外用萘替芬酮康唑乳膏治疗进行疗效比较，现将结果报道如下。, http://www.100md.com(景文文 梁永辉 周永安)