Clinical Observation And Comparative Analysis In Treatment Of Sporotrichsis With Itraconazol And Terbinafine

Background: Sporotrichosis is caused by schenker spores thermosphacta and lurie the variant, caused by a chronic infection of the skin, subcutaneous tissue and adjacent lymph vessels and can cause fester, decay and leak. At present thedisease distribution is global, in our country the northeast area is one of the high-risk areas, in recent years, incidence of a disease is showing on the rise. The disease canaffect all ages of people,Laborer to see more. About the treatment of the disease, the current application Terbinafine,Itraconazole, potassium iodide has curative effect, but what kind of treatment more safe and effective,short course,the cheap price is concern of both doctors and patients. Athome and abroad has not been about itraconazole and Terbinafine, the clinical curative effect of treatment of sporotrichosis, security, and overall cost details comparative evaluation.Objective: To evaluate and compare clinical efficacy,Period of treatment,safetyand the overall priceand of ITC and TBF in treatment of sporotrichosis,so as to provide ascientif icbasis and reference for the effective treatment of sporotrichosis.Methods:A randomized controlled trial.200patients were diagnosised sporotrichosis in October2012to August2014at jilin university second hospital dermatology clinic by the clinical, pathological and/or mycology culture.Any age, gender, location, duration of1to30months.According to the method of random divided into Dingke group,Lanmeishu group,Itraconazole group.Dingke group: children: weight＜20kg,5mg/kg.d once-daily,weight≥20kg,125mg,once-daily;Adults:0.25g once-daily,or0.25g,twice-daily，both after meals.Lanmeishu group:children: weight＜20kg,5mg/kg.d once-daily,weight≥20kg,125mg,once-daily,or0.25g,twice-daily;Adults:0.25g once-daily，after meals;Itraconazole group: children give ITC6-10mg/kg,d;Adults give0.1g，twice-daily, to send served with meals or milk.In addition to the above threegroups dingke group,others are reduced to half of originaldosage, the oral dose to the clinical cure when In clinicalobservation is valid, the oral dose to clinical cure. Compare the curative effect of three groups, the treatment course, the cause of adverse reactions, and the total price. The results are statistically analyzed. Results:200cases of patients, into than Terbinafine group114cases,110cases of complete loss in4cases, which includedin the dingke group63cases,61cases of complete off3cases;Into the Lanmeishu group of51cases,complete the50cases, falloff in1case;Into Itraconazole group86cases,73casescomplete,fall off13cases.A total of200cases,fall off17cases, the successful completion of the183cases.(1)the general condition and clinical data：183patients, male69cases,female114cases,ratio1:1.65,women with highincidence.160cases with rural,23patients with city,100caseswith clear trauma history or exposure history,with corn strawas the fuel of life experiences, the course1to30months, onsettime: January-March61cases（33.33%）, April-June14cases(7.65%), July-September21cases（11.48%）, October-December87cases（47.54%）, the onset time of concentration: Octoberto the following year in March,80.53%(chart1). These183caseswere fixed and lymphatic vessels,did not include skinappearance and disseminated type:118cases including fixedtype（64.48%）, lymphatic type65cases（35.52%）. Lesion features:various skin types and skin lesions mainly for papules,pustules, nodules, erythema, granuloma. Locations:50cases ofupper limb, accounting for27.32%; Head face in128cases, accounting for69.95%;5cases of lower limb, accounting for2.73%;More than half of patients in3months.(2)the clinical curative effect and the overall cost roughly:ITC group73cases, treatment2-6months,2months to cure28cases, cure rate is38.36%, the highest cost is1887.86yuan,the lowest cost1306.98yuan.3months to cure50cases, curerate is68.49%, the highest cost2468.74yuan; The lowest costis1887.88yuan. Six months to cure61cases, cure rate is83.56%,the highest cost is4356.6yuan, the lowest cost3775.76yuan,one of the12patients taking the drug for2months, lesseffective, given to replace the TBF oral treatment; TBF group110cases, treatment2-6months,2months to heal20cases, curerate was18.18%,3months to cure73cases, cure rate is66.36%,six to cure106cases, cure rate is96.36%,4cases in2months,taking the medication effect is poor, to give replacement toITR oral treatment: the author adopted a LAN beauty group of50cases of cure, treatment2-6months,2months and16cases,cure rate was32%, the cost is1034.1yuan;3months to cure33cases, cure rate was66%, the cost is1489.8yuan;6monthsto cure48cases, cure rate is96%, the cost is2979.6yuan.Dingke group60cases, treatment of2-6months,2months thecure rate in4cases, cure rate is6.67%, the highest cost is 1196yuan, the lowest cost598yuan;3months the cure rate of40cases, cure rate is66.67%, the highest cost is1794yuan,the lowest cost897yuan, six months to cure58cases, cure rateis96.67%, the highest cost is3588yuan, the lowest1794yuan.1.128facial sporotrichosis cases,2months to cure48cases:ITC:28cases cured;Dingke:4cases;Lanmeishu:16cases.3months to cure101cases, ITC:40cases; Dingke:35cases;Lanmeishu26cases.Of sporotrichosis in other parts of the outside face:2monthsto cure0case,3months to cure a total of22cases, ITC:8cases in the forearm,2cases in hand;Dingke:4cases of forearmand1case in hand;Lanmeishu:5cases in upper limb,1casein back,1case of lower limbs.2. Fixed type of sporotrichosis, a total of118cases,47casescured2months; ITC:28cases cured, dingke:4cases werecured;Lanmeishu:the15cases.3months to cure104cases; ITC:40cases cured,dingke:37cases cured,Lanmeishu:27casescured.Lymphatic sporotrichosis altogether65cases,2months to healin1case, of lanmeishu group;3months to cure19cases;ITC:10cases were cured, dingke:3cases, lanmeishu:6cases.3. The time and period of treatment:The ITC group:28cases cured, to see a doctor in3months are22 cases;3months the cure rate of50cases, to see a doctor are35cases in3months;Dingke groups:4cases were cured,2months to see a doctor in3months are4cases;The cure rate of40cases3months, seea doctor for35cases in3months;Lanmeishu group:2months cured,16cases in3months for14cases;The cure rate for33cases3months, to see a doctor are28cases in3months.(3)Adverse reactions:9cases have adverse reactions in183cases, the incidence was4.92%, mainly for the digestive tractsymptoms;6cases with adverse reactions in the ITC treatment,1case of nausea, vomiting, stomach discomfort, other3caseswere characterized by nausea, upset stomach, adverse reactionrate was8.22%. TBF treatment of3cases of adverse reactions,main show is upset stomach, incidence was2.73%, the TBF adopted(Lanmeishu),2cases with adverse reactions in treatment ofupset stomach, respectively, the adverse reaction rate was4.0%,the TBF (dingke) in the treatment of adverse reaction,1casein respectively characterized by nausea, upset stomach,adverse reaction rate was1.67%, the incidence of itraconazoleadverse reactions among slightly higher than Terbinafine. Conclusion:(1)The ITC and TBF treatment of sporotrichosis is safe andeffective;(2) The average period of treatment facial sporotrichosis shortin other parts of the fixed sporotrichosis shorter thanlymphatic vessels.(3) The earlier to the patient,the short course.(4) Dingke group initial dose, quick effect,2months have highcure rate.（5）The ITC and TBF the clinical curative effect of treatmentof sporotrichosis and there was no significant differences inincidence of adverse reactions, the ITC adverse reaction wasslightly higher than that of TBF, but no statisticalsignificance.(6) In general, the TBF cost (average1818.72yuan) was slightlylower than the ITC cost (average2075.91yuan).