CAJ | 학술논문

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。
목적：탐토항양충병약물적치료효과。방법장84례양충병환자분위3조균치료7～10 d：다서배소치료조（D조，30례）급여다서배소치료，수차제량200 mg ，이후매12 h급여100 mg ，구복；8～18세적환자수차제량위4 mg/kg ，이후매12 h급여2 mg/kg ，구복；아기매소치료조（A조，28례）급여아기매소500 mg ，인동10mg·kg -1·d-1，정맥적주，매일1차；록매소치료조（C조，26례）급여록매소1.5～2g/d，인동30mg· kg -1· d-1，정맥적주，매일2차。관찰3조환자퇴열시간화비교림상증상체정소실시간、림상내약성급치유정황。결과3조퇴열시간비교차이무통계학의의（ P＞0．05），A조림상증상체정소실시간、치유솔명현우우D조화C조，차이균유통계학의의（균 P ＜0．05），D조화C조비교차이균무통계학의의（균 P ＞0．05）。A조미출현림상내약성，D조유8례（24％）출현림상내약성，C조유5례（28％）출현림상내약성（ P ＜0．05）。결론아기매소대양충병병원치료적림상효과명현우우다서배소화록매소，무림상내약병례출현。
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 statisti-cal 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 az-ithromycin have more advantages than those doxycycline and chloramphenicol for the fighting against Rickettsita orientalis .Meanwhile ,it doesn′t cause drug resistance.