目的 比较局部使用碘伏和克霉唑治疗耳真菌病的疗效。方法 选择2020-10至2021-12在武警北京总队医院就诊的146例单耳耳真菌病患者,随机分为两组,每组73例,分别使用碘伏(碘伏组)和克霉唑(克霉唑组)进行治疗。在首次给药后第7、14和21天评估治疗效果。治疗终结后第10、20天,对治疗有效者进行随访复查,评估复发情况。结果 首次治疗后第7、14、21天,碘伏组有效率分别为71.2%、87.7%和94.5%,克霉唑组有效率分别为78.1%、82.2%和90.4%,两组差异无统计学意义。治疗终结后第10、20天,碘伏组的复发率(5.8%、5.8% )均低于克霉唑组(10.6% 、13.6%),但差异无统计学意义。碘伏组患者不良反应发生率(8.2%)明显低于克霉唑组(32.9%),差异具有统计学意义(χ2=13.593,P<0.05)。结论 碘伏和克霉唑局部治疗耳真菌病的疗效和复发率类似,但碘伏治疗患者耐受性好。
Abstract
Objective To compare the therapy of otomycosis treatment with two topical therapeutic agents: iodophor solution and clotrimazole cream.Methods A total of 146 patients with monoaural ear fungal disease who were treated in Beijing Municipul Corps Hospital of Chinese People's Armed Police Force from October 2020 to December 2021 were randomly divided into iodophor group (n=73) treated with iodophor solution and clotrimazole group (n=73) treated with clotrimazole cream. Treatment effect was assessed on the 7 th,14 th and 21st days after treatment. On the 10th and 20th day after the end of treatment, follow-up review of those who were effective in treatment was carried out to assess recurrence.Results On the 7 th,14 th and 21st days after treatment, the effective rates of the iodophor group were 71.2%, 87.7% and 94.5%, respectively, the efficiency of the clotrimazole group was 78.1%, 82.2% and 90.4%, respectively, and there was no statistical significance between the two groups. On the 10th and 20th days after treatment, the recurrence rates in the iodophor group (5.8%, 5.8%) were lower than those in the clotrimazole group (10.6%, 13.6%), but the difference was not statistically significant. The incidence of adverse reactions in the iodophor group (8.2%) was significantly lower than that in the clotrimazole group (32.9%), and the difference was statistically significant (χ2=13.593, P<0.05).Conclusion The efficacy and recurrence rate of iodophor and clotrimazole in the local treatment of otomycosis were similar, but the patients treated with iodophor are well tolerated.
关键词
耳真菌病 /
抗真菌剂 /
碘伏 /
克霉唑
Key words
otomycosis /
antifungal agents /
iodophor /
clotrimazole
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Dundar R,Iynen I. Single dose topical application of clotrimazole for the treatment of otomycosis: is this enough? [J]. J Audiol Otol,2019, 23(1): 15-19.
[2] Mofatteh M R, Yazdi Z N, Yousefi M, et al. Comparison of the recovery rate of otomycosis using betadine and clotrimazole topical treatment[J]. Braz J Otorhinolaryngol,2018, 84(4):404-409.
[3] Chen Qingguo,Chu Hanqi,Tao Yanling,et al. A comparison of triamcinolone acetonide econazole cream and nystatin suspension in treatment of otomycosis [J]. Laryngoscope,2021, 131(5): E1640-E1646.
[4] Mao Y C, Tsai W J, Wu M L, et al. Acute hemolysis following iodine tincture ingestion[J]. Hum Exp Toxicol,2011, 30(10):1716-1719.
[5] 黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉科头颈外科学[M]. 2版. 北京:人民卫生出版社,2014:1170.
[6] 周梓昭. 60例门诊外耳道炎分泌物真菌培养结果和治疗效果分析[J]. 临床耳鼻咽喉头颈外科杂志,2015,29(10):899-902.
[7] Filiz G,Mehmet A A,Emine D.Efficacy of topical isoconazole nitrate in the treatment of otomycosis [J]. Am J Otolaryngol, 2021, 42(4):102961.
[8] Ali K, Hamed M A, Hassan H, et al. Identification of fungal pathogens in otomycosis and their drug sensitivity: our experience[J]. Int Arch Otorhinolaryngol, 2018, 22(4): 400-403.
[9] Mahdavi Omran S, Yousefzade Z, Khafri S, et al. Effect of combination therapy with ceftizoxime and clotrimazole in the treatment of otomycosis[J]. Curr Med Mycol, 2018,4(1):18-23.
[10] Li Yongqi, He Lifeng. Diagnosis and treatment of otomycosis in southern China[J]. Mycoses, 2019, 62(11): 1064-1068.
[11] Munguia R, Daniel S J. Ototopical antifungals and otomycosis: a review[J]. Int J Pediatr Otorhinolaryngol, 2008, 72: 453-459.
[12] Jimenez-Garcia L, Celis-Aguilar E, Díaz-Pavón G, et al. Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomy-cosis. A randomized controlled clinical trial [J]. Braz J Otorhinolaryngol, 2020,86(3):300-307.
[13] Tom L W. Ototoxicity of common topical antimycotic preparations[J]. Laryngoscope, 2000,110: 509-516.
[14] Şahiner A, Halat E, Yapar E A. Comparison of bactericidal and fungicidal efficacy of antiseptic formulations according to EN 13727 and EN 13624 standards [J]. Turk J Med Sci, 2019, 49(5):1564-1567.
[15] Swain S K, Behera I C, Sahu M C, et al. Povidone iodine soaked gelfoam for the treatment of recalcitrant otomycosis-Our experiences at a tertiary care teaching hospital of eastern India[J]. J Mycol Med, 2018, 28(1):122-127.
[16] Romsaithong S,Tomanakan K,Tangsawad W,et al. Effectiveness of 3 per cent boric acid in 70 per cent alcohol versus 1 per cent clotrimazole solution in otomycosis patients: a randomised, controlled trial[J]. J Laryngol Otol, 2016, 130(9): 811-815.
PDF(944 KB)
