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目的:观察两性霉素B联合利福平复方溶液治疗耳真菌病的临床疗效,进而探讨有效的治疗方法。方法:(1)运用棋盘式微量液基稀释法测定两性霉素B联合利福平对白色念珠菌标准菌株(编号ATCC90028)的体外最低抑菌浓度(MIC)值,在此基础上计算部分抑菌浓度指数(FIC);依据FIC值判断两药联用是否有协同作用;(2)经真菌培养及鉴定确定为耳真菌病的60例患者中,根据临床症状与体征轻重的得分标准,随机分为3组,分别用两性霉素B、两性霉素B联合利福平复方溶液和3%水杨酸酒精滴耳液外耳道局部治疗1周、2周后,观察3组愈显率;并随访1年。结果:(1)两药联用的FIC指数小于0.5;(2)3组愈显率比较,第1周:两性霉素B联合利福平复方溶液组愈显率最高,较其他2组有统计学意义(P<0.05),第2周:两性霉素B和利福平组与两性霉素B组愈显率相比无统计学意义(P>0.05),以上2组分别与3%水杨酸酒精滴耳液组愈显率相比有统计学意义(P<0.05)。随访一年,水杨酸酒精滴耳液组复发率比其他2组高,差异有统计学意义(P<0.05)。结论:(1)两性霉素B联合利福平对真菌有协同作用;(2)两性霉素B联合利福平复方溶液外用制剂是治疗耳真菌病较理想的外用药物,且具有便于取材、配制简单、使用方便、起效快等优点,值得向基层医院推广。
Objective: To observe the clinical efficacy of amphotericin B combined with rifampin compound solution in the treatment of ear fungal disease, and then to explore effective treatment. Methods: (1) The minimum inhibitory concentration (MIC) value of amphotericin B combined with rifampicin against Candida albicans standard strain (ATCC90028) was determined by checkerboard micro fluid-based dilution method. On the basis of this, (FIC); According to the FIC value to determine whether the two drugs synergistic effect; (2) identified by fungal culture and identification of ear fungal disease in 60 patients, according to clinical symptoms and signs of weight score criteria, randomized Divided into three groups, respectively, with amphotericin B, amphotericin B combination of rifampicin solution and 3% salicylic acid drops of ear ear treatment of local external ear for 1 week, 2 weeks after the observation of the three groups significantly; and Followed up for 1 year. Results: (1) The FIC index of the combination of the two drugs was less than 0.5; (2) The cure rates of the three groups were significantly different from that of the other two groups in the first week: the most obvious was the combination of amphotericin B and rifampicin (P <0.05). In the second week, there was no significant difference between the amphotericin B and rifampicin groups and the amphotericin B group (P> 0.05) Salicylic acid drops ear drops group was significantly better than the significant (P <0.05). Follow-up year, salicylic acid drops ear drops group recurrence rate was higher than the other two groups, the difference was statistically significant (P <0.05). Conclusion: (1) amphotericin B combined with rifampicin has a synergistic effect on fungi; (2) Amphotericin B combined with rifampin compound solution is an ideal topical drug for the treatment of ear fungal disease, and has the advantages of convenient material, Preparation of simple, easy to use, fast onset and other advantages, it is worth to promote the primary hospital.