影响甲癣治疗效果的因素分析。

Y Zheng, Y Wu, H Chen, Z Zhu, L Liu, J Zeng
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摘要

为了提高甲癣的疗效,研究人员对影响疗效的因素进行了调查。对 545 例经临床和真菌学诊断的患者(其中男性 245 例,女性 300 例)采用内康唑间歇脉冲疗法进行治疗。通过定期观察和分析以下因素来判断疗效:年龄、指甲生长速度、伴随疾病、家族史、指甲外伤、病原体感染途径、损伤表现、病原体、疗程。结果显示,年轻患者的康复率更高(P < 0.01),康复速度更快(P < 0.001),复发率更低(P < 0.01),新生指甲生长速度更快的患者康复率也更高。此外,有 WSO 和 DLSO 表现的患者痊愈率较高。无论是否延长治疗时间,由红癣菌引起的甲癣患者的治愈率都更高(P < 0.01 至 0.001)。而患有糖尿病或多汗症的患者,以及有阳性家族史或患有外伤、副甲等基础甲病的患者,治愈率较低,疗效也不理想。结论是,虽然单个和部分 DLSO 表现的甲损伤可以通过内服和外用治疗,在拔除病甲的帮助下治愈,治疗时间也可以缩短。在下列情况下,应延长治疗时间,以提高疗效,减少复发:60 岁以上的老年患者;新生甲生长速度慢的患者;拇指和大脚趾损伤及嵌甲患者;糖尿病、多汗症或雷诺现象患者;治疗前或治疗期间有甲外伤的患者;有 PSO 或 TDO 表现的患者;由念珠菌或曲霉菌引起的甲癣患者;新生甲颜色异常、表面粗糙或厚度异常的患者。
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Analysis of the factors influencing the therapeutic effects of onychomycosis.

In order to improve the curative effect of onychomycosis, the factors influencing the therapeutic effects were investigated. 545 cases including 245 males and 300 females, who were diagnosed both clinically and mycologically, were treated by Intraconazole with intermittent pulse therapy. The therapeutic effects were judged by the following observations regularly and analyzed from the factors as follows: age; growing speed of nails; accompanied diseases; family history; trauma of nails; infection ways of the pathogens; manifestation of the injury; pathogens; duration of the treatment. The results showed that the recovery rate was higher in younger patients (P < 0.01) with a quicker recovery rate (P < 0.001), and a lower recurrent rate (P < 0.01), as well as in those with quicker growing speed of new-born nail. Also the patients with WSO and DLSO manifestation had a higher recovery rate. The patients with onychomycosis caused by T. rubrum had a higher recovery rate (P < 0.01 to 0.001) no matter whether to prolong the treatment duration. The patients with diabetes mellitus or hyperhidrosis, as well as with positive family history or basic nail diseases such as trauma and paronychia, had a lower recovery rate and the curative effects were not satisfactory. It was concluded that although the single and some DLSO-manifestation nail injury could be cured by internal and external treatments with the help of removing the sick nail and the duration of the treatment could be shortened. The treatment duration should be prolonged in order to increase the curative effects and decrease the recurrence under such conditions as following: old patients above 60 years; patients with low-growing-speed new-borne nails; patients with thumb and big toel injury and ingrowing nail; patients with diabetes mellitus, hyperhidrosis or Renauld's phenomenon; patients with nail trauma before or during the treatment; patients with PSO or TDO manifestation; patients with onychomycosis caused by Candida or Aspergillus; patients with abnormal new-borne nails of abnormal color, coarse surface or abnormal thickness.

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