青蒿琥酯-氨苯曲明与氯喹-乙胺嘧啶-磺胺多辛治疗巴斯塔尔(恰蒂斯加尔邦)部落人群无并发症恶性疟原虫疗效的比较研究。

Harminder Singh, N. Dulhani, B. N. Kumar, P. Tiwari
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引用次数: 2

摘要

目的:对比研究青蒿琥酯-甲苯三嗪与氯喹-乙胺磺胺多辛治疗巴斯塔尔(恰蒂斯加尔邦)部落人群无并发症恶性疟原虫的疗效。患者和方法:研究在Jagdalpur政府医学院医学系进行,91例患者在填写书面同意书后,填写了纳入标准。所有基线参数、随访进展及药物不良反应均记录在每位患者的个人病历中。结果采用配对t检验和卡方检验进行分析。结果:91例患者中,55例采用蒿甲醚-甲苯胺(AL)治疗,36例采用氯喹+乙胺嘧啶-磺胺多辛(CPS)联合治疗。我们注意到,与AL治疗组相比,CPS治疗组的发热清除时间和寄生虫清除时间更长(1.1天vs 1天,P = 0.03;1.7天对2.1天,P < 0.003),蒿甲醚+氨芳碱组的寄生虫清除时间有统计学意义。AL组和CPS组的治愈率分别为100%和90%。AL组和CPS组最常见的不良反应分别是腹痛(8.2%)和恶心/呕吐(14.7%)。所有受试者治疗前后血液学、生化等指标均正常。结论:AL和CPS联合治疗巴斯塔尔(恰蒂斯加尔邦)部落人群无并发症恶性疟疾耐受性良好。然而,AL的疗效明显高于CPS联合用药,这可能是由于对氯喹联合用药的耐药率较高,患者对AL治疗的依从性较好。
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A comparative study of Artesunate-Lumefantrine vs. Chloroquine-Pyrimethamine-Sulfadoxine efficacy for the treatment of uncomplicated Plasmodium falciparum in tribal population in Bastar (Chhattisgarh).
Objective: It was a comparative study to asses the efficacy of Artesunate-lumefantrine and Chloroquine-PyrimethamineSulfadoxine in the treatment of uncomplicated Plasmodium falciparum in tribal population in Bastar (Chhattisgarh). Patient and method: The study was carried out in Department of Medicine, Government Medical College, Jagdalpur. 91 patients who full filed the inclusion criteria were enrolled after taking written consent to participate in study. All the baseline parameters follow up progress and adverse drug reactions were recorded on the personal record of every individual patient. Results were analyzed with paired t test and chi square test. Results: Among the 91 patients, 55 were treated with Artemether-lumefantrine (AL) and 36 with Chloroquine+ Pyrimethamine-Sulfadoxine (CPS) combination. We noted that fever clearance time and parasite clearance time were longer in CPS treated group as compared to AL treated groups (1.1 days vs 1 day, P = 0.03; and 1.7 days vs. 2.1 days, P < 0.003, respectively) and the parasitaemia clearance time in Artemether +lumefantrine group was statistically very significant. Patient’s cured (%) were 100% and 90% in AL and CPS treated groups respectively. The most common adverse effects noted in AL and CPS treated groups were abdominal pain (8.2%) and nausea/vomiting (14.7%) respectively. Hematological, biochemical and other parameters remained normal before and after treatment in all subjects. Conclusion: Both Combinations, AL and CPS were well tolerated for the treatment of uncomplicated falciparum malaria in tribal population in Bastar (Chhattisgarh). However, AL showed significantly higher efficacy than CPS combination, this may be due to the high prevalence of resistance against Chloroquine combination and better patient compliance in AL treatment.
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