加巴喷丁胶囊治疗疱疹后神经痛的多中心临床观察

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.     

新生隐球菌不同变种所致小鼠原发性皮肤感染的比较

目的：探讨新生隐球菌不同变种在原发性小鼠新生隐球菌皮肤感染中的作用。方法：按照我们建立的原发性皮肤隐球菌感染模型的方法，将新生隐球菌新生变种标准野生株B3501与格特变种标准株ATCC32609分别皮内接种于免疫抑制与非抑制的BALB／c小鼠，皮损真菌培养与组织病理检查确证感染。观察2种隐球菌感染的病程，比较皮损形成与消退的平均时间。结果：2种变种的新生隐球菌皮下接种于BALB／c小鼠后，可以在免疫抑制与非抑制的BALB／c小鼠皮肤上产生丘疹、结节、溃疡、传染性软疣样皮损，皮损可以自愈，真菌培养与病理确证为隐球菌感染。2种菌株只在免疫正常小鼠的皮损形成时间上存在差异。结论：新生变种与格特变种的新生隐球菌均可以造成BALB／c小鼠相似的皮肤感染。推测2种变种对原发性皮肤感染的致病力可能无差异，新生变种发病较多可能与其分布有关。     

两性霉素B脂质体治疗19例深部真菌病

我们于1999年3～12月使用美国Ben Venue Laboratories Inc生产的两性霉素B硫酸胶体物[商品名抑霉泰(Amphotec)]治疗深部真菌病,取得了满意的疗效,现报道如下.     

加巴喷丁胶囊治疗疱疹后神经痛的多中心临床观察

目的 观察加巴喷丁治疗疱疹后神经痛的临床疗效和安全性.方法 多中心、随机双盲、安慰剂对照、平行设计临床试验.疱疹后神经痛患者随机分为治疗组和对照组,两组患者分别口服加巴喷丁胶囊1800 mg/d或安慰剂胶囊,总共接受6周的药物治疗.于治疗前及治疗后第1、3、6周各随访1次,进行疗效和安全性评价.以视觉模拟评分法进行疱疹后神经痛的疼痛评分作为主要观察指标,以5点严重程度评分方法进行睡眠质量评分作为次要观察指标.结果 4个中心共人选141例疱疹后神经痛患者,125例完成试验,其中试验组66例,对照组59例.与用药前相比,用药后1周、3周和6周时,两组在疼痛严重程度、睡眠质量方面均有不同程度改善;试验组在用药后1周、3周改善更为明显.用药后第1周和第3周试验组的有效率分别为29.58%和57.75%,对照组分别为13.04%和40.58%,试验组高于对照组,两组比较,差异均有统计学意义(X2CMH分别为5.94,4.12,P＜0.05).加巴喷丁有较好的耐受性,不良反应主要表现为头晕、头昏、嗜睡和转氨酶升高等.结论 加巴喷丁胶囊治疗疱疹后神经痛,能改善患者疼痛严重程度和睡眠质量,不良反应发生率低.     

含马齿苋及牛油果树提取物护肤品对乏脂性湿疹临床效果观察

目的:评价含马齿苋及牛油果树提取物的护肤品(商品名:薇诺娜舒缓柔润保湿霜)辅助治疗乏脂性湿疹的疗效和安全性.方法:乏脂性湿疹患者躯体一侧外用薇诺娜舒缓柔润保湿霜2周,于第0、3、7、14天进行随访,并以使用前后及身体的另一侧作为对照.采用研究者总体评估(IGA)及患者自身评价观察皮损改善情况;评价内容包括皮肤干燥程度、角质层含水量及经皮水分丢失(TEWL)值来反映皮肤的干燥程度和屏障功能.结果:8个中心共入选200例患者,使用保湿霜后IGA评分、患者自评及皮肤干燥程度评分均较使用前和对照侧显著改善(P<0.01),且随着使用时间的延长效果更好.角质层含水量试验侧明显高于对照侧(P<0.05);靶皮损治疗后高于治疗前(P<0.01).治疗后靶皮损TEWL值明显降低(P<0.05).试验过程中不良反应发生率<10%.结论:含马齿苋及牛油果树提取物护肤品可辅助治疗乏脂性湿疹,其疗效、安全性均较高.     

加巴喷丁胶囊治疗疱疹后神经痛的多中心临床观察

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.     

细胞芯片检测新生隐球菌菌株丝氨酸蛋白酶的表达

目的:利用细胞芯片技术检测新生隐球菌菌株中丝氨酸蛋白酶的表达,初步探讨丝氨酸蛋白酶在新生隐球菌致病过程中的作用.方法:不同来源和血清型的新生隐球菌菌株36株,应用组织芯片构建仪制备菌株芯片,利用菌株细胞芯片和免疫组化技术对菌株中丝氨酸蛋白酶的表达情况进行检测.结果:丝氨酸蛋白酶在所有菌株细胞中强阳性表达率为67.0%(25/36),强阳性表达率在血清A型、血清B型、血清D/AD型分别为46.2%(6/13)、92.3%(12/13)、66.7%(4/6),在环境分离株、临床分离株及荚膜缺陷株中分别为55.6%(5/9)、82.6%(19/23)、25%(1/4).不同血清型及不同来源菌株中,以血清B型、临床分离株中的丝氨酸蛋白酶阳性表达率高(P<0.05).结论:菌株细胞芯片是检测致病性真菌样本成分的新技术;致病力强的新生隐球菌临床分离株中的丝氨酸蛋白酶表达最高,提示丝氨酸蛋白酶在临床菌株致病过程中起到主要作用.     

新型酮康唑喷膜的制备及其对湿疹和体癣豚鼠模型的疗效

目的:制备新型酮康唑缓释喷膜,观察其对湿疹和体癣豚鼠模型的疗效.方法:以壳聚糖盐酸盐为成膜辅料,研制新型酮康唑喷膜,采用HPLC法测定其含量.色谱条件:Waters Symttry C18色谱柱(250 mm×4.6 mm,5 μm);流动相为甲醇-磷酸二氢钾缓冲液(4∶1);流速为0.6 ml/min;检测波长为239 nm;柱温为(22±2)℃.建立新型酮康唑喷膜的质量控制标准.观察新型酮康唑喷膜对豚鼠湿疹和体癣模型的疗效,以喷膜基质作对照,并分别与地塞米松止痒霜和复方酮康唑霜的疗效相比较.结果:酮康唑和醋酸地塞米松的线性范围分别为0.2～2.0 mg/ml和0.02～0.20 mg/ml;回收率分别为98.41%和97.84%;两者日内RSD和日间RSD分别为1.17%和1.26%、1.57%和1.40%.皮肤刺激性实验表明其对豚鼠皮肤无刺激.新型酮康唑喷膜对湿疹和体癣模型疗效分别与地塞米松止痒霜和复方酮康唑霜相当.结论:新型酮康唑喷膜制备工艺简单,对湿疹和体癣模型疗效确切,具备复方制剂的优势.     

高脂蛋白血症Ⅲ型黄瘤病一例报告

1 临床资料患者,女性,59岁,因"掌部出现黄色扁平斑块1年余"于2004年12月7日就诊于我院门诊.患者1年前无明显诱因发现手掌沿纹理出现黄色的境界清楚的条状斑块,后逐渐增多,肘部伸侧亦发现黄色的略隆起的圆形结节.患者既往体健,无高血压、糖尿病病史;有高血脂病史2年.家族中无类似病史.体格检查:一般情况尚可,各系统未见明显异常.     

隐球菌性脑膜脑炎疗效判定的指标分析

目的:探讨各种临床指标在隐球菌性脑膜脑炎疗效判断和决定结束治疗过程中的意义.方法:回顾了我院收治的56例治疗有效的隐球菌性脑膜脑炎病例,对所出现的症状、体征及实验室检查指标在治疗过程中改善和消失的时间逐一分析.结果:在临床症状中,依发病率的高低排序,前三位的分别为头痛(100%)、脑膜刺激征(91%)和发热(75%),它们在两性霉素B(AmB)静脉治疗后的消失时间分别为7～33 d[平均(15.2±3.6) d]、11～28 d[平均(18±4.8)d]和5～11 d [平均(6.0±3.1) d];而菌体计数、乳胶凝集试验的滴度和脑脊液生化指标的改变与病情演变不尽一致;颅压增高可发生在治疗中;20例被测患者中有8例出现CD4 T淋巴细胞减少,且不随治疗的进行而增高.结论:在非艾滋病性隐球菌性脑膜脑炎患者中,头痛、脑膜刺激征和发热的减轻和消失是早期判定疗效的重要指标;在后期,菌体计数和乳胶凝集试验的滴度可以作为治疗转归的指标,但确定有意义的改变值仍有待研究,同时它也不能作为终止治疗的依据;不能根据颅压和脑脊液生化指标的改变来判定病情的演变.