فلوکونازول موضعی توام با تزریق موضعی گلوکانتیم در مقایسه با تزریق موضعی گلوکانتیم در درمان لیشمانیوز

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه قارچ و انگل شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: لیشمانیوزپوستی بیماری انگلی ایران و یک معضل بزرگ بهداشتی درمانی در سطح کشور است که جز 6 بیماری مهم عفونی و انگلی معرفی شده توسط سازمان بهداشت جهانی می باشد. هدف از این مطالعه مقایسه دو روش درمانی فلوکونازول و گلوکانتیم و گلوکانتیم به تنهایی در درمان لیشمانیوز است.روش‌ها: این مطالعه به صورت کار آزمایی بالینی تصادفی دو سویه کور می باشد. صد بیمار مبتلا به لیشمانیوز دراین مطالعه شرکت کردند که 50 بیمار تحت درمان موضعی با تزریق گلوکانتیم همراه با کرم فلوکونازول 1% و 50 بیمار تحت درمان موضعی با تزریق گلوکانتیم همراه با کرم دارونما قرار گرفتند. بیماران براساس تعریف در 3 گروه شامل (بهبود همه ضایعات)، بهبود نسبی (بیش از50% ضایعه یا هر گونه بزرگ شدن ضایعه یا بدتر شدن وضعیت کلینیکی ان طبقه بندی شدند. بیماران حداکثر تا پایان 12 هفته پیگیری شدند.یافته‌ها: میزان التیام پارازیتولوژیک بین دو گروه در پایان هفته 12 معنی دار بود (001/0 > P). میزان التیام بالینی بین دو گروه در پایان 6 هفته و 12 هفته هر دو معنی‌دار بود (001/0 > P در هر دو مورد). زمان لازم رسیدن به بهبودی بالینی نیز در دو گروه معنی‌دار بود (001/0 > P).نتیجه‌گیری: در کل آ نچه از این مطالعه بر می‌آید این است که قدرت اثر بخشی فلوکونازول تداوم با گلوکانتیم موضعی در افزایش میزان التیام بالینی، تسریع زمان لازم برای بهبودی نسبت به گلوکانتیم داخل ضایعه به تنهایی بهتر است. این مطلب از جهت کاهش عوارض جانبی ناشی از گلوکانتیم بدنبال کاهش دوز داروی گلوکانتیم مورد نیاز حایز اهمیت می باشد در این زمینه می توان این تئوری را مطرح کرد که احتمالاً گلوکانتیم روی بهبود زخم‌های سالک از طریق سینرژیسم و همکاری ناشی از فلوکونازول افزایش می یابد و این دارو می تواند با حداقل عوارض جانبی، در دسترس بودن به عنوان یک روش درمانی موضعی کمکی در درمان لیشمانیوز جلدی حاد مورد استفاده قرار گیردواژگان کلیدی: لیشمانیوز، گلوکانتیم، فلوکونازول

عنوان مقاله [English]

Topical Fluconazole Combined with Local Glucantime Injection Compared with Local Glucantime Injections in Treatment of Leishmaniasis

نویسندگان [English]

  • Seyed Hossein Hejazi 1
  • Reza Nabipour 2
1 Associate Professor, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Medical Student, Isfahan University of Medical Sciences, Isfahan, Iran.
چکیده [English]

Background: Leishmaniasis is one of the 6th important infectious diseases in the world that has been certificated as an endemic disease in Iran. The aim of this study was comparison of two methods of treatment included flouconazole with glucantime and glucantime alone in treatment of leishmaniosis.Methods: In this double blind prospective clinical trial, 100 patients with confirmed cutaneous leishmaniasis were enrolled and randomized in to two groups. Fifty patients (group A) treated with topical flouconazole twice daily along with intralesional of glucantime once weekly until complete healing of the ulcer of for maximum of 6 weeks and fifty patients (group B) were treated with topical placebo twice daily along with intralesional injection of glucantime once weekly until complete healing of the ulcer of for maximum of 6 weeks, The patients were followed for three months.Finding: In group A, 32 (64%) patients had complete cure whereas in the group B, 19 (38%) patients achieved complete cure with significantly difference (P < 0.001).Conclusion: The efficacy of foluconazole along with glucantime is more than placebo along glucontime in the treatment of cutaneous leshmaniasis. Also Fluconazale decrease the time of healing and the dose of glucantime that is needed for the treatment of cutaneous leshmaniasis.Future studies are warranted.Keywords: Leishmaniasis, Glucantime, Fluconazole

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مجله دانشکده پزشکی اصفهان
دوره 28، شماره 118 - شماره پیاپی 118
بهمن و اسفند 1389
صفحه 1281-1289

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  • تاریخ دریافت: 28 اسفند 1389
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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