目的 评价苄星青霉素联合一种皮肤物理抗菌膜(洁悠神长效喷雾敷料,以下简称洁悠神)治疗梅毒硬下疳的临床效果.方法 将130例I期梅毒硬下疳患者随机分成实验组和对照组,均采用中国疾病预防控制中心颁布的<性传播疾病临床诊疗指南>中推荐的I期梅毒苄星青霉素治疗方法,实验组在皮损处增加外用(喷洒)洁悠神.分别于治疗后的第7、11、15、20天随访2组患者皮损愈合时间及病情进展,并于第60天复查快速血浆反应素环状卡片试验(RPR).结果 近期随访时间内,实验组硬下疳皮疹愈合时间较对照组明显缩短.随访第7、11、15天,实验组的皮损愈合率分别为57.58%、80.30%、100.00%,对照组分别为37.50%、59.38%、89.06%,两两比较,差异均有统计学意义(均P<0.05);2个月后随访复查RPR结果及远期观察Ⅱ期梅毒疹的结果比较,2组间差异无统计学意义(P>0.05).结论 沽悠神外用辅助苄星青霉素治疗梅毒硬下疳,可缩短硬下疳的皮损愈合时间,降低梅毒螺旋体的传播.%Objective To evaluate clinical efficacy of benzylpenicillin combined with long-acting antimicrobial agent in treating hard chancre. Methods 130 cases of primary syphilis with hard chancre were randomly divided into two groups. Patients were all treated with benzylpenicillin as recommended for primary syphilis in Clinical Guideline of Diagnosis and Treatment of Sexually-Transmitted Diseases issued by Chinese Center for Disease Control and Prevention. In addition to the use of benzylpenicillin, topic long-acting antimicrobial agent was applied to the lesions in the experimental group. The healing time of the lesions and disease progression were observed at follow-ups on day 7,11, 15, and 20 of treatment, rapid-plasma-reagin test (RPR) was checked on day 60. Results Healing time of the hard chancre in the experimental group was obviously shorter than that of control group. The healing rate of hard chancre skin rash on day 7,11 and 15 was 57. 58％, 80. 30％ and 100. 00％ respectively in experimental group, and was 37. 50％, 59. 38 ％ and 89. 06 ％ respectively in control group, there was significant difference in two groups (all P＜0. 05); The results of RPR teat at 2-month follow-up and long-term observation on the secondary syphilis showed no significant difference(P＞0. 05). Conclusion Benzylpenicillin in combination with long-acting antimicrobial agent ean shorten healing time of lesions of hard chancre and reduce transmission of Treponema pallidum.
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