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目的观察青蒿琥酯(青)与阿奇霉素(阿)伍用治疗疟疾的疗效。方法将云南省中缅边境西部地区对镜检确诊的单一感染间日疟或恶性疟的患者,各分两组(A、B组和C、D组)。A组为青阿治疗间日疟组,B组为标准氯伯8d疗法治疗间日疟对照组,C组为青阿治疗恶性疟组,D组为标准双氢青蒿素哌喹疗法治疗恶性疟对照组,按《抗疟药使用原则和用药方案》用药,观察患者体温恢复正常时间、原虫转阴时间、临床治愈率及不良反应等。结果 A、B、C、D组分别观察52、38、23、22例,平均退热时间分别为(31.69±1.73)h、(32.4±2.02)h、(42.57±3.74)h和(37.09±4.67)h,平均原虫转阴时间分别为(30.31±1.71)h、(30.82±1.98)h、(41.13±3.63)h、(35.55±4.66)h。4组临床治愈率均为100%,其中A、B组(28±2)d根治率分别为78.3%和97.4%,(90±2)d根治率分别为68.4%和87.2%,差异有统计学意义(P<0.01);C、D组28d治愈率分别为65.0%和100.0%,差异有统计学意义(P<0.01)。结论青阿伍用治疗间日疟及恶性疟显效快,但对间日疟根治率不如氯伯喹,对恶性疟治愈率不及双氢青蒿素哌喹片。该治疗方案具有服用方便、疗程短,患者依从性好、不良反应率低而轻,安全性好等优点。
Objective To observe the efficacy of artesunate (az) and azithromycin in the treatment of malaria. Methods A total of two groups (groups A, B and C, D) were randomly divided into two groups: one infected with Plasmodium vivax and one with falciparum malaria, which were diagnosed by microscopy in the western region of China-Myanmar border in Yunnan Province. Group A was treated with Cholera malaria in group A, Group B was treated with standard Chlorine 8d in the control group, Plasmodium falciparum was treated in group C, Group D was treated with standard dihydroartemisinin and piperaquine in the treatment of malignant Malaria control group, according to the “Antimalarial drug use principles and medication programs” medication, observation of patients with normal body temperature recovery, protozoa negative time, clinical cure rate and adverse reactions. Results The average duration of fever in group A, B, C and D were 52, 38, 23 and 22, respectively, and the mean time to fever was (31.69 ± 1.73) h, (32.4 ± 2.02) h, (42.57 ± 3.74) h and 4.67) h, and the average time for protozoal metastasis was (30.31 ± 1.71) h, (30.82 ± 1.98) h, (41.13 ± 3.63) h and (35.55 ± 4.66) h, respectively. The cure rates of the four groups were all 100%. The cure rates of 28 ± 2 days in group A and group B were 78.3% and 97.4%, respectively. The cure rates of (90 ± 2) days were 68.4% and 87.2%, respectively (P <0.01). The cure rates of 28d in group C and D were 65.0% and 100.0%, respectively, with statistical significance (P <0.01). Conclusions Green Awu is effective in treating vivax malaria and falciparum malaria. However, the cure rate is not as good as that of chlorpromazine, and the cure rate of falciparum malaria is less than that of dihydroartemisinin and piperaquine. The treatment program has the advantages of convenient taking, short course of treatment, good patient compliance, low and light adverse reaction rate, good safety and the like.