中华皮肤科杂志

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不同疗程5%咪喹莫特乳膏预防尖锐湿疣的复发

胡东艳, 陈蕾, 李明   

  1. 复旦大学附属中山医院皮肤科, 复旦大学上海医学院皮肤性病学系 上海 2300032
  • 收稿日期:2005-07-25 出版日期:2006-04-15 发布日期:2006-04-15
  • 通讯作者: 李明,email:liming@zshospital.net E-mail:liming@zshospital.net

Preventing the recurrence of condyloma acuminatum with different treatment courses of imiquimod cream

HU Dong-yan, CHEN Lei, LI Ming   

  1. Department of Dermatovenereology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Received:2005-07-25 Online:2006-04-15 Published:2006-04-15

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摘要： 目的 探讨应用不同疗程5%咪喹莫特乳膏预防尖锐湿疣复发的疗效和安全性。方法 采用随机、对照的方法,将患者分成3组:A组单用CO2激光治疗:B组用CO2激光祛除疣体后外用5%咪喹莫特乳膏4周,每周3次;C组用CO2激光祛除疣体后外用5%咪喹莫特乳膏8周,每周3次。所有患者均随访6个月。结果 共有90例外生殖器及肛周尖锐湿疣患者完成临床研究,6个月后,3组的复发率分别为64.29%、50%及21.88%,3组复发率比较,差异有统计学意义(P=0.0033)。外用咪喹莫特乳膏8周组复发率低于前两组;外用4周组与8周组复发率比较,差异有统计学意义(P=0.0207)。激光治疗后外用5%咪喹莫特乳膏4周组与8周组出现的不良反应率分别为73.33%,84.38%。不良反应包括:红斑、瘙痒、疼痛、灼热、糜烂、溃疡,以及流感样症状,两组差异无统计学意义(P>0.05)。结论 激光治疗后外用5%咪喹莫特乳膏8周,皮损的复发率比外用4周明显下降。两组安全性无明显差异。

关键词: 尖锐湿疣, 复发, 化学预防, 咪喹莫特

Abstract: Objective To evaluate the efficacy and safety of imiquimod 5% cream applied with different treatment courses for preventing the recurrence of condyloma acuminatum lesions.Methods A randomized,controlled clinical trial was conducted.Patients with condyloma acuminatum were divided into 3 groups (Group A,B and C).Group A was treated with CO2 laser only.Group B was given topical imiquimod 5% cream three times a week over 4 weeks after laser treatment of visible warts.Group C was given topical imiquimod 5% cream three times a week over 8 weeks after laser treatment of visible warts.All patients were followed up for 6 months.Results A total of 90 patients with anogenital warts were enrolled in,and finished the study.The recurrence rates of the Group A,B,and C were 64.29%,50%,21.88%,respectively,in 6 months of follow-up.The recurrence rate was statistically lower in Group C than in Group A and B (P=0.0033),and in Group C than in Group B (P=0.0457).Adverse reactions occurred in 73.33% and 84.38% of patients in Group B and C,respectively,which included erythema,itching,pain, burning,erosion,ulceration and flu-like symptoms.There was no significant difference of the frequencies of adverse reactions between Group B and C (P>0.05).Conelusion The recurrence rate of anogenital warts declines significantly in patients treated with imiquimod 5% cream for 8 weeks,but not in the 4 weeks group,after laser therapy.The frequencies of adverse reactions are not significantly different in both groups.

Key words: Condylomata acuminata, Recurrence, Chemoprevention, Imiquimod