張海龍+陳澤偉+邱燕+林平+江麗君

【摘要】 目的：觀察不同抗生素對(duì)早期梅毒的臨床療效觀察。方法：隨機(jī)選取于2014年5月-2015年

5月前來本科接受診治的Ⅰ、Ⅱ期梅毒患者76例。通過隨機(jī)數(shù)字法分為試驗(yàn)組（使用阿奇霉素治療）和對(duì)照組（使用芐星青霉素治療），每組各38例。觀察臨床皮疹消失時(shí)間；治療前，治療后3、6、9、12個(gè)月分別對(duì)患者進(jìn)行甲苯胺紅不加熱血清試驗(yàn)（TRUST），對(duì)比兩組患者不同時(shí)間點(diǎn)轉(zhuǎn)陰率的情況及臨床療效。結(jié)果：試驗(yàn)組梅毒Ⅰ期梅毒皮疹癥狀消失時(shí)間為6 d左右，Ⅱ期梅毒為7 d左右；對(duì)照組梅毒Ⅰ期梅毒皮疹癥狀消失時(shí)間為6 d左右，Ⅱ期梅毒為8 d左右，兩組臨床皮疹癥狀消失時(shí)間兩個(gè)時(shí)期比較，差異均無明顯統(tǒng)計(jì)學(xué)意義（P>0.05）。兩組患者治療后轉(zhuǎn)陰率隨著時(shí)間的增加不斷增加，試驗(yàn)組治療后12個(gè)月達(dá)89.47%，對(duì)照組達(dá)86.84%，兩組間轉(zhuǎn)陰率比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。試驗(yàn)組臨床治愈率為84.21%，對(duì)照組臨床治愈率為81.57%；試驗(yàn)組血清學(xué)治愈率為89.47%，對(duì)照組血清學(xué)治愈率為86.84%，兩組患者的治愈率比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：阿奇霉素和芐星青霉素對(duì)早期梅毒的臨床療效均有效，兩組間無療效差異。

【關(guān)鍵詞】 阿奇霉素； 芐星青霉素； 早期梅毒； 臨床療效

Clinical Observation of Different Antibiotics on Early Syphilis/ZHANG Hai-long，CHEN Ze-wei，QIU Yan，et al.//Medical Innovation of China，2017，14（10）：053-056

【Abstract】 Objective：To observe the clinical effect of different antibiotics on early syphilis.Method： 76 patients with stage Ⅰ and Ⅱ syphilis treated in our hospital from May 2014 to May 2015 were randomly selected，they were divided into experimental group（Azithromycin therapy） and control group（Benzylpenicillin therapy） according to random number table，38 cases in each group.The time of rash disappeared were observed.Before and after 3，6，9 and 12 months treatment，they were given plasma tolulizedred unheated serum test （TRUST）.The negative conversion rate of different time points and the clinical effect of two groups were compared.Result：In experimental group，the rash symptoms disappeared time in stage Ⅰ syphilis was about 6 d，in stage Ⅱ syphilis was about 7 d；in control group，the rash symptoms disappeared time in stage Ⅰ and Ⅱ syphilis was respectively 6 d and 8 d，there were no significant differences（P>0.05）.The negative conversion rate of two group increased with time，after 12 months of treatment，the negative conversion rate of experimental group was 89.47%，the control group was 86.84%，the difference was no statistically significant（P>0.05）.The clinical cure rate of experimental group was 84.21%，control group was 81.57%；the serological cure rate of experimental group was 89.47%，control group was 86.84%，the differences were no statistically significant（P>0.05）.Conclusion：The clinical effect of azithromycin and penicillin on early syphilis both are effective，there is no difference between the two groups.

【Key words】 Azithromycin； Benzylpenicillin； Early Syphilis； Clinical Efficacy

First-authors address：Dongkeng Hospital of Dongguan City，Dongguan 523450，China

doi：10.3969/j.issn.1674-4985.2017.10.015

梅毒是我國乃至全世界的主要性病傳播病毒種類之一[1]，其主要由梅毒螺旋體構(gòu)成，屬于慢性、癥狀體征復(fù)雜多樣化的系統(tǒng)性傳性疾病[2]。根據(jù)目前的臨床研究已證實(shí)性接觸及血液傳播是梅毒的主要散播途徑，近年來其發(fā)病率逐年升高，且呈現(xiàn)年輕化的態(tài)勢(shì)[3-4]。人類醫(yī)學(xué)史記載，青霉素用于抗梅毒已有近百年歷史[5-6]，但是由于青霉素的過敏反應(yīng)限制了該藥的運(yùn)用，因此選擇替代藥物成為近年來醫(yī)學(xué)工作者研究的熱點(diǎn)。隨著運(yùn)用的不斷推廣及科研的不斷深入，阿奇霉素因能適用于不愿進(jìn)行青霉素皮試的患者或者青霉素過敏患者而逐漸進(jìn)入醫(yī)學(xué)工作者的視線。本研究對(duì)76例早期梅毒患者分別使用不同抗生素進(jìn)行治療，并對(duì)臨床結(jié)果進(jìn)行統(tǒng)計(jì)分析總結(jié)，具體情況匯報(bào)如下。