Kochar D K, Aseri S, Sharma B V, Bumb R A, Mehta R D, Purohit S K
Departments of Medicine and. Skin & VD, S.P. Medical College. Veterinary Public Health Department, College of Veterinary and Animal Science, Bikaner, India.
QJM. 2000 Nov;93(11):733-7. doi: 10.1093/qjmed/93.11.733.
We assessed the efficacy of rifampicin in the treatment of cutaneous leishmaniasis (oriental sore) using a double-blind placebo-controlled study. We studied 46 patients with cutaneous leishmaniasis, of whom 23 received rifampicin (group A) and another 23 received placebo (group B) for a period of 4 weeks. Each patient was assessed clinically for size of lesion, type of lesion, duration of lesion, number of lesions, and distribution of lesions, initially, and at the end of 1 week, 2 weeks and 4 weeks. Biochemical tests including enzyme studies were done to detect any toxic effects of the drug. Group A patients received rifampicin 1200 mg/day in two divided doses and group B patients received two doses of an identical placebo capsule. Seventeen (73.9%) of the 23 patients receiving rifampicin had complete healing. Two (8.6%) had partial healing and four (17.3%) showed no response, whereas out of 23 patients receiving placebo one patient (4.3%) showed complete healing, eight (34.7%) patients showed partial healing and 14 (60. 98%) patients showed no healing or exacerbation of lesion. The difference was statistically significant in favour of response to rifampicin. This dose of rifampicin was well-tolerated and no side-effects were seen in any patient. In cases of cutaneous leishmaniasis where injectable treatment is not feasible or not acceptable, as in cases of multiple lesions, rifampicin is a better alternative oral treatment. It is simple to administer, cheap, more effective and less toxic than other available oral drugs, and well-tolerated by patients.
我们采用双盲安慰剂对照研究评估了利福平治疗皮肤利什曼病（东方疖）的疗效。我们研究了46例皮肤利什曼病患者，其中23例接受利福平治疗（A组），另外23例接受安慰剂治疗（B组），为期4周。对每位患者最初以及在第1周、第2周和第4周结束时进行临床评估，包括病变大小、病变类型、病变持续时间、病变数量和病变分布。进行了包括酶学研究在内的生化检查以检测药物的任何毒性作用。A组患者每天服用利福平1200mg，分两次服用，B组患者服用两剂相同的安慰剂胶囊。接受利福平治疗的23例患者中有17例（73.9%）完全愈合。2例（8.6%）部分愈合，4例（17.3%）无反应，而在接受安慰剂治疗的23例患者中，1例（4.3%）完全愈合，8例（34.7%）部分愈合，14例（60.98%）未愈合或病变加重。差异具有统计学意义，表明利福平治疗效果更佳。该剂量的利福平耐受性良好，所有患者均未出现副作用。在皮肤利什曼病患者中，如存在多个病变等情况，注射治疗不可行或不可接受时，利福平是一种更好的口服替代治疗药物。它给药简单、价格便宜、比其他现有口服药物更有效且毒性更小，患者耐受性良好。
