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麻风病的联合化疗

Multidrug therapy in leprosy.

作者信息

Manglani P R, Arif M A

机构信息

Netherlands Leprosy Relief, India Branch, New Delhi 110016.

出版信息

J Indian Med Assoc. 2006 Dec;104(12):686-8.

Abstract

Leprosy is an ancient disease, which was treated by local application of chaulmoogra/hydnocarpus oil during prechemotherapeutic era. Since 1940, dapsone was the only chemotherapeutic agent used for treatment of leprosy for about three decades. Prolonged, interrupted and inadequate use of dapsone monotherapy, leads to development of dapsone-resistant cases. Usefulness of clofazimine was known in 1962. Introduction of rifampicin--a powerful bactericidal drug in 1970 has opened the avenues of multidrug therapy to treat leprosy. Multidrug therapy recommended by World Health Organisation came into practice after 1982. The regimen followed now is for duration of 6 months in paucibacillary and for the duration of 12 months in multibacillary cases. It is proven to be safe and effective. Multidrug therapy for leprosy cases is available in the form of blister calender packs and is available free of cost at all government health facilities. Although more new drugs such as ofloxacin, minocyclin, clarithromycin, etc, are known now but they are used as alternative drugs if a component of combination in multidrug therapy becomes contra-indicated. This article brings the details of various drugs used under multidrug therapy, their characteristics, side-effects, regimens and alternative drugs available for treating leprosy.

摘要

麻风病是一种古老的疾病,在化疗前时代,人们通过局部涂抹大风子油/副大风子油来治疗。自1940年以来,氨苯砜是约三十年间唯一用于治疗麻风病的化疗药物。长期、间断和不充分地使用氨苯砜单一疗法导致了耐氨苯砜病例的出现。1962年人们了解到氯法齐明的效用。1970年强力杀菌药物利福平的引入开启了麻风病多药联合治疗的大门。世界卫生组织推荐的多药联合疗法于1982年后开始实施。目前采用的治疗方案是,少菌型病例疗程为6个月,多菌型病例疗程为12个月。事实证明该疗法安全有效。麻风病病例的多药联合治疗以泡罩包装形式提供,在所有政府卫生机构均可免费获得。尽管现在已知更多新药,如氧氟沙星、米诺环素、克拉霉素等,但如果多药联合治疗中的某一成分出现禁忌,则将它们用作替代药物。本文详细介绍了多药联合治疗中使用的各种药物、它们的特性、副作用、治疗方案以及可用于治疗麻风病的替代药物。

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