Sharma Nidhi, Sharma Sanjeev, Singhal Chetna
Senior Resident, Department of Dermatology, Government Medical College, Amritsar, Punjab. India.
Associate Professor, Department of Surgery, Government Medical College, Amritsar, Punjab. India.
J Clin Diagn Res. 2017 Mar;11(3):WC01-WC05. doi: 10.7860/JCDR/2017/23797.9339. Epub 2017 Mar 1.
Condyloma Acuminata (CA) is a common viral sexually transmitted disease. Although various treatment modalities are available for treating CA, but none of them can achieve 100% response rate. In a search for better response rate and less recurrence rate, the combination of cytotoxic agent Podophyllin with ablative liquid nitrogen cryotherapy was evaluated over cryotherapy alone.
To evaluate the synergistic effect of Podophyllin as a chemotherapeutic adjunct to an ablative therapy of liquid nitrogen cryotherapy versus liquid nitrogen cryotherapy alone in the treatment of CA.
Sixty patients with multiple CA were randomly assigned to two groups in the study. Thirty patients in group A received double freeze thaw cycle of 25 seconds of liquid nitrogen cryotherapy. Thirty patients in Group B were subjected to liquid nitrogen cryotherapy in a similar manner followed by application of not more than 0.5 ml of 25% Podophyllin solution. All patients were followed up at 1, 4, 8, 12 and 24 weeks after the treatment to monitor the response to therapy and evaluation for any recurrence. When the number of unresponsive lesions were more than 30% of original lesions at 4 weeks follow-up, then the whole procedure was repeated again.
The complete response rate and the recurrence rate in the Group B in our study were comparable to Group A as the difference was statistically insignificant. But the differentiating point was that the similar results were obtained in Group B with an average1.2 sessions per patient in comparison to an average of 1.67 sessions per patient in Group A.
Cryotherapy represents a simple, safe and effective regimen for the treatment of multiple CA which in combination with Podophyllin is even more effective as a single session procedure; thereby shortening the treatment regimen.
尖锐湿疣（CA）是一种常见的病毒性性传播疾病。尽管有多种治疗方式可用于治疗CA，但它们都无法达到100%的有效率。为了寻求更高的有效率和更低的复发率，对细胞毒性药物鬼臼树脂与液氮冷冻消融疗法联合使用的效果与单纯冷冻疗法进行了评估。
评估鬼臼树脂作为化疗辅助药物与液氮冷冻消融疗法联合使用，相较于单纯液氮冷冻消融疗法，在治疗CA时的协同效果。
本研究将60例患有多发性CA的患者随机分为两组。A组30例患者接受了25秒的液氮冷冻消融双冻融循环。B组30例患者以类似方式接受液氮冷冻消融治疗，随后涂抹不超过0.5毫升的25%鬼臼树脂溶液。所有患者在治疗后1、4、8、12和24周进行随访，以监测治疗反应并评估是否复发。在4周随访时，若无反应的病灶数量超过原始病灶的30%，则整个治疗过程需再次重复。
本研究中B组的完全缓解率和复发率与A组相当，差异无统计学意义。但不同之处在于，B组平均每位患者治疗1.2个疗程即可获得相似结果，而A组平均每位患者需要1.67个疗程。
冷冻疗法是治疗多发性CA的一种简单、安全且有效的治疗方案，与鬼臼树脂联合使用时，作为单次治疗程序更为有效，从而缩短了治疗疗程。
