Department of Pathology, Saidu Medical College, Swat, Pakistan.
Department of Microbiology, IBMS, Khyber Medical University, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2020 Oct-Dec;32(4):558-561.
Leishmaniasis is an endemic disease and a major public health problem throughout the world. Its geographic distribution has been extended over the past few years in Pakistan. The available treatment options of Leishmaniasis are limited and mostly parenteral, and hence a nontoxic oral alternative therapy is urgently needed to overcome the problem. The objective of this study was to evaluate the synergistic effect of Allopurinol as an adjunct therapy along with conventional intra-lesional sodium Stibogluconate in the treatment of cutaneous Leishmaniasis.
This single blinded randomized controlled trial was carried out at the tertiary care hospitals of district Peshawar, Pakistan. A total of one hundred and sixty-four (164) patients of age range from 19-56 years, consisting of both genders were included in this study. All subjects were randomly allocated to Group-1 and Group-2 where each group had 82 patients of comparable age and genders. Group-1 patients were given an intra-lesional injection of sodium Stibogluconate at a dose of 1-5 ml depending on the lesion size, where one ml injection contained 100 mg of the drug. Group-2 patients were given combination therapy of oral Allopurinol (20 mg/kg/day in divided doses) along with the same intra-lesional sodium Stibogluconate dose as group-1 until complete cure of the lesion.
Combination therapy of sodium Stibogluconate along with Allopurinol was found superior to sodium Stibogluconate alone in terms of duration of treatment. Group-1, patients who received only sodium Stibogluconate required prolonged treatment duration of 6-9 weeks depending upon the lesion size, while group-2 patients who received combination therapy of sodium Stibogluconate and Allopurinol responded more quickly and their lesions cured in 3-6 weeks depending upon the lesion size.
Oral Allopurinol has a synergistic effect when used with intra-lesional sodium Stibogluconate and effectively reduces the treatment duration required for complete cure of cutaneous Leishmaniasis. Treatment duration was reduced by 3 weeks in the present study when combination therapy was given to the patients of cutaneous Leishmaniasis.
利什曼病是一种地方性疾病，也是全世界的一个主要公共卫生问题。在过去的几年中，它的地理分布范围已经扩大。现有的利什曼病治疗方法有限，且大多为注射治疗，因此急需一种非毒性的口服替代疗法来克服这一问题。本研究的目的是评估别嘌呤醇作为辅助治疗与常规病灶内注射葡甲胺锑合用治疗皮肤利什曼病的协同作用。
这是一项在巴基斯坦白沙瓦地区三级医院进行的单盲随机对照试验。共纳入 164 名年龄在 19-56 岁之间的患者，包括男女。所有患者均被随机分配至第 1 组和第 2 组，每组 82 例患者，年龄和性别相似。第 1 组患者接受病灶内注射葡甲胺锑，剂量为 1-5ml，取决于病变大小，其中 1ml 注射剂含有 100mg 药物。第 2 组患者接受口服别嘌呤醇（20mg/kg/天，分剂量）联合病灶内注射相同剂量的葡甲胺锑治疗，直至病变完全治愈。
葡甲胺锑联合别嘌呤醇治疗在治疗持续时间方面优于单独使用葡甲胺锑。仅接受葡甲胺锑治疗的第 1 组患者的治疗持续时间较长，为 6-9 周，取决于病变大小，而接受葡甲胺锑联合别嘌呤醇治疗的第 2 组患者的治疗时间更短，病变在 3-6 周内治愈，取决于病变大小。
口服别嘌呤醇与病灶内葡甲胺锑联合使用具有协同作用，可有效缩短皮肤利什曼病完全治愈所需的治疗时间。在本研究中，当联合治疗皮肤利什曼病患者时，治疗时间缩短了 3 周。
