Waters M F, Rees R J, Pearson J M, Laing A B, Helmy H S, Gelber R H
Br Med J. 1978 Jan 21;1(6106):133-6. doi: 10.1136/bmj.1.6106.133.
Over 100 patients with lepromatous leprosy were treated with rifampicin in a series of pilot, uncontrolled, and controlled trials in 1968-77. The rapid bactericidal effect of rifampicin on Mycobacterium leprae was confirmed. Clinical improvement became apparent sometimes as early as 14 days after the start of treatment. Nevertheless, a few persisting viable M leprae were detected as long as five years after the start of treatment with rifampicin either by itself or in combination with the bacteriostatic drug thiambutosine. Treatment with rifampicin and dapsone for six months reduced the number of persisting leprosy bacteria more than treatment with dapsone alone. Although rifampicin proved more effective than dapsone, it is unlikely that used by itself if can significantly shorten the length of treatment in lepromatous leprosy. Therefore initial intensive combined treatment with two or more bactericidal drugs (including rifampicin) warrants further investigation in both untreated leprosy and lepromatous leprosy resistant to dapsone.
1968年至1977年期间，在一系列初步试验、非对照试验和对照试验中，对100多名瘤型麻风患者使用利福平进行了治疗。利福平对麻风分枝杆菌的快速杀菌作用得到了证实。临床改善有时早在开始治疗后的14天就很明显。然而，在用利福平单独治疗或与抑菌药物氨苯硫脲联合治疗开始后的长达五年时间里，仍检测到一些存活的麻风分枝杆菌。利福平和氨苯砜联合治疗六个月比单独使用氨苯砜治疗能减少持续存在的麻风杆菌数量。尽管利福平被证明比氨苯砜更有效，但仅使用利福平本身不太可能显著缩短瘤型麻风的治疗时间。因此，对于未经治疗的麻风患者和对氨苯砜耐药的瘤型麻风患者，使用两种或更多种杀菌药物（包括利福平）进行初始强化联合治疗值得进一步研究。
