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聚维酮碘浸泡的明胶海绵与克霉唑单药局部应用治疗耳真菌病的疗效比较:一项随机对照临床试验

Efficacy of Pyodine Soaked Gelfoam vs Single Topical Application of Clotrimazole in Treatment of Otomycosis: A Randomized Controlled Clinical Trial.

作者信息

Shabbir Zuneera, Ashfaq Ahmed Hasan, Arshad Muhammad, Riaz Nida

机构信息

Department of ENT, Head & Neck Surgery, Benazir Bhutto Hospital Rawalpindi, Rawalpindi, Pakistan.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5091-5097. doi: 10.1007/s12070-024-05076-x. Epub 2024 Sep 17.

Abstract

To compare the efficacy of gel foam-soaked pyodine with a single topical application of clotrimazole ointment in the treatment of otomycosis. This randomized controlled trial included 90 patients who presented to ENT OPD with complaints of earache, watery ear discharge, pruritis, and ear blockage and were clinically diagnosed as a case of otomycosis via otoscopy. The external auditory canal of the patient was cleared of fungal debris via suction before treatment. In Group A, the ear canal was filled with 1% clotrimazole ointment by using an IV catheter and syringe and in Group B 10% pyodine-soaked gel foam was placed in the external auditory canal. The patients were followed up on post-treatment days 7 and 14. The results showed that out of 90 patients with otomycosis, the left ear was affected in 50(55.6%) patients and the right ear in 40(44.4%). 8(8.9%) of 90 patients had controlled preexisting diabetes mellitus. On the 7th post-treatment follow-up day, 17 (41.5%) patients in Group A and 28(66.7%) patients in Group B showed no fungal spores. Other symptom resolution was also comparable in both groups. At the 14th day follow-up 33(80.5%) patients in Group A and 38(92.7% patients in Group B showed no fungal hyphae on otoscopy. In terms of treatment response 19(46.34%) patients in Group A and 21(51.21%) patients in Group B showed good treatment response at the end of 2nd post-treatment week with a p-value of 0.798. yodine-soaked gel foam placement in the external auditory canal is a safe and effective method for the treatment of otomycosis with the efficiency of this method comparable to a single topical clotrimazole ointment application.

摘要

比较浸有聚维酮碘的凝胶泡沫与单次局部应用克霉唑软膏治疗耳霉菌病的疗效。这项随机对照试验纳入了90例因耳痛、耳流水、瘙痒和耳堵塞等症状前来耳鼻喉科门诊就诊且经耳镜检查临床诊断为耳霉菌病的患者。治疗前通过吸引清除患者外耳道的真菌碎屑。A组使用静脉导管和注射器向耳道内注入1%克霉唑软膏,B组将10%聚维酮碘浸泡的凝胶泡沫置于外耳道。在治疗后第7天和第14天对患者进行随访。结果显示,90例耳霉菌病患者中,左耳受累50例(55.6%),右耳受累40例(44.4%)。90例患者中有8例(8.9%)患有已得到控制的糖尿病。在治疗后第7天的随访中,A组17例(41.5%)患者和B组28例(66.7%)患者未发现真菌孢子。两组其他症状的缓解情况也相当。在第14天的随访中,A组33例(80.5%)患者和B组38例(92.7%)患者耳镜检查未发现真菌菌丝。在治疗反应方面,A组19例(46.34%)患者和B组21例(51.21%)患者在治疗后第二周结束时显示出良好的治疗反应,p值为0.798。将聚维酮碘浸泡的凝胶泡沫置于外耳道是一种安全有效的耳霉菌病治疗方法,该方法的疗效与单次局部应用克霉唑软膏相当。

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本文引用的文献

1
Single Topical Application of 1% Clotrimazole Cream in Otomycosis.1%克霉唑乳膏单次局部应用于外耳道真菌病
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):147-154. doi: 10.1007/s12070-022-03206-x. Epub 2022 Dec 8.
2
Review of Recurrent Otomycosis and Clotrimazole in Its Treatment.复发性耳真菌病及其治疗中克霉唑的综述
Cureus. 2022 Oct 9;14(10):e30098. doi: 10.7759/cureus.30098. eCollection 2022 Oct.
6
Topical azole treatments for otomycosis.局部唑类药物治疗真菌性外耳道炎。
Cochrane Database Syst Rev. 2021 May 25;5(5):CD009289. doi: 10.1002/14651858.CD009289.pub2.
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Outer Ear Infections in Iran: A Review.伊朗的外耳感染:综述
Open Access Maced J Med Sci. 2019 Apr 14;7(7):1233-1240. doi: 10.3889/oamjms.2019.176. eCollection 2019 Apr 15.

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