Munday P E, Thomas B J, Johnson A P, Altman D G, Robinson D T
Br J Vener Dis. 1981 Oct;57(5):327-33. doi: 10.1136/sti.57.5.327.
A double-blind placebo-controlled study of minocycline in 221 men with non-gonococcal urethritis (NGU) was undertaken. Techniques were used which enabled diagnoses of chlamydial and mycoplasmal infections to be made within 24 hours of a patient attending a clinic. All patients from whom Chlamydia trachomatis was isolated were treated with minocycline, while patients from whom Ureaplasma urealyticum or Mycoplasma hominis was isolated, or from whom no micro-organisms were isolated, were treated on a double-blind basis with either minocycline or placebo. Chlamydia were isolated from 77 (35%) patients and were eradicated by minocycline from 76 (99%). Ureaplasmas were isolated initially from 96 (43%) patients. Treatment with minocycline eradicated them from 43 of 52 (83%) patients, and they disappeared from six of 31 (19%) patients who were treated with placebo. After one week significantly more patients had responded clinically to minocycline than to placebo. The response to minocycline was not influenced by the microbiological status of the patients, which suggests that ureaplasmas are playing a similar role to chlamydia in the pathogenesis of the disease and that an antibiotic-sensitive micro-organism may be producing disease in the isolate-negative group. An immunological approach is required to resolve the problem of the persistent urethral inflammation which occurred despite eradication of the micro-organisms.
开展了一项针对221名非淋菌性尿道炎（NGU）男性患者的米诺环素双盲安慰剂对照研究。采用了一些技术，能够在患者就诊诊所的24小时内对衣原体和支原体感染进行诊断。所有分离出沙眼衣原体的患者均接受米诺环素治疗，而分离出解脲脲原体或人型支原体的患者，或未分离出微生物的患者，则在双盲基础上接受米诺环素或安慰剂治疗。77名（35%）患者分离出衣原体，其中76名（99%）患者的衣原体被米诺环素根除。最初从96名（43%）患者中分离出脲原体。米诺环素治疗使52名患者中的43名（83%）的脲原体被根除，31名接受安慰剂治疗的患者中有6名（19%）的脲原体消失。一周后，对米诺环素产生临床反应的患者明显多于对安慰剂产生反应的患者。对米诺环素的反应不受患者微生物学状态的影响，这表明脲原体在该疾病的发病机制中与衣原体发挥着相似的作用，并且在分离阴性组中可能是一种对抗生素敏感的微生物在引发疾病。需要采用免疫学方法来解决尽管微生物已被根除但仍持续存在的尿道炎症问题。
