Hofmann H, Bräutigam M, Weidinger G, Zaun H
Department of Dermatology, Technical University Mũnchen, Germany.
Arch Dermatol. 1995 Aug;131(8):919-22. doi: 10.1001/archderm.131.8.919.
The fungicidal mode of action of terbinafine should make it feasible to reduce treatment duration in onychomycosis. For this reason, a randomized, double-blind study in 195 patients with severe dermatophyte infections of the toenails was performed comparing a 24-week treatment with terbinafine (250 mg/d) with a 48-week treatment with micronized griseofulvin (1000 mg/d).
After 48 weeks, effective treatment was achieved in 67% of the patients treated with terbinafine and in 56% of those treated with griseofulvin (two-tailed P = .120). At a follow-up visit 24 weeks later, cure rates had decreased to 60% in the terbinafine group and to 39% in the griseofulvin group (two-tailed P = .006). At the same time, the mycological cure rate was 81% with terbinafine and 62% with griseofulvin (two-tailed P = .02).
This study has demonstrated the longterm therapeutic superiority of terbinafine to high-dose griseofulvin in the treatment of toenail mycosis. Furthermore, with the new antifungal terbinafine, treatment is no longer necessary until all affected nail material has grown out.
特比萘芬的杀菌作用方式应使缩短甲癣治疗疗程成为可能。因此，对195例严重趾甲皮肤癣菌感染患者进行了一项随机双盲研究，比较了特比萘芬（250毫克/天）24周治疗方案与微粉化灰黄霉素（1000毫克/天）48周治疗方案。
48周后，接受特比萘芬治疗的患者中有67%获得有效治疗，接受灰黄霉素治疗的患者中有56%获得有效治疗（双侧P = 0.120）。24周后的随访中，特比萘芬组治愈率降至60%，灰黄霉素组降至39%（双侧P = 0.006）。同时，特比萘芬的真菌学治愈率为81%，灰黄霉素为62%（双侧P = 0.02）。
本研究证明了特比萘芬在治疗趾甲癣方面相对于高剂量灰黄霉素具有长期治疗优势。此外，使用新型抗真菌药特比萘芬，在所有受感染的指甲物质全部长出之前无需继续治疗。
