Xiao S, Shi Z, Zhuo S, Wang C, Zhang Z, Chu B, Zheng J, Chen M
Institute of Parasitic Diseases, Chinese Academy of Preventive Medicine, Shanghai.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 1995;13(3):170-3.
From August to October 1994, a field trial of preventive treatment with artemether (Art) was carried out in Minglang District of Yiyang City, Hunan Province, an islet with embankment type endemic area nearby southern Donting Lake region. The residents who frequently contacted with the infested water were selected for study and allocated to the Art group and the control group in reference to paired methods of randomization table. About one month before administration of Art, all residents under study were examined by stool hatching technique after nylon-bag concentration to determine the infection rate of each group, and then treated with praziquantel at a single dose of 40 mg/kg in stool egg-negative residents and 50 mg/kg in stool egg-positive ones. In Art group, the first dose of 6 mg/kg was given in late August, followed by repeated dosing every 15 days for 3 times. Placebo (starch) was given to the study residents in the control group at the same time as in Art group. The efficacy was evaluated by stool examination 25-32 days after the last medication. The results showed that after the preventive administration of Art, 20 out of 365 study residents in Art group revealed stool positive with an infection rate of 5.5%, while in the control group 51 out of 376 study residents showed stool positive with an infection rate of 13.6%. The difference between the two groups was statistically significant. Meantime, two cases of acute schistosomiasis were seen in the control group, but none was observed in Art group. The egg per gram of feces (EPG) determined with the Kato-Katz method was 122 +/- 79 (range 12-192) in Art group and 681 +/- 909 (range 12-2,760) in the control group. No apparent adverse side effect was seen during the treatment with Art, and no abnormal change in liver and renal function was detected after the last medication. The preliminary study indicates that application of the preventive administration of Art in the endemic area during the transmission season may effectively reduce both the infection rate and intensity of schistosomiasis.
1994年8月至10月，在湖南省益阳市明朗区进行了蒿甲醚预防性治疗的现场试验。明朗区是一个靠近洞庭湖地区南部的堤围型血吸虫病流行区。选择经常接触疫水的居民作为研究对象，并参照随机数字表配对的方法将其分为蒿甲醚组和对照组。在服用蒿甲醚前约1个月，对所有研究对象进行尼龙袋集卵后粪便孵化技术检查，以确定每组的感染率，然后对粪便虫卵阴性的居民采用40mg/kg的单剂量吡喹酮治疗，粪便虫卵阳性者采用50mg/kg的剂量治疗。蒿甲醚组于8月下旬给予首剂6mg/kg，随后每15天重复给药1次，共3次。对照组的研究对象在与蒿甲醚组相同的时间给予安慰剂（淀粉）。末次给药后25 - 32天通过粪便检查评估疗效。结果显示，蒿甲醚预防性给药后，蒿甲醚组365名研究对象中有20人粪便阳性，感染率为5.5%，而对照组376名研究对象中有51人粪便阳性，感染率为13.6%。两组之间的差异具有统计学意义。同时，对照组出现2例急性血吸虫病病例，而蒿甲醚组未观察到。用加藤厚涂片法测定的蒿甲醚组每克粪便虫卵数（EPG）为122±79（范围12 - 192），对照组为681±909（范围12 - 2760）。蒿甲醚治疗期间未观察到明显的不良反应，末次给药后未检测到肝肾功能异常变化。初步研究表明，在传播季节对流行区应用蒿甲醚预防性给药可有效降低血吸虫病的感染率和感染度。
