Shenoy R K, Sandhya K, Suma T K, Kumaraswami V
Department of Medicine, TD Medical College Hospital, Alleppey, Kerala, India.
Southeast Asian J Trop Med Public Health. 1995 Jun;26(2):301-5.
Episodic adenolymphangitis (ADL) is one of the important clinical manifestations of lymphatic filariasis. Recurrent ADLs contribute to the progress of the disease and also have important socioeconomic implications since they cause significant loss of man days. The present study was conducted in order to identify the precipitating factors responsible for ADL attacks and also to examine the different modalities of treatment. Sixty-five individuals with filariasis related ADL attacks, who are residents of Alleppey district (endemic for Brugia malayi) were studied. All efforts were taken to identify the precipitating factors for ADLs in these individuals. They were hospitalized for a period of five days or more. All of them received symptomatic antipyretic/antiinflammatory therapy and topical antibiotic/antifungal treatment of the affected limbs. They were then randomly allocated to one of the following four regimens: group I - symptomatic alone; group II - symptomatic plus antibiotics; group III - symptomatic followed by diethylcarbamazine citrate (DEC) and group IV - symptomatic plus antibiotic followed by DEC. Patients in groups III and IV received DEC every three months up to one year. There was a significant relationship between the number of ADL attacks and the grade of edema. Presence of focus of infection in the affected limb could be identified in 28 of the 65 patients. In the majority of patients (48) response to treatment was rapid (resolution in less than five days). Neither antibiotics nor DEC (given at intervals of three months) appeared to alter the frequency of ADL attacks. On the otherhand simple hygienic measures combined with good foot care and local antibiotic/antifungal cream application (where required), were effective in reducing the number of ADL attacks.
发作性腺淋巴管炎（ADL）是淋巴丝虫病的重要临床表现之一。复发性ADL会促使疾病进展，还具有重要的社会经济影响，因为它们会导致大量工作日的损失。本研究旨在确定导致ADL发作的诱发因素，并研究不同的治疗方式。对65名居住在阿拉普扎区（马来布鲁线虫流行区）、患有与丝虫病相关的ADL发作的个体进行了研究。尽一切努力确定这些个体中ADL的诱发因素。他们住院观察了五天或更长时间。所有人都接受了对症的退热/抗炎治疗以及对患肢进行局部抗生素/抗真菌治疗。然后将他们随机分配到以下四种治疗方案之一：第一组——仅对症治疗；第二组——对症治疗加抗生素；第三组——对症治疗后服用枸橼酸乙胺嗪（DEC）；第四组——对症治疗加抗生素后服用DEC。第三组和第四组的患者每三个月服用一次DEC，持续一年。ADL发作次数与水肿程度之间存在显著关系。65名患者中有28名在患肢发现了感染灶。大多数患者（48名）对治疗反应迅速（不到五天症状消退）。抗生素和DEC（每三个月服用一次）似乎都没有改变ADL发作的频率。另一方面，简单的卫生措施加上良好的足部护理以及在必要时局部涂抹抗生素/抗真菌乳膏，可有效减少ADL发作的次数。
