Vanijanonta S, Chantra A, Phophak N, Chindanond D, Clemens R, Pukrittayakamee S
Hospital for Tropical Diseases, Faculty of Tropical Medicine, Bangkok, Thailand.
Ann Trop Med Parasitol. 1996 Jun;90(3):269-75. doi: 10.1080/00034983.1996.11813052.
The efficacy and toxicity of oral quinine combined with oral chloroquine were studied in 50 Thai men with uncomplicated falciparum malaria. All were treated for 7 days with quinine sulphate (10 mg salt/kg every 8 h). Twenty-five of the patients, selected at random, were also given oral tetracycline (4 mg/kg four times daily) over the same period and the remainder were given chloroquine (25 mg base/kg over the first 3 days). There were no serious adverse effects. Overall fever-clearance times (FCT) and parasite-clearance times (PCT) in the chloroquine and tetracycline groups were not significantly different, with mean (S.D.) values of 51 (33) and 41 (27) h for FCT and 80 (25) and 83 (21) h for PCT, respectively. Most of the patients (18 in each group) were followed for > or = 2 months. Recrudescence rates (R1) were significantly higher in the chloroquine group than in the tetracycline group (39% v. 6%; P = 0.02), all recrudescences occurring within 4 weeks (18-25 days) of starting treatment. Subsequent parasitaemia with Plasmodium vivax, however, occurred less frequently in the chloroquine group (11%) than in the tetracycline group (33%) (P = 0.11) and took longer to develop in the chloroquine group [51 or 59 days compared with a mean (S.D.) value of 29 (10) days in the tetracycline group; P = 0.01]. Within the chloroquine group, FCT and PCT were both shorter in those with cure than in those with R1 resistance, with mean (S.D.) values of 41 (25) and 70 (33) h for FCT (P = 0.09) and 72 (20) and 100 (18) h for PCT (P = 0.01), respectively. Chloroquine does not potentiate the clinical response to quinine against resistant strains of uncomplicated falciparum malaria, nor does it convey any useful antipyretic effect.
对50名患有非复杂性恶性疟原虫疟疾的泰国男性研究了口服奎宁联合口服氯喹的疗效和毒性。所有患者均接受硫酸奎宁治疗7天（每8小时10毫克盐/千克）。随机选择的25名患者在同一时期还口服四环素（每日4次，每次4毫克/千克），其余患者给予氯喹（前3天25毫克碱基/千克）。未出现严重不良反应。氯喹组和四环素组的总体退热时间（FCT）和寄生虫清除时间（PCT）无显著差异，FCT的均值（标准差）分别为51（33）小时和41（27）小时，PCT分别为80（25）小时和83（21）小时。大多数患者（每组18名）随访时间≥2个月。氯喹组的复发率（R1）显著高于四环素组（39%对6%；P = 0.02），所有复发均发生在开始治疗后4周内（18 - 25天）。然而，氯喹组间日疟原虫的后续寄生虫血症发生率（11%）低于四环素组（33%）（P = 0.11），且氯喹组发生时间更长[51或59天，而四环素组均值（标准差）为29（10）天；P = 0.01]。在氯喹组中，治愈者的FCT和PCT均短于有R1抗性者，FCT的均值（标准差）分别为41（25）小时和70（33）小时（P = 0.09），PCT分别为72（20）小时和100（18）小时（P = ０.０１）。氯喹对非复杂性恶性疟原虫抗药菌株不能增强奎宁的临床反应，也无任何有效的退热作用。
