Aoyagi T
National Higashi Saitama Hospital, Japan.
Kekkaku. 1998 Jul;73(7):459-70.
The discovery of streptomycin in 1944 had given rise to great flowering of chemotherapy for tuberculosis. The times which triple treatment of SM.PAS.INH after the temporal time of SM.PAS had been standard regimens on initial treatment had continued for more than twenty years. The shortening of duration for chemotherapy had become possible by the introduction of RFP, and the duration had reduced to one fourth compared with that of the regimens till then by the addition of PZA for two months at the beginning of treatment on the initial treatment cases. In this paper, historical aspects of early and present-day chemotherapy of tuberculosis and the reports of main studies have been summarized, and pharmacokinetics of INH, action of antituberculous drugs in short-course chemotherapy, MDR-TB and biological response modifiers for treatment of tuberculosis, etc. has been reviewed. It is urgently awaited that more new drugs without cross resistance to previous drugs will be developed for the more shortening of the duration and the improvement of the treatment for MDR-TB.
1944年链霉素的发现使结核病化疗蓬勃发展。在SM.PAS之后的一段时间里,SM.PAS.INH三联疗法一直是初始治疗的标准方案,这种情况持续了二十多年。利福平的引入使化疗疗程缩短成为可能,在初始治疗病例的治疗开始时加入吡嗪酰胺两个月,疗程与之前的方案相比缩短至四分之一。本文总结了结核病早期和现代化疗的历史概况以及主要研究报告,并综述了异烟肼的药代动力学、短程化疗中抗结核药物的作用、耐多药结核病以及治疗结核病的生物反应调节剂等内容。迫切期待能研发出更多与以往药物无交叉耐药性的新药,以进一步缩短疗程并改善耐多药结核病的治疗效果。