Goto M, Miyagi S, Takizawa H, Kitajima S
Division of Research and Examination, National Sanatorium Hoshizuka-Keiaien, Kagoshima, Japan.
Nihon Hansenbyo Gakkai Zasshi. 1998 Jul;67(2):305-11. doi: 10.5025/hansen.67.305.
In order to know leprosy chemotherapy status in Japan, three recently conducted Government-supported nation-wide survey, namely chemotherapy research group survey (Takizawa, 1994, 71 cases) follow up result of Takizawa's study (Miyagi, 1997, 59 cases) and leprosy patient registry (Goto, 1996, 130 cases) were compared and analyzed. For most fresh and relapse cases, multi-drug therapy were applied, among them rifampicin/dapsone or rifampicin/dapsone/clofazimine combinations were selected in about half of new cases and about 1/3 of relapse cases. In many cases dose and intervals were based on WHO protocol, however smaller dosage was used in some cases. Quinolone (ofloxacin) was used in 40% of cases during the therapy. Reversal reaction was observed in 7/71 cases and erythema nodosum leprosum was observed in 6/71 cases. In order to prevent chemotherapy-induced deformities, we propose a modified protocol for new cases accompanied by reactional status, which starts with clofazimine monotherapy and followed by WHO/MB.
为了解日本麻风病化疗状况,对最近由政府支持开展的三项全国性调查进行了比较和分析,这三项调查分别是化疗研究组调查(泷泽,1994年,71例)、泷泽研究的随访结果(宫城,1997年,59例)以及麻风病患者登记(后藤,1996年,130例)。对于大多数新发病例和复发病例,均采用了联合化疗,其中约一半的新发病例和三分之一的复发病例选用了利福平/氨苯砜或利福平/氨苯砜/氯法齐明联合用药。在许多情况下,剂量和间隔均依据世界卫生组织的方案,但在某些情况下使用了较小的剂量。治疗期间40%的病例使用了喹诺酮类(氧氟沙星)药物。71例中有7例出现了逆转反应,71例中有6例出现了麻风结节性红斑。为预防化疗引起的畸形,我们针对伴有反应状态的新发病例提出了一种改良方案,该方案以氯法齐明单药治疗开始,随后采用世界卫生组织的多菌型方案。