目的 探討氟康唑注射液聯(lián)合萘替芬酮康唑乳膏治療外耳道真菌病的臨床療效。方法 選取2021年4月—2024年3月在鄭州大學第一附屬醫(yī)院就診的108例外耳道真菌病患者，共122耳，按隨機數(shù)字表法將患者分為對照組（54例、62耳）和治療組（54例、60耳）。對照組在外耳道患處涂抹萘替芬酮康唑乳膏，每次2個指尖單位，1次/d。治療組在對照組治療基礎上患耳朝上滴入氟康唑注射液5滴/（耳∙次），6次/d。兩組持續(xù)治療14 d。比較兩組患者的臨床療效、癥狀消失時間、聽力程度和血清指標水平。結果 治療組、對照組患者的總有效率分別為96.30%、83.33%，組間比較差異有統(tǒng)計學意義（P＜0.05）。治療后，治療組的耳癢、耳痛、腫脹消失時間明顯短于對照組（P＜0.05）。治療后，兩組耳氣導聽閾值、血清降鈣素原（PCT）、血清淀粉樣蛋白A（SAA）、腫瘤壞死因子-α（TNF-α）水平顯著降低（P＜0.05）；治療組的耳氣導聽閾值、血清PCT、SAA、TNF-α水平低于對照組（P＜0.05）。結論 氟康唑注射液聯(lián)合萘替芬酮康唑乳膏可提高外耳道真菌病的療效，減輕臨床癥狀，改善聽力狀態(tài)，降低炎癥反應。

Objective To investigate the efficacy of Fluconazole Injection combined with Naftifine Hydrochloride and Ketoconazole Cream in treatment of fungal diseases of the external auditory canal. Methods A total of 122 ears were selected from 108 patients of fungal diseases with external auditory canal mycosis treated in the First Affiliated Hospital of Zhengzhou University from April 2021 to March 2024. Patients were divided into control group (54 cases, 62 ears) and treatment group (54 cases, 60 ears) according to random number table method. In the control group, Naftifine Hydrochloride and Ketoconazole Cream was applied to the affected area of the external ear canal, 2 fingertip units each time, once daily. Patients in the treatment group was given Fluconazole Injection on the basis of control group, 5 drops/ear per time, 6 times daily. Both groups were treated for 14 d. The clinical efficacy, symptom disappearance time, hearing level, and serum indicator levels were compared between two groups. Results The total effective rates of the treatment group and the control group were 96.30% and 83.33% of, and the difference was statistically significant between the groups (P < 0.05). The disappearance time of ear itching, ear pain, and swelling in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the auditory threshold of ear air conduction, PCT, SAA, and TNF-α levels in both groups was lower than those before treatment (P < 0.05), and these indexes in the treatment group were lower than those in the control group (P < 0.05). Conclusion Fluconazole Injection combined with Naprofen Ketoconazole Cream can improve the efficacy of fungal diseases of external auditory canal, alleviate clinical symptoms, improve hearing status, and reduce inflammatory reactions.

R986

河南省衛(wèi)生計生科技英才海外研修工程(2018021)