摘要
657例多菌型麻风用WHO(1981)的MDT方案治疗二年,停药后预定监测五年,现已监测一年的临床和细菌疗效明显。42例新病人用MDT前均有活动性皮损,监测达一年时皮损基本消退,皮肤查菌阴转10例(23.％),BI平均由3.07降至0.61,每年下降0.82, 615例用MDT前曾服过抗麻风药者半数左右有活动性皮损,监测达一年时皮损基本消退,皮肤涂片细菌阴转436例(70.89).BI平均由1.55降至0.02,每年下降0.45.三年中出现ENL 96例,神经炎125例,随疗程延长而减少;1型反应32例则多在治疗2～12个月内发生,及时给予激素治疗.即可避免畸形发生。副作用只有皮肤的色素沉着、干燥和鱼鳞病样改变,停药后均逐渐消退.此方案在病人分散、交通不便的少数民族地区及边远山区是可行的,病人乐于接受,但其复发率有待进一步观察。
Six hundred and fifty seven cases of MB leprosy treatW with WHO' S (1981) MDT regimen over two years and predetermined to be monitored of five years af- ter stop of the treatment have already been monitored over one year. BY the end of the first year of monitor- ing, in 42 originally new cases with active skin lesions be- fore MDT, most of the skin lesions resolved, and the BI decreased from 3. 07 to 0. 61 with a yearly decline of 0. 82 and 10 skin smear negative cases (23. 8%). In 615 cases treated with antileprosy drugs and had active skin lesions in about half of them before MDT, all of the skin lesions resolved and BI decreased from 1. 55 to 0. 2 on the average with yearly decline of 0. 45 and 436 skin smear negative cases (70. 89%). In three years of MDT and monitoring ENL in 96 cases and neuritis in 125 cases were found and their number and severity degree have been decreasing as time goes on. Type 1 reaction in 32 cas- es was mostly seen in the period of the 2nd to twelfth months of taking MDT and disability derived from lep, rosy reaction might be prevented with prednison given in time. Pigmentation and ichthyosis -like lesions of the skim caused by B663 would gradually resolve as time goes on after stop of MDT. The authous think that the, WHOs MDT regimen is adoptable in peripheral mountain regions because the patients like to take it. Relapse rate in these cases has yet to be determined.
