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目的 客观、正确评价青蒿琥酯预防日本血吸虫病的现场应用效果及其影响因素和毒副反应 ,为拟定规范的服药方案提供科学依据。方法 在江西、安徽和湖北三省血吸虫病流行区的志愿者中 ,采用双盲试验法将受试居民随机分成实验和对照两组 ,先服单剂吡喹酮 ( 4 0～ 5 0mg/kg)清虫 ,随后实验组于接触疫水后每隔 7天和 15天口服青蒿琥酯 ( 6mg/kg) 1次 ,对照组口服与青蒿琥酯剂型相同的安慰剂。末次给药后 3 0天用孵化法和改良Kato法作粪便检查。在服药过程中和中止服药后不同时期观察毒副反应。结果 在江西省所有 467例实验组“7天间隔服药”粪检阳性率为 0 ,保护率为 10 0 % ;在对照组 3 97例居民粪检平均阳性率为 10 .3 %。湖北省的上述剂量预防作用与江西的相同。而“15天间隔服药”受试志愿者保护率为 3 7.7%～ 10 0 % ,实验组保护率与对照组感染率和暴露率存在明显负相关。青蒿琥酯的副作用轻 ,血和尿常规、心电图、肝、肾功能治疗前后无明显改变。结论 通过上述研究 ,阐明了青蒿琥酯的预防效果及其影响因素 ,并据此提出了获得最佳保护率的服药方案。
Objective To objectively and correctly evaluate the field effect of artesunate against schistosomiasis japonicum and its influencing factors and toxicity in order to provide a scientific basis for formulating a standardized medication regimen. Methods In the volunteers of schistosomiasis endemic areas in Jiangxi, Anhui and Hubei provinces, the residents were randomly divided into experimental group and control group by double-blind test. The first dose of praziquantel (40 ~ 50 mg / kg) In the control group, artesunate (6 mg / kg) was administered orally once every 7 days and 15 days after exposure to water and the control group was given the same placebo as the artesunate dosage form. 30 days after the last administration by hatching method and modified Kato method for stool examination. In the course of medication and abstinence observed after different periods of toxic side effects. Results In all 467 experimental groups in Jiangxi Province, the positive rate of stool examination for 7 days intervals was 0 and the protection rate was 10%. In the control group, the average positive rate of fecal examination for 3 97 residents was 10.3%. Hubei Province, the same dose of preventive effect and Jiangxi. The protective rate of volunteers in “15 days interval medication” was 3 7.7% ~ 100%. There was a significant negative correlation between the protection rate of the experimental group and the infection rate and the exposure rate of the control group. Side effects of artesunate light, blood and urine routine, ECG, liver and kidney function before and after treatment no significant change. Conclusions Through the above study, the prevention effect of artesunate and its influencing factors were clarified, and the dosage regimen for obtaining the best protection rate was proposed accordingly.