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目的研究苄星青霉素、头孢曲松钠、多西环素和阿奇霉素四种药物治疗早期梅毒的疗效,为临床提供可选择的治疗方案。方法 662例早期梅毒患者随机分为四组:苄星青霉素组(A组)308例,予苄星青霉素240万U,每周肌注1次,连续3周;头孢曲松钠组(B组)182例,予头孢曲松钠1g肌注,1次/d,共10d;多西环素组(C组)90例,予多西环素0.1g2次/d口服,共14d;阿奇霉素组(D组)82例,予阿奇霉素第1天1g一次口服,第2天开始0.5g,1次/d口服,共14d,并进行两年的随访,复查RPR。结果苄星青霉素、头孢曲松钠、多西环素和阿奇霉素治愈率分别为94.48%,97.25%,81.11%和67.07%。苄星青霉素和头孢曲松钠疗效优于多西环素和阿奇霉素,差异有统计学意义(P<0.05)。结论苄星青霉素作为治疗梅毒的首选药物仍然值得信赖;头孢曲松钠具有同样高效、安全的优点也可广泛使用;多西环素和阿奇霉素疗效相对较低,仅作为替代方案。
Objective To study the curative effect of four drugs of benzathine penicillin, ceftriaxone sodium, doxycycline and azithromycin in the treatment of early syphilis, so as to provide an alternative treatment for clinical treatment. Methods 662 cases of early syphilis were randomly divided into four groups: 308 cases in group A (group A), 2.40 million U in group B, intramuscular injection once a week for 3 weeks, group B in ceftriaxone sodium group ) 182 cases were given ceftriaxone 1g intramuscular injection, 1 times / d, a total of 10d; doxycycline group (C group) 90 cases, to doxycycline 0.1g2 times / d orally for 14 days; azithromycin group (Group D) 82 cases were given orally with azithromycin 1g on the first day, orally 0.5g on the second day, once a day for 14 days, and were followed up for two years to review the RPR. Results The cure rates of penicillin, ceftriaxone, doxycycline and azithromycin were 94.48%, 97.25%, 81.11% and 67.07%, respectively. Benzathine penicillin and ceftriaxone sodium is superior to doxycycline and azithromycin, the difference was statistically significant (P <0.05). Conclusions Benzathine penicillin is still the drug of choice for the treatment of syphilis. Ceftriaxone sodium is equally effective and safe. It is also widely used. The efficacy of doxycycline and azithromycin is relatively low, as an alternative only.