目的观察乙胺嗪、消肿乳糜清和自我照料3种方法对慢性丝虫病患者下肢象皮肿的疗效,探索有效控制发病的措施。方法选择浙江省桐乡市350名下肢象皮肿患者作为观察对象,按村随机分为4组:A组89例,每人口服乙胺嗪片剂100mg/d;B组91例,口服消肿乳糜清胶囊21粒/d(基质9g);C组86例,口服安慰剂胶囊6粒/d;D组84例,实施自我照料。各组均持续3个月。双盲法在治疗后3个月、1年随访患者,并测量患肢排水量,观察比较疗效。结果完成全程观察324人,感觉好转的171人(52.78%),无变化的153人(47.22%),经χ2检验,差异有统计学意义(χ2=63.67,P<0.0001)。患肢排水容积均值差值经秩和检验、重复测量资料的方差分析,表明乙胺嗪、乳糜清组的近期疗效均优于安慰剂、照料组;远期:乙胺嗪和乳糜清组均优于安慰剂组、乙胺嗪组优于乳糜清组、照料组优于乳糜清组和安慰剂组,且乙胺嗪组与照料组之间的差别无统计学意义。结论乙胺嗪在治疗慢性丝虫性淋巴水肿、象皮肿患者中无论是近期或远期疗效均显著;乳糜清近期显效,远期则不明显;远期观察,照料也是一种有效的治疗手段。 Objective To observe the effects of diethylcarbamazine, chylomicrosin and self-care on edema of lower extremity in patients with chronic filariasis and explore ways to effectively control the disease. Methods 350 lower extremity astigmatism patients in Tongxiang City of Zhejiang Province were selected as observation objects and randomly divided into 4 groups according to the village: 89 cases in group A, each taking 100 mg / d of enzine tablets; 91 cases in group B, oral swelling Chylomicrons 21 capsules / d (matrix 9g); C group of 86 patients, oral placebo capsules 6 / d; D group 84 cases, the implementation of self-care. Each group lasts 3 months. Double-blind method in 3 months after treatment, 1-year follow-up of patients, and measurement of limb displacement, observe and compare the efficacy. Results A total of 324 patients were observed, 171 (52.78%) felt no improvement and 153 (47.22%) had no change. The difference was statistically significant (χ2 = 63.67, P <0.0001) by χ2 test. The difference of mean value of limb drainage volume by rank sum test and repeated measures of variance analysis showed that the recent efficacy of diethylcarbamazine and chyloroide group were better than placebo and caring group; In the placebo group, the chitosan group was superior to the chylomicrone group, and the carotid group was superior to the chylomicrone group and the placebo group. There was no significant difference between the choline group and the vehicle group. Conclusions The effect of diethylcarbamazine in the treatment of chronic filariasis lymphedema and edema was significant both in the short-term and the long-term; chylinerine was effective in the short term but not in the long term; long-term observation and care was also an effective treatment means.