目的 探討兩性霉素B溶液聯(lián)合過氧化氫溶液治療真菌性外耳道炎的臨床療效。方法 選取2021年9月—2023年9月青島市城陽(yáng)區(qū)人民醫(yī)院收治的真菌性外耳道炎患者82例，隨機(jī)分為對(duì)照組（41例）和治療組（41例）。對(duì)照組給予過氧化氫溶液，3%溶液沖洗外耳道，3次/d。在對(duì)照組基礎(chǔ)上，治療組患者滴耳注射用兩性霉素B，25 mg溶于注射用水5 mL，藥液耳浴10 min，3次/d。兩組治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時(shí)間，氣導(dǎo)（AC）和耳骨導(dǎo)（BC）聽閾值，血清降鈣素原（PCT）、腫瘤壞死因子-α（TNF-α）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）和白細(xì)胞介素-6（IL-6）水平。結(jié)果 治療后，治療組總有效率為92.68%，明顯高于對(duì)照組（78.05%，P＜0.05）。治療后，治療組癥狀緩解時(shí)間均明顯短于對(duì)照組（P＜0.05）。治療后，兩組患耳AC聽閾值、BC聽閾值比治療前明顯降低（P＜0.05），且治療組患耳的AC聽閾值、BC聽閾值低于對(duì)照組（P＜0.05）。治療后，兩組患者血清TNF-α、PCT、TGF-β1、IL-6水平低于治療前（P＜0.05），且治療組明顯低于對(duì)照組（P＜0.05）。結(jié)論 兩性霉素B聯(lián)合過氧化氫治療真菌性外耳道炎，可有效改善患耳癥狀，聽力能力明顯緩解，降低外耳道炎性反應(yīng)。

Objective To explore the clinical effect of amphotericin B combined with hydrogen peroxide in treatment of fungal otitis externa. Methods Patients (82 cases) with fungal otitis externa in Qingdao Chengyang People's Hospital from September 2021 to September 2023 were randomly divided into control (41 cases) and treatment (41 cases) group. Patients in the control group were administered with Hydrogen Peroxide Solution, rinsed external ear canal with 3% solution, three times daily. Patients in the treatment group were administered with Amphotericin B for injection on the basis of the control group, 25 mg added into injection water 5 mL for 10 min, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, the AC and BC hearing thresholds, the levels of serum TNF-α, PCT, TGF-β1 and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 92.68%, which was significantly higher than that of the control group (78.05%, P < 0.05). After treatment, the time of symptom relief in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the AC hearing threshold and BC hearing threshold in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were lower than those of the control group (P < 0.05). After treatment, the levels of serum TNF-α, PCT, TGF-β1 and IL-6 in two groups were lower than those before treatment, and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The synergistic treatment of hydrogen peroxide solution and amphotericin B is effective in improving the symptoms of the affected ear, can obviously alleviate the hearing ability and reduce the inflammatory reaction of the external auditory canal.

R987