皮肤癣菌病耐药现状及中药可做贡献
Drug Resistance Status of Dermatophy-Tosis and Contribution of Traditional Chinese Medicine
DOI: 10.12677/ACM.2022.12111531, PDF,   
作者: 袁芳草*：贵州中医药大学，贵州 贵阳；吴 然#：贵州中医药大学第一附属医院皮肤科，贵州 贵阳
关键词: 皮肤癣菌；耐药；中药；高通量测序；Dermatophyte； Drug Resistance； Chinese Medicine； High-Throughput Sequencing
摘要: 近年来，由于抗真菌药物自身局限性以及不合理使用等问题，临床耐药菌株不断增多，使顽固性(耐药)皮肤癣菌病的感染发生率大大增加，难以治疗，对人类健康造成很大的威胁。这些问题导致人们寻亟需找新的、替代的、基于天然的抗真菌药物。至今已几百余种中草药被发现具有抗真菌活性，为抗皮肤癣菌耐药感染研究奠定了基础。本文综述皮肤癣菌耐药的感染概况以及近年来国内外中药抗皮肤癣菌作用的研究，为中药治疗耐药皮肤癣菌病提供依据。
Abstract: In recent years, due to the limitations of antifungal drugs and unreasonable use, clinical drug-resistant strains are increasing, so that the incidence of refractory (drug-resistant ) dermato-phytosis infection greatly increased, difficult to treat, causing a great threat to human health. These problems lead to the urgent need to find new, alternative, natural-based antifungal drugs. So far more than hundreds of Chinese herbal medicines have been found to have antifungal activity, which laid the foundation for the study of anti-dermatophyte drug-resistant infection. This article reviews the general situation of drug-resistant dermatophytosis infection and the research on the an-ti-dermatophytosis effect of traditional Chinese medicine at home and abroad in recent years, which provides a basis for the treatment of drug-resistant dermatophytosis with traditional Chinese med-icine.
文章引用：袁芳草, 吴然. 皮肤癣菌病耐药现状及中药可做贡献[J]. 临床医学进展, 2022, 12(11): 10631-10638. https://doi.org/10.12677/ACM.2022.12111531

参考文献

[1] 杨婷. 伊曲康唑联合特比萘芬乳膏治疗泛发性皮肤癣菌病疗效观察[D]: [硕士学位论文]. 南充: 川北医学院, 2020.
[2] Khurana, A., Sardana, K. and Chowdhary, A. (2019) Antifungal Resistance in Dermatophytes: Recent Trends and Therapeutic Implications. Fungal Genetics and Biology, 132, Article ID: 103255. [Google Scholar] [CrossRef] [PubMed]
[3] Gupta, A.K., Renaud, H.J., Quinlan, E.M., et al. (2021) The Growing Problem of Antifungal Resistance in Onychomycosis and Other Superficial Mycoses. The American Journal of Clinical Dermatology, 22, 149-157. [Google Scholar] [CrossRef] [PubMed]
[4] Lopes, A.I., Tavaria, F.K. and Pintado, M.E. (2020) Conven-tional and Natural Compounds for the Treatment of Dermatophytosis. Medical Mycology, 58, 707-720. [Google Scholar] [CrossRef] [PubMed]
[5] Manzano-Gayosso, P., Méndez-Tovar, L.J., Hernández-Hernández, F., et al. (2008) Antifungal Resistance: An Emerging Problem in Mexico. Gaceta Médica de México, 144, 23-26.
[6] Goh, C.L., Tay, Y.K., Ali, K.B., et al. (1994) In Vitro Evaluation of Griseofulvin, Ketoconazole, and Itraconazole against Var-ious Dermatophytes in Singapore. International Journal of Dermatology, 33, 733-737. [Google Scholar] [CrossRef] [PubMed]
[7] Ghannoum, M., Isham, N. and Sheehan, D. (2006) Voriconazole Susceptibilities of Dermatophyte Isolates Obtained from a Worldwide Tinea Capitis Clinical Trial. Journal of Clinical Microbiology, 44, 2579-2580. [Google Scholar] [CrossRef] 
[8] Nofal, A., Fawzy, M.M. and El-Hawary, E.E. (2020) Successful Treatment of Resistant Onychomycosis with Voriconazole in a Liver Transplant Patient. Dermatologic Therapy, 33, e14014. [Google Scholar] [CrossRef] [PubMed]
[9] Mukherjee, P.K., Leidich, S.D., Isham, N., et al. (2003) Clinical Trichophyton rubrum Strain Exhibiting Primary Resistance to Terbinafine. Antimicrobial Agents and Chemotherapy, 47, 82-86. [Google Scholar] [CrossRef] 
[10] Schøsler, L. andersen, L.K., Arendrup, M.C., et al. (2018) Re-current Terbinafine Resistant Trichophyton rubrum Infection in a Child with Congenital Ichthyosis. Pediatric Dermatol-ogy, 35, 259-260. [Google Scholar] [CrossRef] [PubMed]
[11] Saunte, D.M.L., Hare, R.K., Jørgensen, K.M., et al. (2019) Emerging Terbinafine Resistance in Trichophyton: Clinical Characteristics, Squalene Epoxidase Gene Mutations, and a Reliable EU-CAST Method for Detection. Antimicrobial Agents and Chemotherapy, 63, c01126-19. [Google Scholar] [CrossRef] 
[12] 朱红梅, 温海. 特比萘芬耐药皮肤癣菌的研究进展[J]. 中国真菌学杂志, 2020, 15(4): 253-256.
[13] Yamada, T., Maeda, M., Alshahni, M.M., Tanaka, R., et al. (2017) Terbinafine Resistance of Trichophyton Clinical Isolates Caused by Specific Point Mutations in the Squalene Epoxidase Gene. Anti-microbial Agents and Chemotherapy, 61, e00115-17. [Google Scholar] [CrossRef] 
[14] Singh, A., Masih, A., Khurana, A., et al. (2018) High Terbinafine Resistance in Trichophyton interdigitale Isolates in Delhi, India Harbouring Mutations in the Squalene Epoxidase Gene. Mycoses, 61, 477-484. [Google Scholar] [CrossRef] [PubMed]
[15] Ebert, A., Monod, M., Salamin, K., et al. (2020) Alarming India-Wide Phenomenon of Antifungal Resistance in Dermatophytes: Amulticentre Study. Mycoses, 63, 717-728. [Google Scholar] [CrossRef] [PubMed]
[16] Shankarnarayan, S.A., Shaw, D., Sharma, A., et al. (2020) Rapid Detec-tion of Terbinafine Resistance in Trichophyton Species by Amplified Refractory Mutation System-Polymerase Chain Reaction. Scientific Reports, 10, Article No. 1297. [Google Scholar] [CrossRef] [PubMed]
[17] Salehi, Z., Shams Ghahfarokhi, M., Razzaghi-Abyanch, M., et al. (2018) Antifungal Drug Susceptibility Profile of Clinically Im-portant Dermatophytes and Determination of Point Mutations Interbinafine Resistant Isolates. European Journal of Clin-ical Microbiology & Infectious Diseases, 37, 1841-1846. [Google Scholar] [CrossRef] [PubMed]
[18] Taghipour, S., Shamsizadeh, F., Pchelin, I.M., et al. (2020) Emergence of Terbinafine Resistant Trichophyton mentagrophytes in Iran, Harboring Mutations in the Squalene Epoxi-dase (SQLE) Gene. Infection and Drug Resistance, 13, 845-850. [Google Scholar] [CrossRef] 
[19] Ludes, A., et al. (2019) Extensive Tinea Corporis Due to a Terbinafine-Resistant Trichophyton Mentagrophytesisolate of the In-dian Genotype in a Young Infant from Bahrain in Germany. Hautarzt, 70, 888-896. [Google Scholar] [CrossRef] [PubMed]
[20] Hsieh, A., Quenan, S., Riat, A., et al. (2019) A New Mutation in the SQLE Gene of Trichophyton mentagrophytes Associated Toterbinafine Resistance in a Couple with Disseminated Tinea Corporis. Journal of Medical Mycology, 29, 352-355. [Google Scholar] [CrossRef] [PubMed]
[21] Gupta, A.K., Taborda, V.B.A., Taborda, P.R.O., et al. (2020) High Prevalence of Mixed Infections in Global Onychomycosis. PLOS ONE, 15, e0239648. [Google Scholar] [CrossRef] [PubMed]
[22] 宋江勤, 韩利蓉, 刘雄彪, 等. 110株皮肤癣菌病患者临床分离菌株的药敏试验分析[J]. 中华实验和临床感染病杂志(电子版), 2017, 11(6): 587-590.
[23] Oltu, I., Cepoi, L., Rudic, V., et al. (2020) Current Research and New Perspectives in Antifungal Drug Development. Advances in Experi-mental Medicine and Biology, 1282, 71-83. [Google Scholar] [CrossRef] [PubMed]
[24] 黄茹琪, 王爽. 中药抗皮肤癣菌作用研究进展[J]. 中国地方病防治, 2020, 35(4): 432-434.
[25] Li, E., Clark, A.M. and Hufford, C.D. (1995) Antifungal Evaluation of Pseudolaric Acid B, a Major Constituent of Pseudolarix kaempferi. Journal of Natural Products, 58, 57-67. [Google Scholar] [CrossRef] [PubMed]
[26] 陈文浩, 宋国强, 贾小舟, 等. 香鳞毛蕨中1对间苯三酚类同分异构体的分离与抗真菌活性研究[J]. 中草药, 2017, 48(3): 433-436.
[27] 桂蜀华, 付涛, 梁远园, 等. 苦参碱体外抗真菌活性研究[J]. 中药新药与临床药理, 2011, 22(4): 382-385.
[28] 上官信一. 蒺藜甾体皂苷成分TTS-12及其制剂抗皮肤癣菌的内体外活性研究[D]: [硕士学位论文]. 广州: 广东药科大学, 2018.
[29] 袁野, 蔡光明. 汉麻果胶皂苷类成分分离及其抗真菌活性研究[J]. 中国药业, 2014, 23(2): 28-30.
[30] 强伟, 胡娜, 韩丽娟, 等. 柠条锦鸡儿籽油体外抗真菌作用及其机制研究(英文) [J]. 天然产物研究与开发, 2012, 24(11): 1614-1617.
[31] 安惠霞, 古力娜•达吾提, 等. 地锦草有效部位抗真菌作用及其机制研究[J]. 中国药理学通报, 2010, 26(9): 1162-1165.
[32] 李业荣, 桂蜀华, 李翠平, 等. 莪术挥发油主要成分莪术醇的体外抗真菌活性研究[J]. 广州中医药大学学报, 2011, 28(1): 46-48.
[33] 荣在丽, 魏春波, 王刚生, 等. 山苍子油对皮肤癣菌的药物敏感性及临床试验[J]. 中国麻风皮肤病杂志, 2006(3): 247-248.
[34] 高璐, 吴建美, 刘登宇, 等. 中药合剂对皮肤浅部真菌的体外抑菌作用[J]. 中国皮肤性病学杂志, 2022, 36(1): 32-36.
[35] 王玲. 中药提取物体外抗真菌活性的实验研究[D]: [硕士学位论文]. 大连: 大连医科大学, 2007.
[36] 万东华, 黄宝建, 周训胜, 等. 五种中药对甲癣常见致病菌的抑菌实验研究[J]. 中医药学刊, 2004(4): 657-658.
[37] 杨晓伟, 于欢, 古少鹏, 等. 5种中药对常见皮肤癣菌抑菌效果评价[J]. 中国兽医杂志, 2016, 52(5): 69-71.
[38] 刘真, 赵娟, 刘红, 等. 18味中药醇提物对动物3种真菌体外抑菌活性的研究[J]. 畜牧兽医科学(电子版), 2021(16): 1-5.
[39] 邱莹, 于腾. 20种中药及其复方抗真菌实验研究[J]. 济宁医学院学报, 2007(3): 237-238.
[40] 周汛, 李桂明. 23种中药对皮肤浅部真菌感染的体外抗真菌活性研究[J]. 重庆医科大学学报, 2008(11): 1390-1393.
[41] 李昕, 赵月, 苏昕. 32味中药水提物对4种真菌抑菌实验研究[J]. 辽宁中医药大学学报, 2015, 17(3): 36-39.
[42] 万喆, 侯晴, 李若瑜, 等. 采用微量液基稀释法对伊可尔抗菌剂体外抗真菌活性探索性研究[J]. 中国真菌学杂志, 2018, 13(6): 354-356.
[43] 孙明杰, 崔斌, 陈雷, 等. 中药复方喷剂治疗兔须癣毛癣菌病的效果研究[J]. 中国动物传染病学报, 2020, 28(1): 80-86.
[44] 曹亮, 陶晓倩, 李娜, 等. 中西药复方蛇脂清癣软膏抗真菌及抗炎作用研究[J]. 世界科学技术-中医药现代化, 2013, 15(9): 1966-1970.
[45] 胡瑾瑾, 李红文. 水疱型脚癣的中西医结合治疗与盐酸特比奈芬搽剂治疗效果对比[J]. 医药前沿, 2015, 5(14): 63-64.
[46] 杨继勇. 高通量测序技术在感染病原检测中的应用与展望[J]. 中华检验医学杂志, 2020, 43(5): 533-539.
[47] 高璐, 吴建美, 曲琳. 中药对皮肤浅部真菌病抑制作用的研究进展[J]. 四川中医, 2021, 39(1): 218-221.

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