ﻓﺼﻠﻨﺎﻣﻪ ﺗﻨﺪرﺳﺘﻲ و داﻧﺶ، دوره8 ﺷﻤﺎره، 2 ، ﺗﺎﺑﺴﺘﺎن1392 ﭘﺰﺷﻜ ﻋﻠﻮم داﻧﺸﮕﺎه ﺷﺎﻫﺮود درﻣﺎﻧﻲ ﺑﻬﺪاﺷﺘﻲ ﺧﺪﻣﺎت و ﻲ * ﻧﻮﻳﺴﻨﺪه ﻣﺴ ﺌ ﻮل: ﻗﻢ ﭘﺰﺷﻜﻲ ﻋﻠﻮم داﻧﺸﮕﺎه ﺑﻬﺪاﺷﺘﻲ ﻣﻌﺎوﻧﺖ ﺑﻬﺸﺘﻲ، ﺷﻬﻴﺪ ﻣﺘﺮي ﺑﻴﺴﺖ ﻗﻢ،، ﺗﻠﻔﻦ: 36600017 - 025 ، Email: abed.saghafi@yahoo.com ﭘﮋوﻫﺸﻲ ﻣﻘﺎﻟﻪ ً ﺗﻮأﻣﺎ و ﺗﻨﻬﺎﻳﻲ ﺑﻪ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ﻣﻘﺎﻳﺴﻪ ﺟﻠﺪي ﻟﻴﺸﻤﺎﻧﻴﻮز درﻣﺎن در ﻛﺮاﻳﻮﺗﺮاﭘﻲ ﺑﺎ روﺳﺘﺎﻳﻲ: ﺗﺼﺎدﻓﻲ ﺑﺎﻟﻴﻨﻲ ﻛﺎرآزﻣﺎﻳﻲ ﺛﻘﻔﻲ ﻋﺎﺑﺪﻳﻦ ﭘﻮر * 1 ، راﺛﻲ ﻳﺎور 2 ، ﻧﻮروزي ﻣﻬﺪي 3 1 - ﻗﻢ ﭘﺰﺷﻜﻲ ﻋﻠﻮم داﻧﺸﮕﺎه- ﺑﻬﺪاﺷﺘﻲ ﻣﻌﺎوﻧﺖ- ﺣﺸﺮه ارﺷﺪ ﻛﺎرﺷﻨﺎﺳﻲ ﭘﺰﺷﻜﻲ ﺷﻨﺎﺳﻲ. 2 - ﻋﻠﻮ داﻧﺸﮕﺎه ﺗﻬﺮان ﭘﺰﺷﻜﻲ م- ﮔﺮوه ﺣﺸﺮه ﻧﺎﻗﻠﻴﻦ ﺑﺎ ﻣﺒﺎرزه و ﭘﺰﺷﻜﻲ ﺷﻨﺎﺳﻲ- اﺳﺘﺎد. 3 - ﺑﻬﺸﺘﻲ ﺷﻬﻴﺪ ﭘﺰﺷﻜﻲ ﻋﻠﻮم داﻧﺸﮕﺎه- داﻧﺸﻜﺪه ﺑﻬﺪاﺷﺖ- اﭘﻴﺪﻣﻴﻮﻟﻮژي ﮔﺮوه- اﭘﻴﺪﻣﻴﻮﻟﻮژي دﻛﺘﺮي داﻧﺸﺠﻮي. درﻳﺎﻓﺖ ﺗﺎرﻳﺦ: 11 / 11 / 1390 ، ﭘﺬﻳﺮش ﺗﺎرﻳﺦ: 6 / 8 / 1391 ﭼﻜﻴﺪه ﻣﻘﺪﻣﻪ: ﻣﻘﺎﻳﺴﻪ ﻫﺪف ﺑﺎ ﻣﻄﺎﻟﻌﻪ اﻳﻦ درﻣﺎﻧﻲ اﺛﺮات درﻣﺎﻧﻲ روش دو ﺗﺰرﻳﻖ داﺧﻞ ﺿﺎﻳﻌﻪ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ و روش ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ﻫﻤﺮاه ﺑﻪ ﻛﺮاﻳﻮﺗﺮاﭘﻲ در درﻣﺎن ﻗﻢ اﺳﺘﺎن در ﺟﻠﺪي ﻟﻴﺸﻤﺎﻧﻴﻮز اﻧﺠﺎم اﺳﺖ ﺷﺪه. روش و ﻣﻮاد ﻫﺎ: ﺑﻪ ﺟﻠﺪي ﻟﻴﺸﻤﺎﻧﻴﻮز ﺑﻪ ﻣﺒﺘﻼ ﺑﻴﻤﺎران ﺑﺎﻟﻴﻨﻲ، ﻛﺎرآزﻣﺎﻳﻲ ﻣﻄﺎﻟﻌﻪ اﻳﻦ در ﺷﺪﻧﺪ داده اﺧﺘﺼﺎص ﮔﺮوه دو ﺑﻪ ﺗﺼﺎدﻓﻲ ﺻﻮرت. ﮔﺮوه اول ﺗﺤﺖ درﻣﺎن ﺑﺎ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ ﺑﻪ روش ﺗﺰرﻳﻖ داﺧﻞ ﺿﺎﻳﻌﻪ ﺑﻪ ﻃﻮر ﻫﻔﺘﮕﻲ و ﮔﺮوه ﺗﺤﺖ دوم درﻣﺎن درﻣﺎﻧﻲ روش ﺑﺎ ً ﺗﻮأﻣﺎ و ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ﺑﻪ ﻛﺮاﻳﻮﺗﺮاﭘﻲ ﻳﻚ ﺻﻮرت ﻣﻴﺎن در ﻫﻔﺘﻪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. از ﭘﺲ7 و12 درﻣﺎن ﻫﻔﺘﻪ، ﺿﺎﻳﻌﺎت ﻗﺮار ﭘﺎﻳﺶ ﻣﻮرد ﮔﺮﻓﺖ. ﺑﻪ ﺑﻬﺒﻮدي راﭘﻴﺘﻠ ﺻﻮرت ازﺑﻴﻦ و ﻛﺎﻣﻞ ﻴﺎزاﺳﻴﻮن ﺷﺪ ﮔﺮﻓﺘﻪ ﻧﻈﺮ در ﺳﻔﺘﻲ رﻓﺘﻦ. ﻧﺘﺎﻳﺞ: از197 ﺑﻴﻤﺎر ﻣﺒﺘﻼ ﺑﻪ ﺳﺎﻟﻚ،112 ﺑﻴﻤﺎر درﻣﺎن دوره و ﻛﺮده ﺷﺮﻛﺖ ﻣﻄﺎﻟﻌﻪ در ﻣﺎژور، ﻟﻴﺸﻤﺎﻧﻴﻮ ﻋﺎﻣﻞ ﺑﺎ را ﻛﺎﻣﻞ ﻧﻤﻮدﻧﺪ. 54 ﺑﻴﻤﺎر ﺑﺎ116 ﺗﺰرﻳﻖ ﺿﺎﻳﻌﻪ، ﺿﺎﻳﻌﻪ داﺧﻞ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ و 58 ﺑﻴﻤﺎر ﺑﺎ115 ﺿﺎﻳﻌﻪ، و ﻛﺮاﻳﻮﺗﺮاﭘﻲ ﺑﻪ ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ً ﺗﻮأﻣﺎ ﺻﻮرت داﺷﺘﻨﺪ درﻳﺎﻓﺖ را. در ﮔﺮوه ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ﺑﺎ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ1 / 48 % ﺗﺰرﻳﻖ ﻫﻤﺮاه ﺑﻪ ﻛﺮاﻳﻮﺗﺮاﭘﻲ ﮔﺮوه در و ﺿﺎﻳﻌﺎت ﺿﺎﻳﻌﻪ داﺧﻞ2 / 72 % از ﭘﺲ ﺿﺎﻳﻌﺎت7 از ﭘﺲ و ﺷﺪﻧﺪ درﻣﺎن ﻧﻮﺑﺖ12 درﻣﺎن، ﻧﻮﺑﺖ100 % و ﺗﻮأم درﻣﺎن ﺗﺤﺖ ﺿﺎﻳﻌﺎت91 % درﻣ ﺗﺤﺖ ﺿﺎﻳﻌﺎت از ﺿﺎﻳﻌﻪ داﺧﻞ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ ﺑﺎ ﺎن ﺑﺎﻟﻴﻨﻲ، ﻧﻈﺮ ﻳﺎﻓﺘﻨﺪ ﻛﺎﻣﻞ ﺑﻬﺒﻮد. ﻧﺴﺒﻲ ﺧﻄﺮ ﻫﻔﺘﻢ ﻫﻔﺘﻪ ﭘﺎﻳﺎن ﺑﺮاي) اﻃﻤﻴﻨﺎن ﺣﺪود( 86 / 1 ) 15 / 3 - 1 / 1 ( ﺑﻪ دﺳﺖ دوازدﻫﻢ ﻫﻔﺘﻪ ﭘﺎﻳﺎن ﺑﺮاي و آﻣﺪ23 / 2 RR= و) 3 / 4 - 7 / 2 = CI 95 / 0 ( ﮔﺮدﻳﺪ ﻣﺤﺎﺳﺒﻪ از ﻛﻪ ﻣﻲ ﻣﻌﻨﺎدار آﻣﺎري ﻧﻈﺮ ﺑﺎﺷﺪ) 02 / 0 P< .( ﻣﻴﺰان ﺑﻴﻦ ﻣﻌﻨﺎدار راﺑﻄﻪ آﻣﺎري ازﻧﻈﺮ درﻣﺎن ﺗﺤﺖ ﮔﺮوه دو در ﺑﻬﺒﻮدي ي ﺷﺪ دﻳﺪه) 05 / 0 P< .( ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﺑﻪ ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ﻫﻤﺮاه ﺑﻪ ﻛﺮاﻳﻮﺗﺮاﭘﻲ ﺻﻮرت ً ﺗﻮأﻣﺎ در ﻣﻘﺎﻳﺴﻪ ﺑﺎ روش ﺗﺰرﻳﻖ داﺧﻞ ﺿﺎﻳﻌﻪ ﮔﻠﻮﻛﺎﻧﺘﻴﻢ ﻣﺆﺛﺮﺗﺮي درﻣﺎﻧﻲ روش ﻣﻲ ﻛﺎﻫﺶ را درﻣﺎن دوره و ﺑﻮده دﻫﺪ. واژه ﻛﻠﻴﺪي ﻫﺎي: ﻟﻴﺸﻤ ﺎﻧﻴﻮز ﺟﻠﺪي، ﮔﻠﻮﻛﺎﻧﺘﻴﻢ، ﺿﺎﻳﻌﻪ داﺧﻞ ﺗﺰرﻳﻖ ﻛﺮاﻳﻮﺗﺮاﭘﻲ،. Original Article Knowledge & Health 2013;8(2):62-66 Comparison of Efficacy of Intercessional Injection of Glucantime and Cryotherapy with Intralesional Injection in the Treatment of Zoonotic Cutaneous leishmaniasis:a Randomized Clinical Trial Abedin Saghafipour 1* , Yavar Rassi 2 , Mehdi Norooze 3 1- M.Sc. of Medical Entomology, Qom University of Medical Sciences, Qom, Iran. 2- Professor, Dep. of Medical Entomology, Tehran University of Medical Sciences, Tehran, Iran. 3- Ph.D. Student of Epidemiology, Faculty of Health, Shahid Behshti University of Medical Sciences, Tehran, Iran. Abstract: Introduction: This study was done to compare the efficacy of interlesional injection of Glucantime method and cryotherapy with interlesional injection in treatment of cutaneous leishmaniasis in Qom province. Methods: In this randomized controlled trial patients were randomly allocated in the two arms of the study:one receiving interalesional Glucantime injection weekly and the other receiving biweekly cryothrapy with intralesional injections of Glucantime. At first, the lesion size and induration of lesions were recorded after 7 and 12 weeks, and treatment of lesions was monitored. Healing was defined as complete re-epithelialisation and disappearance of induration. Results: Out of a total of 197 CL patientsm 112 cases with L. major were studied. 54 cases with 116 lesions received intralesional Glucantime injection and 58 patients with 115 lesions received cryothrapy with intralesional injections of Glucantime. At 7th week after the initiation of the treatment, complete healing was observed in56 out of 116 lesions (48.1%) in the group which received weekly intralesional IG injection and 83 out of 115 lesions (72.2%) in the group which received biweekly GI with IG&cryothrapy. At 12th week after the initiation of the treatment, complete healing was observed in 105 out of 116 lesions (91%) in the group which received weekly intralesional IG injection and 115 out of 115 lesions (%100) in the group which received biweekly GI with IG & cryothrapy. By the end of 7th week, RR (0.95CI) amounted to 1.86(1.1 – 3.15) and at the end of 12th week they tapped to 3.4 (2.23- 2.27) which are statistically significant (P<0.02). The significant difference was observed between the two groups in terms of complete healing rate (P<0.05). Conclusion: Based on the findings, cryothrapy with biweekly intralesional injections of Glucantime was more effective compared with weekly intercessional Glucantime injection and reduced the period of treatment. Keywords: Cutaneous leshmaniasis, Glucantime, Cryothrapy, Intraregional injection. Conflict of Interest:No Received: 31 January 2012 Accepted: 27 October 2012 *Corresponding author:A. Saghafipour, Email: abed.saghafi@yahoo.com