目的 探讨氟康唑注射液联合萘替芬酮康唑乳膏治疗外耳道真菌病的临床疗效。方法 选取2021年4月—2024年3月在郑州大学第一附属医院就诊的108例外耳道真菌病患者，共122耳，按随机数字表法将患者分为对照组（54例、62耳）和治疗组（54例、60耳）。对照组在外耳道患处涂抹萘替芬酮康唑乳膏，每次2个指尖单位，1次/d。治疗组在对照组治疗基础上患耳朝上滴入氟康唑注射液5滴/（耳∙次），6次/d。两组持续治疗14 d。比较两组患者的临床疗效、症状消失时间、听力程度和血清指标水平。结果 治疗组、对照组患者的总有效率分别为96.30%、83.33%，组间比较差异有统计学意义（P＜0.05）。治疗后，治疗组的耳痒、耳痛、肿胀消失时间明显短于对照组（P＜0.05）。治疗后，两组耳气导听阈值、血清降钙素原（PCT）、血清淀粉样蛋白A（SAA）、肿瘤坏死因子-α（TNF-α）水平显著降低（P＜0.05）；治疗组的耳气导听阈值、血清PCT、SAA、TNF-α水平低于对照组（P＜0.05）。结论 氟康唑注射液联合萘替芬酮康唑乳膏可提高外耳道真菌病的疗效，减轻临床症状，改善听力状态，降低炎症反应。

Objective To investigate the efficacy of Fluconazole Injection combined with Naftifine Hydrochloride and Ketoconazole Cream in treatment of fungal diseases of the external auditory canal. Methods A total of 122 ears were selected from 108 patients of fungal diseases with external auditory canal mycosis treated in the First Affiliated Hospital of Zhengzhou University from April 2021 to March 2024. Patients were divided into control group (54 cases, 62 ears) and treatment group (54 cases, 60 ears) according to random number table method. In the control group, Naftifine Hydrochloride and Ketoconazole Cream was applied to the affected area of the external ear canal, 2 fingertip units each time, once daily. Patients in the treatment group was given Fluconazole Injection on the basis of control group, 5 drops/ear per time, 6 times daily. Both groups were treated for 14 d. The clinical efficacy, symptom disappearance time, hearing level, and serum indicator levels were compared between two groups. Results The total effective rates of the treatment group and the control group were 96.30% and 83.33% of, and the difference was statistically significant between the groups (P < 0.05). The disappearance time of ear itching, ear pain, and swelling in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the auditory threshold of ear air conduction, PCT, SAA, and TNF-α levels in both groups was lower than those before treatment (P < 0.05), and these indexes in the treatment group were lower than those in the control group (P < 0.05). Conclusion Fluconazole Injection combined with Naprofen Ketoconazole Cream can improve the efficacy of fungal diseases of external auditory canal, alleviate clinical symptoms, improve hearing status, and reduce inflammatory reactions.

R986

河南省卫生计生科技英才海外研修工程(2018021)