探讨5%的碳酸氢钠溶液联合克霉唑耳浴治疗外耳道真菌病的临床疗效。

将2016年1月至2019年1月四川省攀枝花市中心医院耳鼻喉科门诊确诊为外耳道真菌病的106例患者分为观察组和对照组各53例，观察组使用5%的碳酸氢钠溶液联合克霉唑耳浴（4次/d，2周），对照组使用5%的碳酸氢钠溶液耳浴（4次/d，2周），观察2组患者治疗2周后治疗总有效率。同时对2组治疗有效的病例随访3个月，观察其复发率及并发症发生情况。采用Fisher确切检验法比较组间治疗有效率和复发率的差异。

治疗2周，观察组治疗总有效率为95.0%（57/60），对照组有效率为78.0%（46/59），2组疗效比较差异具有统计学意义（P=0.007）。随访3个月，观察组1例1耳（1.8%，1/57）复发，对照组2例3耳（6.5%，3/46）复发，2组间复发率比较，差异无统计学意义（P=0.330）。整过治疗过程中，2组均无不良并发症发生。

5%的碳酸氢钠溶液联合克霉唑耳浴治疗外耳道真菌病操作方法简便，临床疗效可靠，避免全身用药，值得临床医师借鉴和使用。

To evaluate the clinical efficacy of 5% sodium bicarbonate solution combined with clotrimazole ear bath in the treatment of external auditory canal mycosis.

One hundred and six patients with otomycosis externa diagnosed at Department of Otorhinolaryngology, Head and Neck Surgery of Panzhihua Central Hospital from January 2016 to January 2019 were randomly divided into either an observation group or a control group. The observation group was given 5% sodium bicarbonate solution combined with clotrimazole ear bath (4 times a day, 2 weeks). The control group was given 5% sodium bicarbonate solution ear bath (4 times a day, 2 weeks) alone. The total effective rate after 2 weeks of treatment were observed. The two groups were followed for 3 months to observe the recurrence rate and complications. The Fisher′s exact test was used to compare the effective rate and recurrence rate between groups.

After 2 weeks of treatment, the total effective rate of the observation group was 95.0% (57/60), and that of the control group was 78.0% (46/59); there was a significant difference between the two groups (P=0.007). During the 3-month follow-up period, there was one case (1 ear, 1.8%, 1/57) of recurrence in the observation group and two cases (3 ears, 6.5%. 3/46) of recurrence in the control group, and the recurrence rates between the two groups showed no significant difference (P=0.330). During the whole treatment course, no adverse complications occurred in either group.

5% sodium bicarbonate solution combined with clotrimazole ear bath is a simple, reliable method for the treatment of external auditory canal mycosis and can avoid systemic medication.