Mesh : Adult Aged Analysis of Variance Antifungal Agents / therapeutic use Dietary Sucrose / adverse effects Double-Blind Method Family Practice / methods Fatigue / microbiology Female Female Urogenital Diseases / microbiology Gastrointestinal Diseases / microbiology Humans Male Male Urogenital Diseases Medical History Taking Memory Disorders / microbiology Middle Aged Multiple Carboxylase Deficiency Mycoses / complications diagnosis diet therapy drug therapy immunology Nystatin / therapeutic use Pain / microbiology Respiratory Tract Diseases / microbiology Skin Diseases / microbiology Surveys and Questionnaires Treatment Outcome

来  源:   DOI:10.1093/fampra/18.3.258   PDF(Sci-hub)

Abstract:
BACKGROUND: Antifungal therapy has been claimed to be effective in polysymptomatic patients with diffuse symptoms from multiple body systems and even well defined diseases, traditionally not related to fungi. Hypersensitivity to fungus proteins and mycotoxins has been proposed as the cause.
METHODS: We conducted a 4-week randomized, double-blind, placebo-controlled study in 116 individuals selected by a 7-item questionnaire to determine whether the antifungal agent nystatin given orally was superior to placebo. At the onset of the study, the patients were free to select either their regular diet or a sugar- and yeast-free diet, which resulted in four different subgroups: nystatin + diet (ND); placebo + diet (PD); nystatin (N); and placebo (P).
RESULTS: Nystatin was significantly better than placebo in reduction of the overall symptom score (P < 0.003). In six of the 45 individually recorded symptoms, the improvement was significant (P < 0.01). All three active treatment groups reduced their overall symptom scores significantly (P < 0.0001), while the placebo regimen had no effect (P = 0.83). The benefit of diet was significant within both the nystatin (ND > N) and the placebo groups (PD > P).
CONCLUSIONS: Nystatin is superior to placebo in reducing localized and systemic symptoms in individuals with presumed fungus hypersensitivity as selected by a 7-item questionnaire. This superiority is probably enhanced even further by a sugar- and yeast-free diet.
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