皮质类固醇
尽管一些研究报告说,糖皮质激素对登革热感染治疗有效,但需要更多的证据才能提供建议。[79]Rajapakse S. Corticosteroids in the treatment of dengue illness. Trans R Soc Trop Med Hyg. 2009 Feb;103(2):122-6.http://www.ncbi.nlm.nih.gov/pubmed/18789467?tool=bestpractice.com[91]Zhang F, Kramer CV. Corticosteroids for dengue infection. Cochrane Database Syst Rev. 2014;(7):CD003488.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003488.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/24984082?tool=bestpractice.com [
]What are the effects of corticosteroids in people with early stage dengue infection?https://cochranelibrary.com/cca/doi/10.1002/cca.1012/full显示答案 [
]What are the effects of corticosteroids in children with dengue-related shock?https://cochranelibrary.com/cca/doi/10.1002/cca.1013/full显示答案 一项随机对照实验发现,在登革热感染的早期急性期使用口服泼尼松龙与病毒血症或其他不良影响的延长无关。 虽然没有评估疗效,研究发现,休克和其他等登革热感染并发症并没有减少。[92]Tam DT, Ngoc TV, Tien NT, et al. Effects of short-course oral corticosteroid therapy in early dengue infection in Vietnamese patients: a randomized, placebo-controlled trial. Clin Infect Dis. 2012;55:1216-1224.http://cid.oxfordjournals.org/content/55/9/1216.longhttp://www.ncbi.nlm.nih.gov/pubmed/22865871?tool=bestpractice.com
抗病毒药物
安全有效的抗登革热病毒药物极其重要。 虽然已经尝试过抗病毒治疗,但目前尚未成功。[93]Noble CG, Chen YL, Dong H, et al. Strategies for development of dengue virus inhibitors. Antiviral Res. 2010;85:450-462.http://www.ncbi.nlm.nih.gov/pubmed/20060421?tool=bestpractice.com Balapiravir是核苷酸类似物(R1479)的前体,能够在体内抗HCV病毒复制。 在一项随机双盲对照实验中,发现Balapiravir对登革热病毒无效。[94]Nguyen NM, Tran CN, Phung LK, et al. A randomized, double-blind placebo controlled trial of balapiravir, a polymerase inhibitor, in adult dengue patients. J Infect Dis. 2013;207:1442-1450.http://jid.oxfordjournals.org/content/207/9/1442.longhttp://www.ncbi.nlm.nih.gov/pubmed/22807519?tool=bestpractice.com
他汀类药物
他汀类药物有多重作用,可改善内皮功能。 已有人推断这些作用可缓解登革热的严重表现,这些表现部分原因在于影响血管内皮的炎症过程。 一项随机对照临床试验发现,虽然洛伐他汀在登革热患者中很安全且有良好耐受性,但没有证据表明存在有益效果。[95]Whitehorn J, Nguyen CVV, Khanh LP, et al. Lovastatin for the treatment of adult patients with dengue: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2016;62:468-476.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725386/http://www.ncbi.nlm.nih.gov/pubmed/26565005?tool=bestpractice.com