标题：乳酸菌阴道胶囊联合氟康唑治疗念珠菌性阴道炎的疗效及对阴道菌群的影响

      作者：李艳梅，贺雯，欧洁贤，李雯琳    深圳市沙井人民医院禧园社区健康服务中心，广东 深圳 518104

      卷次： 2019年30卷19期

      【摘要】 目的 探讨乳酸菌阴道胶囊联合氟康唑治疗念珠菌性阴道炎的疗效及对患者阴道菌群的影响。方法 选择 2015年4月至2016年4月在深圳市沙井人民医院禧园社区健康服务中心治疗的108例念珠菌性阴道炎患者为研究对象，按随机数表法将患者分为观察组和对照组，每组54例，对照组患者给予氟康唑治疗，观察组患者则在此治疗基础上联合乳酸菌阴道胶囊治疗，均连续治疗两周。比较两组患者的临床疗效、临床症状、炎性因子水平及复发情况。结果 治疗后，观察组患者的临床疗效总有效率为92.59%，明显高于对照组的77.78%，差异有统计学意义(P<0.05)；观察组和对照组患者阴道瘙痒[(1.14±0.48)分 vs (2.31±0.4)分]、疼痛[(1.02±0.37)分 vs(2.15±0.53)分]、阴道分泌物[(1.20±0.55)分 vs (2.39±0.68)分]、黏膜充血性水肿[(1.36±0.41)分 vs (2.04±0.83)分]评分比较，观察组均明显低于对照组，差异均有统计学意义(P<0.05)；观察组和对照组的炎性因子血清C反应蛋白(CRP)[(3.60±0.57) ng/mL vs (5.09±0.41) ng/mL]、肿瘤坏死因子-α (TNF-α) [(72.44±3.13) pg/L vs (86.29±3.90) pg/L]，白细胞介素-6 (IL-6) [(3.28±0.37) pg/L vs (4.54±0.70) pg/L]水平比较，观察组均明显低于对照组，差异均有统计学意义(P<0.05)；观察组患者的乳酸杆菌阳性率为 92.59%，明显高于对照组的 70.37%，念珠菌阳性率和复发率分别为11.11%、3.70%，明显低于对照组的27.78%、14.81%，差异均有统计学意义(P<0.05)。结论 乳酸菌阴道胶囊联合氟康唑治疗念珠菌性阴道炎可有效改善阴道菌群的失调，临床治疗效果显著。
      【关键词】 乳酸菌阴道胶囊；氟康唑；念珠菌性阴道炎；阴道菌群；炎性因子；疗效
      【中图分类号】 R711.31 【文献标识码】 A 【文章编号】 1003—6350（2019）19—2521—04

Efficacy of Lacidophilin Vaginal Capsules combined with fluconazole in the treatment of vaginal candidiasis andits influence on vaginal flora.
LI Yan-mei, HE Wen, OU Jie-xian, LI Wen-lin. Xiyuan Community Health Service Center,Shenzhen Shajing People's Hospital, Shenzhen 518104, Guangdong, CHINA
【Abstract】 Objective To study the efficacy of Lacidophilin Vaginal Capsules combined with fluconazole inthe treatment of vaginal candidiasis and its influence on vaginal flora. Methods A total of 108 patients with vaginalcandidiasis treated at the Xiyuan Community Health Service Center of Shenzhen Shajing People's Hospital from April2015 to April 2016 were selected as subjects. They were divided into observation group and control group according tothe random number table method, with 54 cases in each group. Patients in the control group were treated with flucon-azole, while patients in the observation group were additionally treated with Lacidophilin Vaginal Capsules on the basisof this treatment. Both groups were treated continuously for 2 weeks. The clinical efficacy, clinical symptoms, inflamma-tory factors levels and recurrence were compared between the two groups. Results After treatment, the total effectiverate of clinical efficacy in the observation group was 92.59%, which was significantly higher than 77.78% in the controlgroup (P<0.05). Comparison of the scores such as vaginal pruritus (1.14±0.48 vs 2.31±0.4), pain (1.02±0.37 vs 2.15±0.53), vaginal secretion (1.20±0.55 vs 2.39±0.68), and mucosal congestive edema (1.36±0.41 vs 2.04±0.83) between ob-servation group and control group showed that the scores were significantly lower in the observation group than in thecontrol group (P<0.05). Comparison of the serum levels of inflammatory factor such as C-reactive protein , tumor necro-sis factor-α, interleukin-6 between observation group and control group showed that the serum levels were significant-ly lower in the observation group than in the control group: CRP: (3.60±0.57) ng/mL vs (5.09±0.41) ng/mL; TNF-α:(72.44±3.13) pg/L vs (86.29±3.90) pg/L; IL-6: (3.28±0.37) pg/L vs (4.54±0.70) pg/L (P<0.05). In the observation group,the positive rate of Lactobacillus was 92.59%, which was significantly higher than 70.37% in the control group; thepositive rate and recurrence rate of Candida were 11.11% and 3.70%, respectively, which were significantly lower thancorresponding 27.78% and 14.81% in the control group (P<0.05). Conclusion Lacidophilin Vaginal Capsules com-bined with fluconazole in the treatment of vaginal candidiasis can effectively improve the imbalance of vaginal flora,and the clinical treatment effect is significant.
      【Key words】 Lacidophilin Vaginal Capsules; Fluconazole; Vaginal candidiasis; Vaginal flora; Inflammatory fac-tor; Efficacy