女性外阴瘙痒病因及用药调查分析  

Etiology and self-medication of pruritus vulvae

作　　者：王雪连 王高峰[1] 刘芳[2] 孔庆涛[2] 冯姣[1] 党洁明[3] 桑红[1] 

机构地区：[1]南方医科大学南京临床医学院(南京军区南京总医院)皮肤科,南京医学硕士研究生210002 [2]南京大学医学院临床学院(南京军区南京总医院)皮肤科,南京210002 [3]南京军区南京总医院妇产科,南京210002

出　　处：《医学研究生学报》2012年第6期612-615,共4页Journal of Medical Postgraduates

摘　　要：目的外阴瘙痒病因复杂,且外阴瘙痒患者普遍存在自行用药治疗的问题。文中调查分析女性外阴瘙痒患者病因及自行用药情况。方法收集262例皮肤科及妇产科门诊女性外阴瘙痒患者,分别对她们进行阴道分泌物真菌学镜检及其他一系列实验室检查。调查分析所有患者就诊之前外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)病史及自行应用药物特别是抗真菌药物的情况,分析比较有VVC病史与无VVC病史2组患者之间2月内抗真菌药物自行使用率及就诊时分泌物直接镜检念珠菌阳性率。结果对262例以外阴瘙痒为主诉的患者进行研究发现VVC、其他细菌性阴道炎及细菌性阴道病(bacterial vaginosis,BV)为引起外阴瘙痒的主要原因。再次就诊时,有VVC病史与无VVC病史患者之间VVC患病率差异无统计学意义;有VVC病史的患者就诊之前抗真菌药物的使用率明显高于无VVC病史的患者。结论许多外阴瘙痒患者根据既往临床确诊的VVC病史错误的使用抗真菌药物,仅靠VVC病史并不能可靠地诊断为VVC。Objective The etiology of pruritus vulvae is complex, and many of the pruritic patients have the history of self- medication. The present study aims to investigate the etiology of pruritus vulvae and the proportion of pruritic women purchasing over-the-counter products for its treatment. Methods A total of 262 women complaining of pruritus vulvae underwent microscopic and laboratory examinations of the vaginal secretion, and received a questionnaire investigation on the history of vulvovaginal candidiasis （VVC） and the use of over-the-counter products for the its treatment of pruritie symptoms. We analyzed the proportion of the self-users of antifungal drugs in the past 2 months and the rate of VVC on direct examination in those with and those without previously diagnosed VVC. Results The main causes of pruritus vulvae in the 262 women were VVC, bacterial vaginosis, and other bacterial vaginitis. On the second visit to the clinic, the incidence of VVC showed no significant difference between the women with and those without confirmed VVC. The percentage of the previous self-users of antifungal drugs was obviously higher in those with than in those without diagnosed VVC. Conclusion Many women with pruritic symptoms mistakenly use over-the-counter products for misdiagnosed VVC. The causes of pruritus vulvae are varied and the medication should be based on the results of definite diagnosis.

关 键 词：外阴瘙痒 病因 药物 滥用 

分 类 号：R756[医药卫生—皮肤病学与性病学]