不同方法治疗绝经后老年性阴道炎的疗效比较  

Clinical comparison of different methods of administration in the treatment of senile vaginitis

作　　者：毛秀珍[1] 赵黎华[1] 黄海燕[1] 车向前[1] 

机构地区：[1]南京市第一医院集团泗洪县分金亭医院妇产科,江苏省宿迁市223900

出　　处：《实用老年医学》2015年第8期635-638,共4页Practical Geriatrics

摘　　要：目的比较甲硝唑栓联合不同给药途径雌激素治疗绝经后老年性阴道炎(senile vaginitis,SV)的疗效及安全性。方法选取于2010年5月至2013年12月在我院收治的绝经后SV患者450例,随机分为单纯甲硝唑栓阴道剂组(A组)、甲硝唑阴道栓剂联合雌激素制剂局部外用组(B组)及甲硝唑阴道栓剂联合口服雌激素组(C组),每组150例。A组给予甲硝唑栓治疗,B组给予甲硝唑+雌激素软膏治疗,C组给予甲硝唑+复方雌孕片(Ⅲ)口服,疗程均为3周,停药1周后复查临床症状和体征消失情况,检测治疗前后的血清促卵泡生成素(FSH)和血清雌二醇(E2)含量,观察临床疗效,统计不良反应发生率。结果治疗后,B组和C组的总有效率均显著高于A组,差异有统计学意义(P均<0.01)。同时,治疗后B组和C组的血清FSH、E2水平明显高于A组(P均<0.01),且B组、C组阴道脱落细胞成熟指数、阴道炎症状评分和阴道健康评分改善程度显著优于A组(P均<0.05),但B和C组上述指标之间比较,差异无统计学意义。C组不良反应发生率显著高于B组(P<0.05)。结论甲硝唑栓联合雌激素制剂局部外用能够更好地控制绝经后SV患者的临床症状,提高疗效,且相对于口服给药安全性更高,可作为治疗SV的首选方法。Objective To compare the clinical efficacy and safety of metronidazole-based therapy in combination with estrogen through different delivery methods for senile vaginitis in old women.Methods From May 2010 to December 2013,a total of 450 old women with senile vaginitis were recruited in this study.According to the treatment methods,all the patients were random divided into three groups,with 150 patients in each group.Group A was given metronidazole,group B received the combination treatment of metronidazole and topical estrogens paste（Beimeili）,and group C received the combination treatment of metronidazole and oral estrogen（Prempro）.All patients were treated for successive three weeks.The improvement of the clinical symptoms,the levels of serum follicular stimulating hormone（FSH） and estradiol（E2） were evaluated and compared among three groups.The incidence rate of the adverse event was also evaluated.Results After the treatment,the total effective rate of group B and group C was obviously higher than that of group A（P〈0.01）,but no difference was found between group B and group C.Moreover,compared to group A,the level of FSH and E_2 was significantly higher in group B and group C（P〈0.01）.The improvement of the maturation value index,vaginitis symptom scores and vaginal health score were obviously greater in group B and group C than those in group A（P〈0.05）,but showed no statistical difference between group B and group C.The incidence rate of adverse event in group C was significantly higher than that of group B.Conclusions The combination treatment of metronidazole and topical estrogens paste is an effective and safe method for old women with senile vaginitis.

关 键 词：老年女性 老年性阴道炎 甲硝唑 雌激素制剂局部外用 口服雌激素 

分 类 号：R711.31[医药卫生—妇产科学]