克霉唑阴道片治疗复发性外阴阴道假丝酵母菌病疗效分析  

Efficacy of clotrimazole vaginal tablets in the treatment of recurrent vulvovaginal candidiasis

作　　者：陈秋珍 严少梅[1,2] 黄丽婷 梁轶珩 樊尚荣[1,2] CHEN Qiu-zhen;YAN Shao-mei;HUANG Li-ting;LIANG Yi-heng;FAN Shang-rong(Shantou University Medical College,Shantou 515041,China;Department of Obstetrics and Gynecology,Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]北京大学深圳医院,广东深圳518036 [3]深圳市龙岗区妇幼保健院,广东深圳518172

出　　处：《中国实用妇科与产科杂志》2021年第3期384-387,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：深圳科创委基础研究项目(JCYJ20190809101409603)。

摘　　要：目的探讨应用克霉唑阴道片强化治疗联合巩固治疗复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidiasis RVVC)的效果和RVVC患者的假丝酵母菌种类。方法回顾性分析北京大学深圳医院2014年8月至2019年8月收治的267例RVVC患者的假丝酵母菌种类和应用克霉唑阴道片强化治疗联合巩固治疗的效果。结果患者年龄(32.75±6.68)岁,均无人免疫缺陷病毒(HIV)感染。全部患者治疗前培养出假丝酵母菌,包括:白假丝酵母菌236株(占88.4%)、光滑假丝酵母菌22株(占8.2%)、其他非光滑假丝酵母菌非白假丝酵母菌9株(占3.4%)。患者强化治疗治愈219例,治愈率82.0%(219/267);巩固治疗治愈159例,治愈率72.6%(159/219);完成巩固治疗6个月内复发41例,巩固治疗后复发率25.8%(41/159)。白假丝酵母菌所致RVVC患者强化治疗治愈率、巩固治疗治愈率和完成巩固治疗后6个月内复发率依次为85.2%(201/236)、74.6%(150/201)、24.7%(37/150)。光滑假丝酵母菌所致RVVC患者强化治疗治愈率、巩固治疗治愈率和完成巩固治疗后6个月内复发率依次为50.0%(11/22)、36.4%(4/11)、25.0%(1/4)。其他非光滑假丝酵母菌非白假丝酵母菌所致RVVC患者强化治疗治愈率、巩固治疗治愈率和完成巩固治疗后6个月内复发率依次为77.8%(7/9)、71.4%(5/7)、60.0%(3/5)。没有患者在治疗过程中出现药物严重不良反应。结论克霉唑阴道片治疗RVVC安全有效。Objective candidiasis(RVVC)by intensive therapy combined with consolidation therapy,and Candida species in RVVC patients.Methods Shenzhen Hospital from August 2014 to August 2019. These patients were treated with clotrimazole vaginal tablets by intensive therapy combined with consolidation therapy. The treatment efficacy and Candida species distribution were investigated.ResultsThe average age of patients was 32.75 ± 6.68 years old,and all of them had no HIV infection.Before treatment,based on SDA culture,all the 267 patients were confirmed of candida infection,including 236 Candida albicans(88.4%),22 C.glabrata(8.2%)and 9 non-albicans non-glabrata strains(3.4%). 219 patients were cured with intensive therapy,with a cure rate of 82.0%(219/267);159 patients were cured with consolidation therapy,with a curerate of 72.6%(159/219);41 patients relapsed within 6 months after completion of the consolidation therapy,andthe recurrence rate after consolidation treatment was25.8%(41/159). Among them,the cure rate of C.albicans after intensive therapy and consolidation therapy withclotrimazole vaginal tablets was 85.2%(201/236)、74.6%(150/201)and the recurrence rate of C.albicans within 6months after completion of consolidation therapy was 24.7%(37/150). Similarly,the cure rate of C.glabrata was they was50.0%(11/22),36.4(4/11),with a recurrence rate of 25.0%(1/4).In addition,the non-albicans non-glabrata strains were 77.78%(7/9),71.4%(5/7)and 60.0%(3/5),respectively. No serious side reaction appeared during the treatment.ConclusionClotrimazole vaginal tablets was effective and safe in treatment of RVVC patients.

关 键 词：复发性外阴阴道假丝酵母菌病 假丝酵母菌 克霉唑 治疗 

分 类 号：R711.31[医药卫生—妇产科学]