氟康唑口服联合克霉唑栓及乳酸杆菌阴道用药治疗外阴阴道假丝酵母菌病对阴道分泌物中抗菌肽LL-37、防御素5水平的影响观察  

Effect of Oral Administration of Fluconazole Combined with Clotrimazole Suppositories and Lactobacillus for Vaginal Use on the Levels of Antibacterial Peptide LL-37 and Human Defensin 5 in Vaginal Secretions in the Treatment of Vulvovaginal Candidiasis

作　　者：曾妍 ZENG Yan(Hubei 672 Orthopaedics Hospital of Integrated Chinese and Western Medicine,Wuhan 430079,China)

机构地区：[1]湖北六七二中西医结合骨科医院,湖北武汉430079

出　　处：《中国医学创新》2021年第17期135-139,共5页Medical Innovation of China

摘　　要：目的:探究氟康唑口服联合克霉唑栓及乳酸杆菌阴道用药治疗对外阴阴道假丝酵母菌病(VVC)患者阴道分泌物中抗菌肽LL-37、防御素5(HD5)的水平影响。方法:选取2019年12月-2020年9月到本院就诊的VVC患者86例。采用随机数字表法将患者分为观察组和对照组,各43例。给予对照组氟康唑片口服及克霉唑栓治疗,观察组在对照组的基础上给予阴道用乳杆菌活菌胶囊联合治疗。比较两组患者停药2、4周的临床疗效;比较两组治疗前及停药2、4周时的症状体征评分、阴道微生态环境(乳杆菌分级)及阴道分泌物中相关因子(抗菌肽LL-37、HD5)水平;比较两组患者治疗期间不良反应发生情况及停药后6个月内的复发情况。结果:观察组的治疗效果优于对照组(P<0.05)。停药2、4周时,两组的临床症状体征评分均明显低于治疗前,且观察组均显著低于对照组(P<0.05)。停药2、4周时,两组乳杆菌分级均较治疗前明显改善,且停药2周时,观察组的乳杆菌分级情况明显优于对照组(P<0.05);停药4周时,两组乳杆菌分级情况比较,差异无统计学意义(P>0.05)。停药2、4周时,两组抗菌肽LL-37及HD5水平均较治疗前明显降低,且观察组停药2周时上述指标水平均显著低于对照组(P<0.05)。两组头晕头痛、恶心呕吐等轻度不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者停药后6个月内复发率明显低于对照组(P<0.05)。结论:抗真菌药物与乳酸杆菌阴道用药相结合的治疗模式具有起效快,提高机体免疫力,有效预防短期内复发的优势。Objective:To explore the effect of oral administration of Fluconazole Tablets combined with Clotrimazole Suppositories and Lactobacillus for vaginal use on the levels of antimicrobial peptide LL-37 and human defensin 5(HD5)in vaginal secretions of patients with vulvovaginal candidiasis(VVC).Method:A total of 86 patients with VVC who visited our hospital from December 2019 to September 2020 were selected.The patients were divided into observation group and control group by random number table method,43 cases in each group.The control group was treated with Fluconazole Tablets orally and Clotrimazole Suppositories,while the observation group was additively treated with Live Lactobacillus Capsule for vaginal use.The clinical efficacy of two groups were compared after 2 and 4 weeks of drug withdrawal.The scores of symptoms and signs,the vaginal microecological environment(Lactobacillus classification)and the levels of related factors(antimicrobial peptide LL-37 and HD5)in vaginal secretion were compared between the two groups before treatment and after 2 and 4 weeks of drug withdrawal.The incidence of adverse reactions during treatment and the recurrence within 6 months after drug withdrawal were compared between the two groups.Result:The treatment effect of the observation group was better than that of the control group(P<0.05).After 2 and 4 weeks of drug withdrawal,the scores of clinical symptoms and signs in both groups were significantly lower than those before treatment,and the scores in the observation group were significantly lower than those in the control group(P<0.05).After 2 and 4 weeks of drug withdrawal,the classification of Lactobacillus in both groups were significantly improved compared with those before treatment;and after 2 weeks of drug withdrawal,the classification of Lactobacillus in observation group was significantly better than that in control group(P<0.05);there was no significant difference in the classification of Lactobacillus between the two groups after 4 weeks of drug withdrawal(P>0.05)

关 键 词：外阴阴道假丝酵母菌病 氟康唑片 阴道用乳杆菌活菌胶囊 抗菌肽LL-37 防御素5 复发 

分 类 号：R711.31[医药卫生—妇产科学]