阴道用乳杆菌活菌胶囊治疗复发性外阴阴道念珠菌病患者的临床研究  

Clinical trial of vaginal live Lactobacillus capsule in the treatment of patients with recurrent vulvovaginal candidiasis

作　　者：黄华 王文艳[1] HUANG Hua;WANG Wen-yan(Department ofGynaecology and Obstetrics,The Second Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui Province,China)

机构地区：[1]安徽医科大学第二附属医院妇产科,安徽合肥230000

出　　处：《中国临床药理学杂志》2025年第1期21-25,共5页The Chinese Journal of Clinical Pharmacology

基　　金：安徽省自然科学基金资助项目(2008085MH283)。

摘　　要：目的观察阴道用乳杆菌活菌胶囊联合硝呋太尔制霉素阴道软胶囊用于复发性外阴阴道念珠菌病(RVVC)患者的临床效果及对患者阴道微生态环境的影响。方法将RVVC患者按照队列法分为对照组及试验组,对照组患者给予硝呋太尔制霉素阴道软胶囊,睡前1粒阴道栓塞治疗,试验组患者予以阴道用乳杆菌活菌胶囊0.25 g,晨起阴道局部用药联合硝呋太尔制霉素阴道软胶囊睡前1粒阴道栓塞治疗,2组初始治疗时间均持续7 d,停药7 d后均进行阴道分泌物病原菌培养,阴性者为治愈。治愈者进行硝呋太尔制霉素阴道软胶囊巩固治疗,每周1次,持续6个月。比较2组患者的临床治疗效果,比较2组患者治疗前及治疗7 d后阴道微生态及阴道分泌物人β防御素(HβD)-3、白细胞介素(IL)-1β、IL-8变化情况,并进行安全性评价。结果本研究共入组268例,其中试验组136例,对照组132例。试验组和对照组初始治疗真菌学治愈率分别为84.56%(115例/136例)和73.48%(97例/132例),巩固治疗真菌学治愈率分别为82.61%(95例/115例)和70.10%(68例/97例),在统计学上差异均有统计学意义(均P<0.05)。治疗7 d后,试验组及对照组的阴道清洁度Ⅲ~Ⅳ级占比分别为24.26%和36.36%,阴道菌群密集度Ⅱ~Ⅲ级占比分别为79.41%和68.18%,阴道菌群多样性Ⅱ~Ⅲ级占比分别为77.94%和65.91%,优势菌为乳杆菌的占比分别为82.35%和68.18%,阴道分泌物HβD-3水平分别为(129.65±11.51)和(135.87±10.46)pg·mL^(-1),IL-1β水平分别为(65.48±9.27)和(72.46±10.38)pg·mL^(-1),IL-8水平分别为(159.36±12.50)和(176.30±13.19)pg·mL^(-1),在统计学上差异均有统计学意义(均P<0.05)。试验组和对照组患者的药物不良反应总发生率分别为23.53%(32例/136例)和18.38%(25例/132例),在统计学上差异无统计学意义(P>0.05)。结论阴道用乳杆菌活菌胶囊联合硝呋太尔制霉素阴道软胶囊治疗相较于硝呋太尔制霉素软胶囊单独治�Objective To observe the clinical effect of live vaginal Lactobacillus capsule for vaginal use combined with nifuratel nystatin vaginal soft capsule on patients with recurrent vulvovaginal candidiasis(RVVC)and its influence on vaginal microecological environment of patients.Methods The RVVC patients were divided into the control group and the treatmentg group according to the cohort method.The patients in the control group were treated with one grain of vaginal embolization before going to bed with nifuratel nystatin vaginal soft capsule.The patients in the treatment group were treated with 0.25 g of vaginal live Lactobacllus capsule in the morning combined with one grain of vaginal embolization before going to bed with nifuratel nystatin vaginal soft capsule.The initial treatment time of the two groups lasted for 7 days.Initial treatment lasted for 7 days in both groups.Pathogenic bacteria culture was performed after 7 days of drug withdrawal.The negative patients were cured,and the cured patients were treated with nifuratel nysfungin vaginal suppository for consolidation treatment once a week for 6 months.The clinical therapeutic effect in the two groups was recorded.The changes in vaginal microecology and human β-defensin(HβD)-3,interleukin(IL)-1β and IL-8 in vaginal secretions were compared between the two groups before treatment and after 7 days of treatment,and the safety evaluation was carried out.Results A total of 268 patients were enrolled in this study,including 136 in the treatment group and 132 in the control group.The mycological cure rates of initial treatment in the treatment group and the control group were 84.56%(115 cases/136 cases)and 73.48%(97 cases/132 cases),respectively;the mycological cure rates of consolidation treatment were 82.61%(95 cases/115 cases)and 70.10%(68 cases/97 cases),respectively;the differences were statistically significant(all P<0.05).The proportions of vaginal cleanliness grade Ⅲ-Ⅳ in treatment group and control group after 7 days of treatment were 24.26% and 36.

关 键 词：乳杆菌活菌胶囊 硝呋太尔制霉素阴道软胶囊 复发性外阴阴道念珠菌病 阴道微生态 强化 巩固 

分 类 号：R978[医药卫生—药品]