乳杆菌制剂与抗真菌药物联合及序贯应用治疗重度外阴阴道假丝酵母菌病疗效研究

摘要

Objective To compare the recurrence rate of severe vulvovaginal candidiasis (VVC)and the treatment effect of combined and sequential therapy (Lactobacillus agents + antifungal drugs).Methods A prospective,case control clinical study was carried out.A total of 125 women were enrolled in the study finally.They were divided into three groups,namely,the combination group,sequential group and simple antifungal drugs group.The first group was treated with the combination of Lactobacillus agents and fluconazole.The second one was treated with fluconazole first followed by Lactobacillus agents and the third one with fluconazole only.Observation of effective and recurrence rate began 14-2 ldays after the start of treatment for the first review,the 28～35 days for the second review.Observe the effective rate and recurrence rate after the two reviews.Results In the first review,efficiency of three groups was 79.1％,83.3％ and 42.5％,and the difference was statistically significant between the first second group and the third group (P＜0.05);in the second review,the efficiency was 75.6％,59.0％ and 27.5％,and recurrence rate was 0,0 and 12.5％,the difference being statistically significant (P＜0.05).Conclusion Combined and sequential therapy can achieve higher efficiency and lower recurrence rate,with superior effect.%目的 探讨阴道乳杆菌活菌制剂定君生与抗真菌药物联合及序贯应用治疗重度外阴阴道假丝酵母菌病(VVC)的有效性及复发情况.方法 选取北京大学第一医院2015年10月至2016年1月收治的125例重度VVC患者,采用随机数字表法分为3组,即联合组(46例)、序贯组(39例)、单纯用药组(40例),其中联合组为定君生与氟康唑同时联合用药,序贯组为采用氟康唑先行治疗随后序贯应用定君生,单纯用药组仅应用氟康唑治疗.3组均在治疗开始后第14～21天进行第1次复查,第28～35天进行第2次复查,观察两次复查后的有效率及复发率.结果 第1次复查时联合组、序贯组、单纯用药组有效率分别为79.1％、83.3％、42.5％,联合组与序贯组差异无统计学意义,与单纯用药组差异有统计学意义(P＜0.05);第2次复查时有效率分别为75.6％、59.0％、27.5％,联合组与其他两组比较差异有统计学意义(P＜0.05);复发率为0、0、12.5％,3组间差异有统计学意义(P＜0.05).结论 乳杆菌制剂与氟康唑联合及序贯用药治疗重度VVC均可达到更高的有效率并减低复发率,联合用药效果更佳.