苦参凝胶与两性霉素B阴道泡腾片治疗孕妇产后外阴阴道假丝酵母菌病的疗效及安全性

摘要

Objective To explore the safety and efficacy of Kushen Gel and amphotericin B vaginal effervescent tablets in the treatment of postpartum vulvovaginal candidiasis.Methods A total of 186 postpartum vulvovaginal candidiasis patients in postpartum lactation in our hospital were randomly divided into monotherapy group(n =90) and combination group(n =96),receiving amphotericin B vaginal effervescent tablets alone,and Kushen Gel combined with amphotericin B effervescent tablets treatment,respectively.And vaginal pH value before and after treatment,vaginal flora density,sexual pain after treatment and adverse reactions of two groups were compared.Results There was no significant difference in vaginal pH,vaginal flora density of the two groups before treatment (P ＜ 0.05).After treatment,the leucorrhea was decreased,improvement time of pruritus vulvae,mucosal hyperemia symptoms in the combination group were significantly shorter when compared to the monotherapy group (P ＜ 0.05);Vaginal pH value of the two groups was significantly improved,and showed a significant difference at 3 months of follow-up (P ＜ 0.05);After treatment and 3 months of follow-up,proportions of vaginal flora density for grade 1 of the combined group were significantly higher than that of the monotherapy group (P ＜ 0.05).After treatment,grade I sexual pain of the combination group was higher than that of the monotherapy group (63.54％ vs.42.22％,P ＜ 0.05).But there was no significant differences in adverse reactions in two groups (P ＞ 0.05).Conclusion Amphotericin B effervescent tablets for the treatment of patients with postpartum vulvovaginal candidiasis presents certain effect on improvement of symptoms and vaginal micro ecological environment,but has more adverse reactions,so Kushen Gel in combination can enhance the effect and safety.%目的 探讨苦参凝胶与两性霉素B阴道泡腾片治疗孕妇产后外阴阴道假丝酵母菌病的疗效及安全性.方法 选取产后哺乳期外阴阴道假丝酵母菌病患者186例,随机分为单独用药组90例和联合用药组96例,单独用药组予以两性霉素B阴道泡腾片治疗,联合用药组予以苦参凝胶+两性霉素B泡腾片治疗,对比2组治疗前后阴道内环境pH值、阴道菌群密集度、治疗后性生活疼痛分度及不良反应情况.结果 2组治疗前阴道内pH值、阴道菌群密集度分级比较无显著差异(P＜0.05).治疗后,联合用药组白带减少、外阴瘙痒及黏膜充血症状改善时间显著短于单独用药组(P＜0.05);2组患者阴道内pH值均显著改善(P＜0.05),且治疗后及随访3个月2组pH值比较差异显著(P＜0.05);治疗后及随访3个月后联合用药组患者阴道菌群密集度1级所占比例均显著高于单独用药组(JP＜0.05).治疗后,联合用药组性生活疼痛Ⅰ度所占比例为63.54％,显著高于单独用药组42.22％(P＜0.05).2组不良反应比较,差异无统计学意义(P＞0.05).结论 两性霉素B泡腾片用于产后外阴阴道假丝酵母菌病治疗对患者症状及阴道微生态环境改善有一定效果,但不良反应较多,联合应用苦参凝胶可增强效果,安全性高.