氯喹那多-普罗雌烯阴道片联合甲硝唑阴道泡腾片对细菌性阴道病患者阴道微生态的影响

Effect of Chlorquinaldol-Promestriene Vaginal Tablets Combined with Metronidazole Vaginal Effervescent Tablets on the Vaginal Microecology of Patients with Bacterial Vaginosis

分析氯喹那多-普罗雌烯阴道片联合甲硝唑阴道泡腾片对细菌性阴道病患者阴道微生态的影响。方法选取2013年3月至2015年3月济钢集团有限公司总医院收治的细菌性阴道病患者134例,按照随机数字表法将其分为A组(40例)、B组(44例)、C组(50例)。A组给予甲硝唑阴道泡腾片每晚1粒,阴道给药,连用12 d。B组给予甲硝唑阴道泡腾片每晚1粒(连用12 d)联合氯喹那多-普罗雌烯阴道片每晚1片,阴道给药,连用12 d。C组给予甲硝唑阴道泡腾片每晚1粒联合氯喹那多-普罗雌烯阴道片治疗每晚1片,阴道给药,连用18 d。治疗前后定期测定各组患者乳酸菌检出率以及各组患者微生态改变情况。结果 A组患者治疗后变性梯度凝胶电泳(DGGE)条带数及组内相似度较治疗前均显著减少[4±1比24±5,(11±5)%比(35±6)%](P<0.05)。B组患者治疗后DGGE条带数较治疗前减少(13±1比26±5),差异有统计学意义(P<0.05);但组内相似度与治疗前相比有所提高[(39±10)%比(35±6)%],差异有统计学意义(P<0.05)。C组患者治疗后DGGE条带数与治疗前比较差异无统计学意义(P>0.05);组内相似度明显较治疗前升高[(72±10)%比(34±6)%](P<0.05)。治疗后,B组和C组DGGE条带数、组内相似度高于A组,C组DGGE条带数、组内相似度高于B组(P<0.01)。A组、B组、C组治疗后乳酸菌检出率分别为15.0%(6/40),52.3%(23/44),76.0%(38/50),B组乳酸菌检出率显著高于A组,C组高于A组和B组(P<0.05)。结论单独采用甲硝唑治疗细菌性阴道病会破坏阴道微生态环境,而氯喹那多-普罗雌烯阴道片联合甲硝唑治疗可以有效减少对阴道微生态环境的影响,适当地延长氯喹那多-普罗雌烯阴道片和甲硝唑联合用药的时间将有利于抗生素治疗后阴道微生态环境的重建。

Objective To analyze effects of chlorquinaldol-promestriene vaginal tablets combined with metrenidasole vaginal effervescent tablets on vaginal microecology of patients with bacterial vaginosis. Methods Total of 134 patients with bacterial vaginal disease in General Hospital of Jinan Iron and Steel Group Co. Ltd. from Mar. 2013 to Mar. 2015 were included in the study, and according to the random number table methed,they were divided into three groups： group A（40 cases）, B （44 cases） and C （50 cases）. The group A was given metronidazole vaginal effervescent tablets with one in vagina per nlght,continuously for 12 days. The group B was given metrenidazole vaginal effervescent tablets （ continuously for 12 d） combined with colposeptine-promestriene in vagina per night,continuously for 12 d. The group C was given metronidasole vaginal effervescent tablets combined with colposeptine-promestriene in vagina per night, continuously for 18 d. The detection rate of lactic acid bacteria and the micro ecological change of the patients were measured regularly before and after treatment. Results The number of denaturing gradient gel electro- phoresis （DGGE） bands and similarity within group of group A were significantly decreased than before treatment [ 4 ± 1 vs 24 ± 5, （ 11 ± 5 ） % vs （ 35 ±6） % ] （ P 〈 0. 05 ）. The DGGE bands number of group B was reduced after treatment,the difference was statistically significant （ 13 ±1 vs 26 ±5） （P 〈0. 05） ;but the similarity within the group was increased compared with before treatment[ （39 ±10） % vs （35 ±6） % ], the difference was statistically significant（P 〈0. 05）. The DGGE band number of group C had no significant difference from before the treatment（P 〉0. 05） ;while the similarity within the group was significantly higher than before the treatment [ （72 ± 10）% vs （34 ± 6）% ] （P 〈 0. 05 ）. After treatment, DGGE band number and similarity of group B and group C were significantly higher than group A, group C was significantly higher than group B （ P 〈0. 01 ）. After treatment,lactic acid bacteria detection rates of group A, group B, group C were 15.0% （6/40）, 52. 3% （23/44）, 76. 0% （38/50） ,group B was significantly higher than group A, group C was significantly higher than group B （ P 〈 0. 05 ）. Conclusion Pure metronidazole treatment for bacterial vaginosis seriously affects the vaginal micro ecological environment, while chlorquinaldol-premestriene vaginal tablets combined with metronidazole treatments can effectively reduce the influence on the vaginal micro ecological environment, and the appropriate extension of the application time is helpful for the reconstruction of the vagina micro ecological environment after antibiotic treatment.