活性乳酸杆菌制剂治疗妊娠期细菌性阴道病疗效观察及其对妊娠结局的影响

Curative Effect of Lactobacillus-based Medicament to Bacterial Vaginosis of Pregnant Women

目的对妊娠期细菌性阴道病(BV)患者采用乳酸杆菌活菌制剂治疗,追踪观察治愈率、复发率,及其对妊娠结局的影响。方法对5 047例正常妊娠妇女常规筛查出BV患者748例,其中146例无症状BV未行治疗,其余602例BV患者随机分为实验组与对照组各301例。实验组采用活性乳酸菌阴道胶囊2枚(0.25 g/枚:600万活性乳酸杆菌),每日1次,阴道上药,×10 d。对照组采用灭滴灵栓1枚,每日1次,阴道上药,×10 d。结果实验组与对照组的临床痊愈率分别为86.0%(259/301)、79.7%(240/301),总有效率分别为89.7%(270/301)、82.4%(248/301),差异均无显著性意义(P>0.05);复发率分别为3.3%(10/301)、33.9%(102/301),差异有极显著性意义(P<0.01);两组治疗后阴道乳酸杆菌的检出率分别为97.3%(293/301)、33.2%(100/301),差异有极显著性意义(P<0.01)。146例无症状BV组与实验组的胎膜早破率分别为14.4%(21/146)、4.0%(12/301),流产/早产率分别为16.4%(24/146)、4.3%(13/301),产褥感染率分别为11.0%(16/146)、3.0%(9/301),新生儿感染率分别为5.5%(8/146)、1.7%(5/301),两组比较差异均有显著性意义(均P<0.05)。实验组与对照组的妊娠结局虽无显著差异,但总体预后优于对照组。临床观察活性乳酸菌胶囊无毒副作用,对胎儿无影响。结论应用活性乳酸杆菌制剂治疗BV短期疗效与对照组基本相同,但治疗后阴道乳酸杆菌的恢复程度明显优于对照组,复发率明显低于传统疗法,改善了母儿预后。

Objective To investigate the curability, recurrent rate and curative effect of lactobacillus-based medicament to bacterial vaginosis （BV） of pregnant women, Methods 748 sufferers with BV were screened in 5047 pregnant women, including 146 without any BV symptom. The remaining 602 samples with BV were divided into 2 peer groups： experimental group and control group. Two pieces of lactobaeillus-based drug （0.25 g/piece with 6 million laetobaeillus） were applied to the experimental group every day for 10 days. One piece of metronidazole drug was used to the control group per day for 10 days. Results The clinical curability in the two groups was 86.0% （259/301） and 79.7% （240/301） respectively. The total efficiency in the two groups was 89.7% and 82.4% respectively, There was no significant difference between the two groups. The recurrent rate in experimental and control groups was 3.3% and 33.9% respectively. The detectable rate of laetobaeillus in the experimental and control groups after the treatment was 97.3% and 33.2% respectively （P〈0.01）, The rate of premature rupture of membranes, premature and abortion, puerperal infection, and newborn infection in the 146-pregnant-women group without BV symptom and experimental group was 14, 4% and 4.0%, 16.4% and 4.3%, 11.0% and 3.0%, 5.5% and 1.7%, respectively （all P〈0.05）. Though the gestation outcomes in experimental and control groups bad no significant difference, the overall outcomes in the former were superior to those in the latter. Clinically, laetobaeillus-based drug bad no toxic and side effects to the sufferers and fetus. Conclusion The short-term curative effect of the laetobaeillus-based drug is almost same with the result of control group, But the use of the laetobaeillus-based drug never decreases the laetobaeillus number opposite to the use of metronidazole, so that depresses the recurrent rate of the BV-reinfeetion.