不同方案硝酸咪康唑栓治疗VVC再发的疗效比较

Comparison of effects of miconazolenitrate suppository on recurrent vulvovaginal candidiasis

目的评价硝酸咪康唑1200mg强化治疗及巩固不同疗程治疗外阴阴道念珠菌病(VVC)再发的效果,探讨再发VVC的优化治疗方案。方法采取开放、非对照性临床试验。试验分三组,A组强化治疗,B组在此基础上巩固1个月,C组巩固2个月。对不同疗程患者用药前、用药后7～14d、用药后每个月进行妇科检查、临床症状体征评分、真菌学检查,评估疗效至停药2个月。结果70例患者入选,6例失访,停药2个月时共64例可评价人群。硝酸咪康唑1200mg强化治疗和巩固1～2个疗程的临床治愈率分别为52.4%、52.6%、54.2%;临床总有效率分别为85.7%、94.7%、91.7%;真菌学疗效分别为90.5%、94.7%、95.8%;三组间无统计学差异。结论VVC再发强化治疗效果满意,与巩固1～2疗程治疗疗效相当,增加1～2个疗程不能提高远期疗效和降低复发率。

Objective To evaluate the effects of 1200mg miconazole nitrate intensive treatment and consolidation treatment on recurrent vulvovaginal eandidiasis. Methods An open,non-controlled clinical trial was conducted by allocating the subjects into three groups： group A,intensive treatment; group B, consolidation treatment for one more month than group A; group C, consolidation treatment for two nore than group A. The gynecological examination,clinical signs and symptoms score and mycological examination were conducted monthly. Results A total of 70 patients were enrolled in the trial, among which five lost follow-up and three dropped out in advance during follow-up observation due to being positive in the mycological examination. Sixty-two cases were evaluable two months after drug withdrawal. The clinical cure rates of patients using 1 200 mg mieonazole nitrate intensive treatment and 1-2 courses of consolidation were respectively 55%, 52.6% and 56.5%; the total clinical effective rates were 90% ,94.7% and 95.7%; mycological clearance rates were 90.9%, 94.7% and 95.8%; without showing statistical difference among the three groups. Conclusion The efficacy of intensive treatment on reeurrent vulvovaginal candidiasis is satisfactory.