细菌性阴道病的诊断方法及治疗效果

Diagnostic methods and treatment effects of bacterial vaginosis

目的:探讨细菌性阴道病的诊断方法及治疗效果。方法:对780例门诊妇科病人,分别采用唾液酸酶法与传统诊断标准法(Amsel)检测,比较两种方法的检测结果;并将255例确诊为细菌性阴道病随机分成4组。A组:阴道内应用甲硝唑组;B组:阴道内应用定君生组;C组口服甲硝唑同时阴道应用甲硝唑组;D组:口服甲硝唑同时阴道应用定君生组,比较4个治疗组的治愈率、总有效率及复发率。结果:在细菌性阴道病的诊断中,唾液酸酶法阳性率为31.7%,传统诊断标准法Amsel阳性率为28.2%,经配对资料χ2检验,差异无显著性(P>0.05);治愈率、总有效率及A、B、C三组间无显著性差异(P>0.05),复发率A、B、C三组间无显著性差异(P>0.05),而D组复发率明显低于A、B、C三组,存在显著性差异(P<0.05)。结论:唾液酸酶活性检测具有快速、操作简单、结果稳定、阳性标准明确的优点,在临床上可作为诊断细菌性阴道病常规筛查及治愈标准判定的指标。在治疗方面单一应用甲硝唑或定君生,或联合应用甲硝唑和定君生,均能有效的治疗细菌性阴道病,但联合用药效果更佳。

Objective：To investigate diagnosis methods and treatment effects of bacterial vaginosis. Methods：Using sialic acid enzymatic method or traditional diagnostic criteria （Amsel） detection in 780 cases of out -patient gynecological patients, respectively, and comparison of test results. 255 diagnosed cases of bacterial vaginosis were randomly divided into 4 groups ： intravaginal application of Metronidazole （group A） ; intravaginal application of Living Preparation of Lactobacillus （group B） ; intravaginal application of Metronidazole and oral Metronidazole （ group C） ; oral Metronidazole and intravaginal applications of Living Preparation of Laetobacillus （ group D ）. Compare the treatment cure rate, the total effective rate and recurrence rate between four groups. Results： The positive rate between enzymatic sialic acid （31.7%） and the traditional diagnostic criteria of Amsel （28. 2% ） in diagnosed bacterial Vaginosis were no significant difference （P 〉 0. 05 ） by matching data χ^2 test; The cure rate, the total effective rate were also no significant difference among group A, group B and group C （ P 〉 0. 05 ）. Relapse rate were no significant difference among group A, group B and group C （ P 〉 0. 05 ）. But the recurrence rate in Group D was significantly lower than group A, group B and group C （ P 〈 0.05 ）. Conclusion ： Detection method of sialidase is fast, simple operation, stable result and identify of positive standards, then it can be used as the clinical conventional screening criteria and cured indicators to determine of bacterial Vaginosis. A single application in the treatment of Metronidazole or Living Preparation of Lactobacillus, or a combination of Metronidazole and Living Preparation of Lactobacillus can be effective treatment for bacterial vaginosis, and the combination is better.