中药周期治疗复发性外阴阴道假丝酵母菌病的临床研究

Therapeutic Effect of Chinese Herbal Medicine Cycle Treatment for Recurrent Vulv-vagina Candida Mycoderma

【目的】观察中药周期疗法对复发性外阴阴道假丝酵母菌病（RVVC）的远期疗效及对阴道局部免疫功能的影响。【方法】将100例RVVC患者随机分为中西医结合治疗组（治疗组）和对照组各50例。两组患者均根据敏感药物进行强化治疗及巩固治疗6个月，治疗组在巩固治疗初期加用中药周期疗法2个月，观察远期疗效及对阴道局部免疫功能的影响。【结果】100例中共有86例完成随访，其中治疗组42例、对照组44例，随访率为86％。随访时间13～32个月。治疗组和对照组复发率分别为35．7％（15／42）、65．9％（29／44），两组比较差异有显著性意义（P〈0．05）。治疗组和对照组平均复发时间分别为（8．2±3．7）个月、（2．6±2．2）个月，两组比较差异有显著性意义（P〈0．05）。治疗组患者阴道灌洗液干扰素－γ（IFN－γ）水平显著降低（与治疗前比较，P〈0．05），但对照组IFN－γ及两组白细胞介素4（IL-4）水平治疗前后比较差异无显著性意义（P〉0．05）。【结论】中药周期疗法能显著改善RVVC患者阴道局部的细胞免疫功能，降低复发率并延长复发时间，从而提高RVVC的远期疗效。

Objective To observe the effect of Chinese herbal medicine cycle treatment combined with routine antifungi treatment on vaginal cellular immune function and its prospective efficacy in patients with recurrent vulvvagina eandida mycoderma （RVVCM）. Methods One hundred RVVCM women patients at the reproductive age admitted from May of 2006 to March of 2008 were equally randomized into the control group and the combination group. The two groups were given sensitive medicine according to the results of fungus culturing and drug sensitivity test for the consolidation of therapeutic effect, the treatment lasting half a year. Additionally, the combination group was given Chinese herbal medicine cycle treatment for two months at the early consolidation stage. Results A follow-up was carried out in 86 cases （42 in the combination group and 44 in the control group） , the follow-up rate being 86%. The follow-up period ranged from 13 to 32 months. During the follow-up period, the recurrence rate was 35.7% （15/42） in the combination group and 65.9% （29/44） in the control group, the difference being significant （ P 〈 0. 05 ）. The average recurrence interval was （ 8.2 ± 3.7 ） months in the combination group and （2.6 ± 2.2 ） months in the control group （P 〈 0.05 ）. Interferon gama （IFN-γ） level in vaginal douche of the combination group was decreased after treatment （ P 〈 0. 05 compared with that before treatment）. No significant difference of IFN-γ and IL-4 was found in the control group before and after treatment （P 〉 0. 05 ）. Conclusion Chinese herbal medicine cycle treatment can improve the vaginal cellular immune function, decrease the recurrence rate, prolong the recurrence interval, and increase the prospective efficacy in patients with recurrent vulv-vagina eandida mycoderma.