3种药物治疗妊娠中期外阴阴道假丝酵母菌病的疗效比较

Observation on the effect of three species of drug treatment on vulvovaginal candidiasis in the mid trimester of pregnancy

目的 观察并评价克霉唑阴道片（凯妮汀）、硝呋太尔-制霉菌素阴道栓（麦咪康帕）、保妇康栓治疗妊娠中期外阴阴道假丝酵母菌病的疗效.方法 选取83例妊娠中期外阴阴道假丝酵母菌病患者随机分为3组.A组30例,采用克霉唑阴道片0.5克,阴道上药,3天1次,连用两次;B组28例,采用硝呋太尔-制霉菌素阴道栓阴道上药,每天1次,1次1枚,连用6天;C组25例,采用保妇康栓阴道上药,每天1次,1次1枚,连用8天.停药7天,观察3组药物治疗的临床疗效、微生物疗效和不良反应.结果 A组的临床有效率为86.67%,真菌转阴率为93.33%;B组临床有效率为57.14%,真菌转阴率为75%;C组临床有效率为60%,真菌转阴率为80%;3组均未出现不良反应.3组治疗前VVC评分分别为：A组（5.13±2.15）分,B组（6.00±2.04）分,C组（5.68±2.19）分;3组治疗后VVC评分分别为：A组（0.63±0.89）分,B组（1.86±1.34）分,C组（1.60±1.35）分;治疗前、后比较差异均有极显著性（P＜0.01）： 3组间A组临床治愈率（53.33%）和临床有效率（86.67%）显著高于B组（17.86%,57.14%）和C组（16%,60%）,差异有显著性（P＜0.05）,而B组和C组比较差异无显著性（P＞0.05）： 3组微生物疗效评定治愈率（A组93.33%,B组75%,C组80%）比较差异无显著性（P＞0.05）.结论 3种方法均可有效治疗妊娠期VVC,且均无不良反应克霉唑阴道片500mg两剂间隔3天序贯治疗法在临床疗效上优于硝呋太尔-制霉菌素阴道栓和保妇康栓单疗程治疗法.

Objective To observe the clinical therapeutic effect of the treatment on vulvovaginal candidiasis （VVC） in the mid trimester of pregnancy with three species of drug （Clotrimazole,Macmirorcomplex, Baofukang Shuan）. Methods 83 women diagnosed with VVC in the mid trimester of pregnancy were divided into three groups： Group A with 30 cases, treated with Clotrimazole for twice; Group B with 28 cases, treated with Macmirorcomplex for 6 days; Group C with 25 cases, treated with Baofukang Shuan for 8 days. Observed the clinical effect, the microbes therapeutic effect and the adverse effect of the treatment with three species of drug. Results （1）The clinical cure rate of Group A was 86.67% and the fungal negative rate was 93.33%. The clinical cure rate of Group B was 57.14% and the fungal negative rate was 75%. The clinical cure rate of Group C was 60% and the fungal negative rate was 40%. There were no adverse effect to be found in the three groups. （2） The clinical cure rate and curative rate of Group A were significantly higher than those of Group B and Group C（ P〈0,05 ）,but there were no difference in Group B and Group C （ P〉 0.05 ）. The V VC scores of the three groups were significantly descended compared with those of pretherapy （ P〈 0.01 ）, but there were no difference of the curative rate about microbes therapeutic effect in the three groups （ P〉 0.05 ）.Conclusion The three drugs for VVC in pregnancy are all effective and no serious adverse effect. Clotrimazole has better clinical therapeutic effect than Macmirorcomplex and Baofukang Shuan.