药物联合波姆光控制重度外阴阴道假丝酵母菌病症状的疗效观察

The clinical effect of POME optical treatment in patients with severe vulvovaginal candidiasis

目的探讨局部波姆光理疗对控制重度外阴阴道假丝酵母菌病（VVC）症状的临床疗效。方法将我院妇科2009年1—12月确诊的重度VVC患者98例按照不同的治疗方法分成2组：对照组48例，用口服氟康唑和阴道放置硝酸咪康唑栓治疗；理疗组50例，用局部波姆光理疗联合对照组方法治疗；通过对患者的主观症状和治疗后VVC分别评分进行比较，观察2组方法的疗效。结果理疗组患者的临床症状在治疗后4h就快速缓解，其中瘙痒评分低于治疗前[（1．4±0．3）分与（2．8±O．5）分，P〈0．05]，疼痛评分也明显低于治疗前[（1．5±0．4）分与（2．8±0．3）分，P〈0．05]；而对照组48h后症状才明显缓解，其中瘙痒评分低于治疗前[（1．8±0．6）分与（2．9±0．3）分，P〈0．05]，疼痛评分也低于治疗前[（1．5±0．5）分与（2．8±0．4）分，P〈0．05]；理疗组患者在治疗后24h的VVC评分[（5．34±1．6）分与（9．5±2．1）分]和48h的VVC评分[（4．8±1．0）分与（7．9±2．3）分]均低于对照组（P均〈0．05），治疗72h后2组患者比较差异无统计学意义（P〉0．05）。结论局部波姆光理疗联合药物治疗重度VVC，不仅可以加强单纯药物治疗的疗效，而且能快速缓解临床急性期的症状。

Objective To evaluate the clinical effect of local POME optical treatmeat in patients with severe vulvovaginal candidiasis （VVC）. Methods Ninety-eight patients, who were diagnosed as severe vulvovaginal candidiasis from January to December 2009 in Beijing Wuzhou Women＇s Hospital gynecological clinic, were enrolled into this study and divided into control and physiotherapy groups randomly. The patients of control group （n = 48 ） were treated with oral Fluconazole and had Miconazde Nitrate suppositories settlement into vagina, while in the physiotherapy group （ n = 50） the patients accepted local POME optical treatment combined with the same medications as control. The therapeutic effect were evaluated and compared according to the subjective symptoms and VVC scores in both groups. Results The clinical symptoms of physiotherapy group were relieved within 4 hours after the treatment, which were significantly depressed compared to before the treatment ＂（ itching score 1.4±0. 3 vs. 2. 8±0. 5, P 〈 0. 03 ; pain score 1.5±0. 4 vs. 2. 8±0. 3, P 〈 0. 05 ）, while obvious improvements were observed in control group untill 48 hours later （ itching score 1.8±0. 6 vs. 2. 9±0. 3, P 〈 0. 05 ; pain score 1.5±0. 5 vs. 2. 8±0. 4, P 〈 0. 05 ）. The VVC scores were s.ignificantly lower in physiotherapy group than control after treatment at different timepoints （24 h VVC Score 5.3±1.6 vs. 9. 5±2. 1 ,P 〈0. 05 ;48 h Score 4. 8±1.0 vs. 7. 9±2. 3 ,P 〈0. 05） ,but no significant difference was observed in the comparison of VVC Scores between two groups 72 h after treatment （ P 〉 0. 05 ）. Conclusion Local POME optical treatment combined with drug treatment in severe VVC patients not only has better effect than drug treatment alone, but also relieves clinical symptoms more quickly.