3种方案治疗重度外阴阴道念珠菌病300例疗效观察

Observation of 300 cases for severe vulvovaginal candidiasis treated with three regimen

目的观察3种方案治疗重度外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)的临床疗效。方法将300例重度VVC患者随机分为3组,制霉素粉组100例予0.5%碘伏液擦拭阴道外阴后,阴道外阴喷洒制霉素粉,连用7 d;氟康唑组予氟康唑150 mg,每日1次口服;联合用药组予氟康唑150 mg,每日1次口服,同时予0.5%碘伏液擦拭阴道外阴后,阴道外阴喷洒制霉素粉,连用7 d。观察3组满意度、疗效及真菌镜检情况。结果制霉素粉组与联合用药组用药第1、3、6 d后满意度比较差异无统计学意义(P>0.05),制霉素粉组、联合用药组治疗后满意率均高于氟康唑组(P<0.05)。3组停药14 d后近期疗效比较差异均无统计学意义(P>0.05)。氟康唑组、联合用药组临床有效率高于制霉素粉组(P<0.05),氟康唑组、联合用药组远期疗效优于制霉素粉组。结论 3种方案治疗VVC均有效;阴道上药改善患者自觉症状优于口服用药;阴道上药联合口服用药、口服用药远期临床有效率高于单纯阴道上药。

Objective To observe and evaluate the curative effects of three regimens for severe vulvovaginal candidiasis（VVC）.Methods 300 patents with VVC were divided into three groups.Group A： 100 women,were scrubbed their walls of the vagina with the iodophor solution（0.5 g/L） and sprayed with the nysfungin powder in hospital for 7 consecutive days.Group B： 100 women,Oral Fluconazole 150mg quaque day,for the first day and third day.Group C： 100 women,Oral Fluconazole 150 mg quaque day for the first day,and were scrubbed their walls of the vagina with the iodophor solution and sprayed with the nysfungin powder in hospital for 7 consecutive days.Satisfaction,efficacy,and microscopic examination of fungal were observed.Results There was no significant difference between Group A and Group C on satisfaction 1,3 and 6 days after treatment（P0.05）.Satisfaction in Group A and Group C was higher than that in Group B（P0.05）.There was significant difference between three groups on short term effect after 14 days without medicine（P0.05）.The effective rate and long term effect in Group A and Group C were higher than that in Group B（P0.05）.Conclusion Three projects for VVC were all effective.The improvement of symptoms in group with vaginal medication is superior to those with oral medication.The long-term curative effectiveness of vaginal medication combined with oral medication is better than that of vaginal medication alone.