阴道微生态评价指标监测下治疗细菌性阴道病

Bacterial vaginosis treatment under the guidance of vaginal microecology

目的了解BV及RBV患者的阴道微生态被彻底恢复与未被彻底恢复停药后的远期复发率差异。方法 137例BV患者(其中RBV 48例)被随机分成A、B两组。A组67例(其中RBV 19例),B组70例(其中RBV 29例)。A组治疗至Amsel正常、Nugent评分≤3分、阴道菌群密集度Ⅱ～Ⅲ度且乳酸杆菌占明显优势、H2O2≥2μmol/L时停药;B组治疗至Amsel正常时停药。A、B两组停药后均随访6个月。结果 A组随访6个月复发率为22.39%、但B组高达63.08%。A组中BV患者随访6个月复发率为18.75%、B组为33.33%。A组中RBV患者随访2个月复发率为31.58%、但B组高达86.21%,随访3个月时B组全部复发。结论动态监测阴道微生态评价指标,能客观指导临床BV治疗。BV患者、尤其RBV患者经个体化治疗,积极彻底恢复阴道微生态环境,明显降低了其远期复发率。

Objective To learn the difference of the long term recurrence rates between BV and RBV patients whose vaginal microecological imbalance had or had not recovered completely.Methods 137 BV（including 48 RBV） patients were randomly divided into group A（67 patients including 19 RBV patients） and group B（70 patients including 29 RBV patients）.Treatment for group A ended when the Amsel was normal,Nugent score ≤3,vaginal flora intensity was II to III degrees,Lactobacillus dominated and H2O2 ≥2 μmol/L,while treatment for group B ended when the Amsel was normal.Both groups were followed up for 6 months after medication stopped.Results The 6 months recurrence rate of group A was 22.39% while that of group B was 63.08%.The 6 months recurrence rate of BV patients in group A was 18.75% while in group B was 33.33%.The 2 months recurrence rate of RBV patients in group A was 31.58%,while it was 86.21% in group B and 100% at 3 months.Conclusion BV treatment may be guided by vaginal microecology objectively.The long term recurrence rate of BV or RBV patients whose vaginal microecological imbalance were completely recovered can be reduced effectively.