乌鸡白凤丸巩固治疗复发性外阴阴道念珠菌病的临床研究

Maintenance White Phoenix bolus therapy for recurrent vulvovaginal Candidiasis

目的 应用乌鸡白凤丸巩固治疗复发性外阴阴道念珠菌病（Recurrent Vulvovaginal Candidiasis,RVVC）,通过观察其疗效及安全性,探讨其有无降低RVVC复发率的作用.方法 486名处于VVC急性发作且以往有RVVC史的非孕育龄妇女,急性期阴道给予克霉唑栓强化治疗.达到临床及真菌治愈标准后,随机分为3组采取不同方案进行巩固治疗或临床观察.A组：每月月经净后3～7 d,继续单次阴道给予克霉唑栓500 mg,为期3个月;B组：每月月经净后口服乌鸡白凤丸每次1丸,1次/d,3周为1个疗程,连用3个月.对照组：仅作随访观察.各组在巩固治疗期间及巩固治疗结束后6个月内进行随访,观察疗效及不良反应发生情况.结果 巩固治疗期间,A组和B组分别累计有17人（10.12％）和23人（13.61％）出现复发,显著低于对照组（P＜0.001）.巩固治疗结束后,随访第3个月A组和B组分别累计有31人（21.83％）和37人（26.62％）出现复发;随访第6个月A组和B组分别累计有73人（51.41％）和79人（56.83％）出现复发,均显著低于对照组（P ＜0.001）,A、B组间各阶段复发率无显著差异（P＞0.05）,不良反应轻微.结论 RVVC近期治愈后采用乌鸡白凤丸巩固治疗,能够抑制念珠菌生长,增强免疫功能,控制阴道局部炎症反应,有效预防复发,效果满意且相对安全,值得临床应用与推广.

Objective White Phoenix bolus was used to explore and investigate a new optional management of recurrent vulvovaginal candidiasis （RVVC）.Methods After inducing clinical remission and microbiological cure with clotrimazole suppositories given in two 500 mg doses at 72 hour intervals,486 women with recurrent vulvovaginal candidiasis were randomly divided into three groups.After menstruation,group A were treated with intravaginal clotrimazole （500 mg） monthly for three months.Group B were treated with White Phoenix bolus,one pill daily for three monthly except menstrual period.The others were designated as Control Group.All women were followed by six months of observation without therapy.The outcome measure was the proportion of women in clinical remission at the end of the maintenance treatment and six-month follow-up period.Result The proportions of women who suffered with recurrence at the end of the treatment and 3,6 months follow-up in White Phoenix bolus group were 13.61％,26.62％ and 56.83％,similar to those in clotrimazole group （10.12％,21.83％ and 51.41％,P ＞ 0.05）,and significantly decreased as compared with 40.27％,57.30％ and 68.54％,respectively,in the control group （P ＜0.001）.The adverse effect was slight and could rarely be seen.Conclusion Long-term treatment with White Phoenix bolus can inhibit the growth of candida,boost up the immunity of host,control the local inflammation and reduce the rate of recurrence of symptomatic vulvovaginal candidiasis.The study may represent a safe and effective alternative to RVVC.