乳杆菌制剂及恢复阴道微生态平衡在细菌性阴道病治疗中的应用研究

Research on the Application of Lactobacillus Preparation and Vaginal Microecology Recovery in the Treatment of Bacterial Vaginosis

目的:研究乳杆菌制剂在细菌性阴道病(bacterial vaginosis,BV)治疗中的作用及其恢复阴道微生态平衡预防BV复发的价值,探讨治疗BV时应用乳杆菌制剂的重要作用及恢复阴道微生态平衡的时间。方法:选取BV患者150例,随机分为3组,A组单一给予抗生素治疗;B组抗生素治疗后补充乳杆菌制剂1疗程;C组抗生素治疗后补充乳杆菌制剂,每周评估阴道微生态,直至重建阴道微生态平衡后停药;三组停药后均随访3个月。对比分析3种治疗方案的临床疗效及复发情况。结果:3组治愈率均较高,为91.30%-95.73%,无统计学差异(P>0.05);各随访阶段累计复发率,B组和C组明显低于A组,差异有统计学意义(P<0.05);C组与B组相比,累计复发率更低;首发BV、有BV史BV、复发BV患者治疗后重建阴道微生态平衡所需疗程分别为3.53、5.18、7.43,有统计学差异(P<0.01)。结论:单独采用抗生素治疗BV复发率高,联合乳杆菌制剂治疗后可以有效减低复发率,而适当地延长乳杆菌治疗时间彻底恢复阴道微生态平衡将显著降低BV复发率;BV患者既往发生BV次数与重建阴道微生态平衡所需时间呈正相关;因此,应重视每一次BV治疗。

Objective： To investigate the role and value of Lactobacillus preparation in treatment of bacterial vaginosis （BV）, as well as in preventing BV recurrence and restoring vaginal micro ecological balance. The time of recovery of vaginal micro ecological balance were also researched. Methods： 150 BV patents were randomly divided into 3 groups （A, B and C）. Patients in group A were only given antibiotics. Those in group B were treated with one course of Lactobacillus preparation after given antibiotics. And patients in group C had the vaginal micro ecology evaluated weekly, and they were treated with Lactobacillus preparation after given antibiotics until the reconstruction of the vaginal micro ecological balance. The three groups were followed up at 3 months after treatment. The clinical curative effects of 3 treatment schemes were compared and analyzed. Results： The cure rates （91.30%-95.73%） all were high in the 3 groups, without no difference （P〉0.05）. Cumulative recurrence rate in group B and C was lower than in group A （P〈0.05）, and it was lower in group C than in group B （P〈0.05） during the follow-up. After treatment, the average courses of reconstructing the vaginal micro ecological balance was 3.53, 5.18 and 7.43 for initial BV patients, BV patients of BV history and patients of recurrence BV （P〈0. 05）. Conclusions： There was high recurrence rate of bacterial vaginal disease treated with antibiotics alone. Combination treatment with Lactobacillus preparation can effectively reduce the recurrence rate. The proper extension of Lactobacillus treatment time and complete recovery of vaginal micro ecological balance can significantly reduce the recurrence rate of BV. There was a positive correlation between the frequency of BV and the time required to reconstruct the vaginal micro ecological balance. Therefore, we should pay attention to every BV treatment.