乳酸杆菌活菌胶囊治疗复发性外阴阴道白假丝酵母菌病的疗效及对阴道局部免疫功能的影响

Effect of Lactobacillus Living Bacterium Capsule on Vaginal Local Immune Function in the Treatment of Recurrent Vaginal Candida Albicans Disease

目的探讨乳酸杆菌活菌胶囊(Lactobacillus vaginal capsules,LVC)治疗复发性外阴阴道白假丝酵母菌病(recurrent vulvovaginal candidiasis,RVVC)的疗效及对阴道局部免疫功能的影响。方法抽选我院2010年2月~2016年3月收治的109例RVVC患者,随机分为对照组(n=54例,采用抗真菌药物强化和巩固治疗)和观察组(n=55例,在对照组基础上联合乳酸杆菌活菌胶囊),比较两组患者治疗前后阴道分泌物炎性指标(IL-6、TNF-α)、阴道局部细胞免疫功能(IL-4及IFN-γ浓度)变化、临床疗效及复发情况。结果两组治疗前白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)比较差异均无显著性(P>0.05);治疗后观察组患者IL-6和TNF-α水平明显低于对照组(P<0.05)。与治疗前相比,观察组治疗后阴道灌洗液IFN-γ及IL-4水平明显改善(P<0.05);对照组治疗前后IFN-γ及IL-4水平比较差异无统计学意义(P>0.05)。观察组治疗总有效率明显高于对照组(P<0.05)。两组患者复发率比较差异显著(P<0.05)。结论乳酸杆菌活菌胶囊能明显改善RVVC患者阴道清洁度及局部细胞免疫功能,降低复发率,有效提高RVVC的治疗疗效。

Objective To study the effect of LactobacHlus living bacterium Capsule on vaginal local immune function in the treatment of recurrent vaginal Candida albicans disease （RWC ）. Methods 109 cases of RWC patients in our hos-pital during February 2010 - March 2016 were randomly divided into the control group （n = 5 4 ） , receiving the consolidated treatment of antifungal drugs, and the observation group （n = 5 5 ） , treated with Lactobacillus living bacterium capsule on the basis of the treatment in the control group. The two groups were compared in terms of the changes of vaginal secretion of inflammatory indicators （ IL -6, TNF -α ） , vaginal local cellular immune function （ IL -4 and TNF - γ agamma concentration） , clinical efficacy and recurrence before and after treatment. Results There was no significant difference between the two groups in terms of IL - 6 and TNF - α （ P 〉 0. 05 ）. After treatment, the levels of IL - 6 and TNF - α in the observation group were significantly lower than those in the control group （ P 〈0. 05）. Compared with pre - treatment, IFN - γ and IL - 4 levels in the observation group after the treatment of vaginal lavage fluid were significantly improved （ P 〈 0. 05 ） , but there were no significant differences in IFN - γ and IL - 4 levels between the control group and the control group （ P 〉 0. 05 ）. The total effective rate of the observation group was significantly higher than that of the control group （ P 〈 0. 05 ） . The recurrence rate of the two groups was significantly different （ P 〈 0. 05 ） . Conclusion Lactobacillus living bacteria capsules can effectively improve the vaginal cleanliness and local cellular immune function of RW C patients, reduce the recurrence rate and improve the therapeutic efficacy of RWC