阴道冲洗行为对阴道内菌群分布的影响分析

Relationship between vaginal douching behavior and bacterial vaginosis and sexually transmitted diseases

目的:探讨阴道冲洗行为与细菌性阴道炎和性传播疾病的关系。方法:选取100名生育年龄的妇女,其中有0~2个性伴侣的女性75名,有3个或3个以上性伴侣女性25名,让她们使用冲洗产品进行阴道冲洗,并分三个阶段进行观察。第一阶段定为时间是4周的冲洗阶段,第二阶段定为时间是10周的停止冲洗阶段,第三个阶段定为时间是4周的自主选择阶段,让观察者自主选择继续冲洗还是停止冲洗。在最初的14周中,每个观察者每周去医院进行2次阴道样本采集,从第15周开始每个观察者每周来医院进行1次阴道样本采集,分别观察三个阶段低性伴侣女性细菌性阴道炎的患病情况和多性伴侣女性的性传播疾病的患病情况。结果:在第一阶段和第二阶段期间,细菌性阴道炎的平均评分为(2.11±0.52)分和(1.89±0.23)分,无统计学差异(P>0.05)。第三个阶段共有156个样本选择继续冲洗,244个样本选择停止冲洗。继续冲洗者的细菌性阴道炎评分显著高于停止冲洗者(P<0.05)。继续冲洗样本的阴道炎菌群检出数显著多于停止冲洗样本(P<0.05)。结论:过度的阴道冲洗并不能有效地阻止感染的发生,当停止阴道冲洗时,乳酸内环境恢复,感染明显下降。故合理进行阴道冲洗,积极控制感染,帮助建立乳酸内环境,才是治疗和预防疾病的关键。

Objectives： To investigate the clinical relationship between vaginal douching behavior and bacterial vaginosis and sexually transmitted diseases. Methods： 100 women of reproductive age,including 75 women with 0- 2 sexual partners and 25 women with 3 or more sexual partners were selected and conducted vaginal douching which was divided into three stages. The first stage was 4 weeks for vaginal douching; the second stage was 10 weeks to stop douching and the third stage were another 4 weeks for subjects to self- determine whether to continue douching or not.In the first 14 weeks,each subject went to the hospital twice a week to collect vaginal samples and from the 15 thweek they went once a week. The bacterial vaginosis prevalence of female with no more than 2 sexual partners and the prevalence of sexually transmitted diseases of women with no fewer than 3 sexual partners was observed. Results： 81 women were valid in the study,including 58 ones with no more than 2 sexual partners and 23 ones with no fewer than3 sexual partners. For the 58 women with few sexual partners,the prevalence of bacterial vaginosis was higher in the first stage,while the prevalence of sexually transmitted diseases among the 23 women with more sexual partner was higher in the first stage,which reduced when vaginal douching was stopped. Conclusion： Excessive vaginal douching cannot effectively prevent infection,and the infection decreases when the vaginal douching was stopped because of the recovery of lactic acid environment. Therefore,the rational use of vaginal douching and active infection control is the key to the prevention and treatment of infection by helping establish suitable lactic acid environment.