制霉菌素联合小剂量甲硝唑治疗滴虫性阴道炎的临床疗效及对炎性因子水平的影响

Curative effect of nystatin combined with small dose of metronidazole in the treatment of trichomonal vaginitis and its effect on the levels of inflammatory factors

目的探讨制霉菌素联合小剂量甲硝唑治疗滴虫性阴道炎的临床疗效及对炎性因子水平的影响，为临床治疗提供参考依据。方法收集本院2014年1月至2016年5月收治的73例滴虫性阴道炎患者，根据随机数字表法分为两组：常规组35例给予小剂量甲硝唑治疗，观察组给予制霉菌素联合小剂量甲硝唑治疗。治疗10d后，比较两组患者的临床疗效、临床症状改善率、炎性因子水平及不良反应发生率；随访1个月后观察复发情况。结果治疗10d后，观察组总有效率明显高于常规组（P〈0．05）；观察组外阴瘙痒、黄色白带、白带臭味、自带过多改善率均明显高于常规组（P〈0．05）；观察组TNF-α、IL-6、IL-8和IL-13均明显低于常规组（P〈0．05l随访1个月后，观察组复发率明显低于常规组（P〈0．05）;2组患者不良反应发生率比较差异无统计学意义（P〉0．05）。结论制霉菌素联合小剂量甲硝唑治疗滴虫性阴道炎疗效显著，明显改善了患者临床症状和炎症反应，减少了短期复发的发生，且未加重不良反应。

Objective To investigate the curative effect of nystatin combined with small dose of metronidazole in the treatment of trichomonal vaginitis and its effect on the levels of inflammatory factors, to provide reference for clinical treatment. Methods 73 cases of trichomonal vaginitis in our hospital from January 2014 to May 2016 were collected, and were divided into 2 groups according to the random number table method. The conventional group （n=35） was treated with small dose of metronidazole, and the observation group （n=38） was treated with nystatin combined with small dose of metronidazole. After treatment of 10 d, the clinical effect, improvement rate of clinical symptoms, levels of inflammatory factors, and incidence of adverse reactions were compared between the 2 groups. All patients were followed up for 1 months, the recurrence of the 2 groups were observed. Results After treatment of 10 d, the total effective rate of the observation group was significantly higher than that of the conventional group （P〈0.05）; the improvement rate of genital itching, yellow vaginal discharge, vaginal odor, leukorrhagia in the observation group were significantly higher than those in the conventional group （P〈0.05）; the levels of TNF-α, IL-6, IL-8, and IL-13 in the observation group were significantly lower than those in the conventional group （P〈0.05）. After 1 month＇s follow-up, the recurrence rate of the observation group was significantly lower than that of the conventional group （P〈0.05）; there was no statistically significant difference in the incidence of adverse reactions between the 2 groups （P〉0.05）. Conclusions Nystatin combined with small dose of metronidazole in the treatment of trichomonal vaginitis has significant effect, which significantly improves the clinical symptoms and inflammatory reaction of patients, reduces the short-term recurrence, and does not increase adverse reactions.