龙胆泻肝汤联合西药治疗阴道炎(肝胆湿热)随机平行对照研究

Longdan Xiegan Decoction combined with Western Medicine in the Treatment of Vaginitis(Gandan Shire) Randomized Controlled Study

[目的]观察龙胆泻肝汤联合西药治疗阴道炎(肝胆湿热)疗效。[方法]使用随机平行对照方法,将128例患者按就诊顺序号方法随机分为两组。对照组64例甲硝唑,200mg/次,3次/d,高锰酸钾溶液(1∶5000),坐浴,1次/d;甲硝唑栓,1枚/次,睡前阴道置入。治疗组64龙胆泻肝汤:泽泻、龙胆草、柴胡、黄芩、栀子、当归各10g,车前子、生地黄各15g,木通8g,甘草6g,阴痒阴肿严重加白鲜皮10g,地肤子15g;带下黄浊臭秽加土荆皮8g,黄柏10g;热甚加白花蛇舌草、穿心莲、半枝莲各10g,七叶一枝花6g;白带量增多、色黄,味臭加蒲公英10g,土茯苓15g。水煎500mL,1剂/d,早晚分服;西药治疗同对照组。连续治疗5d为1疗程。观测临床症状、尿频、尿痛、阴道瘙痒、阴道分泌物、氨试验、阴道pH、阴道黏膜、不良反应。连续治疗4疗程(20d),判定疗效。随访6个月,观测复发率。[结果]治疗组痊愈34例,显效28例,无效2例,总有效率96.88%;对照组痊愈30例,显效24例,无效10例,总有效率84.88%;治疗组疗效优于对照组(P<0.05)。不良反应治疗组发生率4.96%低于对照组17.19%(P<0.05)。随访6个月,对照组复发8例(8/30,26.67%)高于治疗组1例(1/34,2.94%)(χ~2=5.133,P=0.015<0.05)。[结论]龙胆泻肝汤联合西药治疗阴道炎(肝胆湿热),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the Longdan Xiegan decoction combined with western medicine treatment of vaginitis curative effect （Gandan Shire）. [Methods] 128 patients were randomly divided into two groups by random parallel control method. The control group of 64 cases of metronidazole, 200 mg/times, 3 times/d, potassium permanganate （1：5000） solution, bath, 1 times/d; metronidazole suppositories, 1/times, before going to bed inside the vagina. The treatment group of 64 Longdan Xiegan decoction： Alisma, gentian, bupleurum, Scutellaria, gardenia, angelica, 10g, Plantago, Rehmannia 15g, Akebia 8g, licorice 6g, Yin Yin swollen badly with fresh white skin 10g, Kochia 15g; yellow leucorrhea foul plus Pseudolaricis 8g, cypress, 10g; very hot with Hedyotis diffusa, Scutellaria barbata, Andrographis, 10g, seven leaf flower 6g; leucorrhea increased, the color is yellow, smell and dandelion 10g, Poria 15g. The water was decocted 500mL, 1 doses of/d, early and evening, and western medicine was treated with the control group. The continuous treatment of 5d was 1 courses. Observation of clinical symptoms, frequent urination, dysuria, vaginal itching, vaginal secretions, ammonia test, vaginal pH, vaginal mucosa, adverse reaction. 4 courses of continuous treatment （20d） were used to determine the curative effect. The recurrence rate was observed for 6 months. [Results] In the treatment group, 34 cases were cured, 28 cases were markedly effective, 2 cases were invalid, the total effective rate was 96.88%, the control group was cured in 30 cases, markedly effective in 24 cases, ineffective in 10 cases, the total effective rate was 84.88%, and the treatment group was better than the control group （P〈0.05）. The incidence of adverse reaction in the treatment group was 4.96% lower than that of the control group （17.19%） （P〈0.05）. After 6 months of follow-up, 8 cases of relapse in the control group （8/30, 26.67%） were higher than those in the treatment group （1/34, 2.94%） （χ^2=5.133, P=0.0150.05）. [Conclusion] Longdan Xiegan decoction combined with western medicine treatment of vaginitis （the curative effect is satisfied, liver and gallbladder） without serious adverse reactions, worthy of promotion.