定君生联合氟康唑序贯治疗重度外阴阴道假丝酵母菌病临床观察

Clinical Observation on Dingjunsheng Combined with Fluconazole in the Sequential Treatment of Severe Vulvovaginal Candidiasis

目的研究阴道用乳杆菌活菌胶囊(定君生)联合氟康唑序贯治疗重度外阴阴道假丝酵母菌病(SVVC)的疗效、安全性及对炎性因子水平的影响。方法选取广州医科大学附属第三医院2016年2月至2017年11月收治的SVVC患者107例,采取随机数字表法分为观察组(53例)和对照组(54例),观察组患者先给予氟康唑胶囊治疗1周,后序贯利用定君生胶囊治疗1周,对照组患者仅采用氟康唑胶囊治疗2周。结果观察组总有效率为79. 25%,显著高于对照组的31. 48%(χ2=24. 669,P <0. 01);治疗后,两组患者血清C反应蛋白(CRP)、白细胞介素6(IL-6)及肿瘤坏死因子-α(TNF-α)水平均明显下降(P <0. 05),观察组下降幅度均大于对照组(P <0. 05),且恢复至正常值;观察组真菌清除率为75. 47%,明显高于对照组的22. 22%(χ2=30. 361,P <0. 01);两组不良反应发生率相当(11. 32%比12. 96%,χ2=0. 068,P> 0. 05)。结论定君生联合氟康唑序贯治疗SVVC安全有效,能抑制阴道内假丝酵母菌的生长,并改善微生态环境,值得临床推广。

Objective To study the effiect and safety of Live Lactobacillus Capsule for Vaginal Use（Dingjunsheng） combined with flu- conazole in the sequential treatment of severe vulvovaginal candidiasis（SVVC） and its effect on inflammatory factors. Methods Totally 107 SVVC patients admitted to The Third Affiliated Hospital of Guangzhou Medical University from February 2016 to November 2017 were selected and divided into the observation group（53 cases） and the control group（54 cases） according to the random number table method. The patients in the observation group were treated with Fluconazole Capsules for 1 week and then treated by the sequential treatment of Dingjunsheng Capsules for 1 week. The patients in the control group were treated with Fluconazole Capsules for 2 weeks. Results The total effective rate of the observation group was 79.25% ,which was significantly higher than 31.48% of the control group（x2 =24. 669, P 〈 0.01）. After treatment,the levels of serum CRP,IL-6 and TNF-α in the two groups were significantly decreased（P 〈 0.05）,and the decrease in the observation group was more significant than that of the control group（P 〈 0.05）,and the levels of the above indexes returned to normal. The clearance rate of fungi in the observation group was 75.47% ,which was signif- icantly higher than 22.22% in the control group（x2=30.361, P 〈 0.01）.The incidence rate of adverse reactions in the two groups was similar（11.32% vs. 12.96% ,Xe = 0. 068, P 〉 0.05）. Conclusion Dingjunsheng combined with fluconazole in the sequential treat- ment of SVVC is safe and effective,it can inhibit the growth of vaginal Candida albicans,and improve the micro-ecological environment,which is worthy of clinical promotion.