念珠菌性阴道炎复发时采用氟康唑联合克霉唑治疗的临床意义探讨

Investigation on the Clinical Significance of Fluconazole Combined with Clotrimazole in the Treatment of Recurrent Candida Vaginitis

目的:观察在念珠菌性阴道炎复发时采用氟康唑联合克霉唑治疗的临床意义。方法:将笔者所在医院妇科门诊2015年1-12月收治的念珠菌性阴道炎复发患者200例,随机分为对照组(100例)与联合组(100例),对照组采取氟康唑口服,联合组在对照组基础上联合克霉唑阴道给药。对照两组治疗前后阴道分泌物pH值与症状消失时间,停药后3、6、12个月进行随访,对比两组的疗效及复发率。结果:治疗后联合组阴道分泌物pH值明显低于对照组,各症状消失时间均明显早于对照组(P<0.05)。停药后3个月联合组与对照组总有效率分别为93.00%、81.00%,复发率分别为5.00%、11.00%;停药后6个月联合组与对照组总有效率分别为91.00%、77.00%,复发率分别为5.00%、13.00%;停药后12个月联合组与对照组总有效率分别为87.00%、73.00%,复发率分别为9.00%、22.00%。联合组停药后3、6、12个月的总有效率及复发率均优于对照组,差异均有统计学意义(P<0.05)。结论:念珠菌性阴道炎复发时采用氟康唑联合克霉唑,即外用与口服相结合的治疗方式,可明显改善患者阴道分泌物pH水平,缩短病程,提高停药后的临床效果,降低复发率。

Objective:To observe the clinical significance of Feconazole combined with Clonazole in the treatment of recurrent candida vaginitis.Method:From January to December 2015,200 patients with recurrent candida vaginitis who were admitted to the gynecological department of our hospital were randomly divided into the control group(100 cases) and the combined group(100 cases).The control group received oral administration of Fluconazole,and the combined group received vaginal administration of Clotrizole on the basis of the control group.The pH value of vaginal secretions before and after treatment and the time of symptom disappearance were compared between the two groups.The total effective rate and recurrence rate of patients in the two groups were observed and compared at 3,6 and 12 months after treatment discontinuation.Result:After treatment,the combined group of the pH value of vaginal secretions was lower than that of the control group obviously,and the time of symptom disappearance were significantly shorter than those of the control group(P<0.05).Three months after drug withdrawal,the total effective rate of the combined group and the control group were 93.00% and 81.00% respectively,and the recurrence rate were5.00% and 11.00% respectively.Six months after drug withdrawal,the total effective rate of the combined group and the control group were 91.00% and 77.00%respectively,and the recurrence rate were 5.00% and 13.00% respectively.Twelve months after drug withdrawal,the total effective rate of the combined group and the control group were 87.00% and 73.00% respectively,and the recurrence rate were 9.00% and 22.00% respectively.The differences were statistically significant(P<0.05).Conclusion:In patients with recurrent candida vaginitis,the combination of Fluconazole and Clotrizole,namely the combination of topical use and oral administration,can significantly improve the pH level of patients’ vaginal secretions,shorten the course of disease,improve the treatment effect after drug withdrawal,and reduce the recurrence rate.