伊曲康唑联合制霉菌素治疗复发性阴道假丝酵母病疗效

Clinical efficacy of itraconazole combined with nystatin in treatment of recurrent vaginal candidiasis

目的探究伊曲康唑联合制霉菌素局部用药对复发性阴道假丝酵母病(RVVC)患者炎症因子及T淋巴细胞改变的影响。方法选择三亚市中医院妇产科2018年5月-2019年6月确诊为RVVC的患者120例作为研究对象,随机分为研究组(n=60)及对照组(n=60),对照组接受制霉菌素片研磨后阴道给药治疗,研究组在此基础上接受口服伊曲康唑胶囊的治疗,对两组患者治疗前,治疗后1周、1月、3月进行阴道假丝酵母病(VVC)评分,治疗3月后疗效、阴道分泌物炎性因子白介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)及免疫细胞CD_4^+(%)、CD_8^+(%)、CD_4/CD_8水平进行检测。结果两组患者病原培养结果均以白假丝酵母为主;初次治疗后第一次复查、第二次复查、第三次复查VVC评分均不断降低,研究组均低于对照组,差异具有统计学意义(P<0.05);研究组总有效率高于对照组(P<0.05);治疗3个月后两组患者IL-6、IL-10、TNF-α水平均下降,研究组IL-6、IL-10、TNF-α水平低于对照组(P<0.05);治疗3个月后,两组患者CD_4^+(%)、CD_4/CD_8水平均上升,CD_8^+(%)水平下降,研究组CD_4^+(%)、CD_4/CD_8水平高于对照组,CD_8^+(%)水平低于对照组(P<0.05)。结论伊曲康唑联合制霉菌素局部用药对复发性阴道菌具有良好的临床效果,可有效恢复患者阴道炎症因子及免疫细胞水平。

OBJECTIVE To explore the effects of itraconazole combined with nystatin on changes of inflammatory factors and T lymphocyte of the patients with recurrent vaginal candidiasis(RVVC).METHODS A total of 120 patients who were diagnosed with RVVC in the Obstetrics and Gynecology Department of Sanya City Hospital of Traditional Chinese Medicine from May 2018 to Jun.2019 were recruited as the study objects and randomly divided into the study group with 60 cases and the control group with 60 cases.The control group was treated with vaginal administration of nystatin tablets after grinding,while the study group was given additional oral administration of itraconazole capsules on basis of the treatment of the control group.Vaginal candidiasis(VVC)scoring was performed for the two groups of patients before the treatment and after the treatment for 1 week,1 month and 3 months.After the treatment for 3 months,the curative effect was observed,and the levels of inflammatory factors of vaginal secretions interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and immune cells CD4+(%),CD8+(%)and CD4/CD8 were detected.RESULTS Candida albicans was dominant among the pathogens isolated from the two groups of patients.The VVC scores of the first reexamination,second reexamination and third reexamination were constantly reduced after the initial treatment,which were significantly lower in the study group than in the control group(P<0.05);the total effective rate of the study group was significantly higher than that of the control group(P<0.05).The levels of IL-6,IL-10 and TNF-αof the two groups of patients were significantly reduced after the treatment for 3 months,the levels of IL-6,IL-10 and TNF-αof the study group were significantly lower than those of the control group(P<0.05).The levels of CD4+(%)and CD4/CD8 of the two groups of patients were significantly elevated after the treatment for 3 months,the CD8+(%)level was reduced;the levels of CD4+(%)and CD4/CD8 of the study group were significantly higher than those of the control group,and the CD8+(%)level of the study group was significantly lower than that of the control group(P<0.05).CONCLUSION Itraconazole combined with nystatin can achieve significantly clinical effect on treatment of RVVC and facilitate the recovery of vaginal inflammatory factors and immune cells of the patients.