甲硝唑与乳杆菌活菌制剂对细菌性阴道病患者阴道微生物群的影响

Effects of Metronidazole and Live Lactobacillus Preparation on the Vaginal Microflora of Patients with Bacterial Vaginosis

目的分析甲硝唑与乳杆菌活菌制剂对细菌性阴道病患者阴道微生物群的影响。方法选取2019年1月~2020年1月我院接诊的98例细菌性阴道病患者为研究对象,采用随机数字表法分为对照组和观察组,各49例。对照组采用甲硝唑治疗,观察组应用乳杆菌活菌制剂治疗,比较两组临床治疗总有效率、治疗前后阴道菌群密集度和多样性以及复发率。结果观察组临床治疗总有效率为91.82%,与对照组的93.87%比较,差异无统计学意义(P>0.05);治疗后两组阴道菌群密集度Ⅰ级、Ⅱ级分布率均高于治疗前,Ⅲ级、Ⅳ级均低于治疗前,且观察组Ⅰ级分布率高于对照组,Ⅱ级分布率低于对照组,差异有统计学意义(P<0.05);治疗后两组阴道菌群多样性Ⅰ级、Ⅱ级分布率均高于治疗前,Ⅲ级、Ⅳ级均低于治疗前,且观察组Ⅰ级分布率高于对照组,Ⅱ级、Ⅲ级分布率低于对照组,差异有统计学意义(P<0.05);随访1个月,观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论甲硝唑与乳杆菌活菌制剂对细菌性阴道病均会影响阴道微生物群的密集度、多样性,但乳杆菌活菌制剂影响更显著,可促进阴道微生物群多样性和密集度的恢复,重建微生态平衡,有效降低复发率,具有临床应用的重要价值。

Objective To analyze the effects of metronidazole and live Lactobacillus preparation on the vaginal microbiota of patients with bacterial vaginosis.Methods A total of 98 patients with bacterial vaginosis admitted to our hospital from January 2019 to January 2020 were selected as the research objects.They were divided into a control group and an observation group using a random number table method,with 49 cases in each group.The control group was treated with metronidazole,and the observation group was treated with live Lactobacillus preparation.The total effective rate of clinical treatment,the density and diversity of vaginal flora before and after treatment,and the recurrence rate were compared between the two groups.Results The total effective rate of clinical treatment in the observation group was 91.82%.Compared with 93.87%in the control group,there was no significant difference(P>0.05).After treatment,the distribution rates of vaginal flora density grade I and II were higher than before treatment,grade III and Grade IV were lower than before treatment,and the distribution rate of gradeⅠin the observation group was higher than that in the control group,and the distribution rate of gradeⅡwas lower than that in the control group,the difference was statistically significant(P<0.05);diversity distribution rates of grade I and grade II were higher than before treatment,grades III and IV were lower than before treatment,and the distribution rate of grade I in the observation group was higher than that of the control group,and the distribution rates of grade II and grade III were lower than those of the control group,the difference was statistically significant(P<0.05);the recurrence rate of the observation group was lower than that of the control group after a 1-month follow-up,the difference was statistically significant(P<0.05).Conclusion Metronidazole and live Lactobacillus preparation can affect the density and diversity of vaginal microbiota for bacterial vaginosis,but the effect of live Lactobacillus preparation was more significant,which can promote the recovery of vaginal microbiota diversity and density,rebuilding the microecological balance,effectively reducing the recurrence rate,had important clinical application value.