甲硝唑对阴道炎患者阴道分泌物病原体分布的影响

Effects of metronidazole on the distribution of pathogens in vaginal secretions of patients with vaginitis

目的观察甲硝唑对阴道炎患者阴道分泌物病原体分布及肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平的影响。方法将阴道炎患者60例,随机分为对照组和试验组,各30例。对照组患者给予制霉菌素片,每次50万~100万U,每天3次,口服;试验组在对照组基础上给予甲硝唑片,每次400 mg,每天2次,口服。2组均连续治疗12 d。检测所有患者阴道分泌物病原体分布情况及构成比;比较2组患者治疗前后阴道分泌物中TNF-α、IL-6、IL-8水平;比较2组患者治疗期间药物不良反应发生情况。结果治疗后,对照组临床总有效率为60.00%,试验组为90.00%,差异有统计学意义(P<0.05)。治疗后,对照组与试验组TNF-α水平分别为(8.37±1.06),(5.43±1.21)ng·mL^-1;IL-6水平分别为(10.52±3.24),(6.21±2.04)pg·mL^-1;IL-8水平分别为(12.25±1.43),(7.16±3.22)pg·mL^-1,差异均有统计学意义(均P<0.05)。对照组出现恶心1例,眩晕1例,口中金属味1例,药物不良反应发生率为10.00%;试验组出现恶心2例,眩晕1例,口中金属味1例,药物不良反应发生率为13.33%。2组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论女性阴道分泌物病原体构成较为复杂,以细菌性阴道炎和霉菌性阴道炎发病率最高,甲硝唑治疗阴道炎疗效显著,可明显抑制炎症反应,且安全性好。

Objective To investigate the effects of metronidazole on the distribution of vaginal secretion pathogens and the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in patients with vaginitis.Methods Sixty patients with vaginitis were randomly divided into control group and treatment group,with 30 cases in each group.Control group was given nystatin tablets,5.0×105-1.0×106 u,3 times·d-1,oral;treatment group was given metronidazole tablets 400 mg·times-1,on the basis of control group,twice a day,oral.Both groups were treated continuously for 12 d.The vaginal secretion pathogen distribution and composition ratio in all patients were detected;the levels of TNF-α,IL-6 and IL-8 in vaginal secretions before and after treatment in two groups were compared;the incidence of adverse drug reactions during the treatment was compared between the two groups.Results After treatment,the total clinical effective rate in control group was60.00%,which in treatment group was 90.00%,with significant difference(P<0.05).After treatment,the levels of TNF-αin control group and treatment group were(8.37±1.06)and(5.43±1.21)ng·mL^-1;the levels of IL-6 were(10.52±3.24)and(6.21±2.04)pg·mL^-1;the levels of IL-8 were(12.25±1.43),(7.16±3.22)pg·mL^-1,all with significant difference(all P<0.05).There were 1 case of nausea,1 case of dizziness,1 case of metallic taste in mouth in control group,the incidence of adverse drug reactions was 10.00%.There were 2 cases of nausea,1 case of dizziness,1 case of metallic taste in mouth in treatment group,the incidence of adverse drug reactions was 13.33%.There was no significant difference in the incidence between the two groups(P>0.05).Conclusion The composition of vaginal secretion pathogens in women was more complicated,bacterial vaginitis and fungal vaginitis had the highest incidence,metronidazole had a significant effect on the treatment of vaginitis,it can obviously inhibit the inflammatory reaction,with good safety.