甲硝唑凝胶联合普罗雌烯乳膏治疗绝经后萎缩性阴道炎的临床疗效分析

Clinical Effect Analysis of Metronidazole Gel Combined with Promestriene Ointment on Postmenopausal Atrophic Vaginitis

目的:探讨甲硝唑凝胶联合普罗雌烯乳膏治疗绝经后萎缩性阴道炎的临床疗效。方法:选取2018年9月~2020年11月本院妇科门诊治疗绝经后萎缩性阴道炎的患者166例为研究对象,采用随机数字表法分为观察组(甲硝唑凝胶+普罗雌烯乳膏)和对照组(甲硝唑凝胶),每组83例。观察组:每日晨起普罗雌烯乳膏涂抹阴道及外阴1次,睡前阴道放置甲硝唑凝胶1支;对照组:每晚睡前放置甲硝唑凝胶1支。14天为1个疗程,两组分别于14和30天复查。观察两组患者临床症状(阴道瘙痒、白带增多、白带异味、阴道烧灼痛)、阴道清洁度、临床症状好转时间、血清雌二醇水平、子宫内膜厚度、30天后复查情况。结果:观察组治疗总有效率高于对照组(98.8%vs 84.3%,P<0.05);观察组实验室清洁度检查指标高于对照组(95.2%vs 77.1%,P<0.05);观察组临床症状好转时间短于对照组,中位时间分别为7.0(5.75~12.00)和12.87(11.10~15.89)天(P<0.05);治疗前后观察组及对照组血清雌二醇的浓度和子宫内膜厚度无统计学差异(P>0.05);观察组复发率[8.4%(7/83)]低于对照组[34.9%(29/83),P<0.05]。结论:甲硝唑凝胶联合普罗雌烯乳膏治疗绝经后萎缩性阴道炎疗效较好,几乎不吸收入血,安全性高且不易复发。

Objective:To investigate the clinical effect of metronidazole gel combined with promestriene ointment in treating atrophic vaginitis.Methods:A total of 166 patients with postmenopausal atrophic vaginitis treated in gynecological outpatient department of our hospital from September 2018 to November 2020 were analyzed and randomly divided into observation group and control group,83 cases in each group.The observation group was applied with metronidazole gel combined with promestriene ointment,and promestriene ointment was applied to the vagina and vulva once every morning,and one metronidazole gel was applied to the vagina before bedtime.The control group was applied with metronidazole gel,which was placed before bedtime every night.14 d was one course of treatment.Reexamination was performed on day 14 and day 30 respectively.Clinical symptoms(vaginal pruritus,increased leucorrhea,peculiar smell of leucorrhea,vaginal burning pain),vaginal cleaning,time of improvement of clinical symptoms,serum estradiol level,endometrial thickness and the situation of reexamined on day 30 of 2 groups were observed.Results:After treatment,total effective rate of the observation group was significantly higher than that of the control group(98.8%vs 84.3%,P<0.05);the cleanliness of the observation group was significantly higher than that of the control group(95.2%vs 77.1%,P<0.05);the improvement time of clinical symptoms in observation group was significantly shorter than that in control group,median time was respectively 7.0(5.75~12.00)days and 12.87(11.10~15.89)days(P<0.05).There was no statistically significance in the serum estradiol concentration and endometrial thickness of the observation group and the control group before and after treatment(P>0.05).The recurrence rates in the observation group and the control group were 8.4%(7/83)and 34.9%(29/83)respectively.The recurrence rate in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Metronidazole gel combined with promestriene ointment has obvious curative effect in treating atrophic vaginitis,with little absorption into the blood,high safety and not easy to relapse.