改善年轻女性阴道微生态从而促进LSIL/CINI消退的临床分析

Clinical analysis of improving vaginal microecology in young women to promote LSIL/CINI regression

目的观察乳杆菌通过维持年轻女性阴道微生态平衡从而促进低度鳞状上皮内病变/子宫颈上皮内瘤变1级(low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia 1,LSIL/CINI)消退的临床疗效。方法选择2018年1月至2019年12月在福建中医药大学附属第二人民医院就诊的261例病理诊断LSIL/CINI年轻患者为研究对象,随机数字表法分为用药组125例和观察组136例,用药组给予乳杆菌治疗,观察组不予任何治疗,比较随访6个月、12个月宫颈病变的消退情况。结果随访6个月、12个月用药组消退率分别为29.6%和58.1%,明显高于观察组20.6%、47.8%(P<0.001);261例LSIL/CINI患者随访12个月137例消退,102例病变持续,22例进展。消退组阴道正常菌群构成比例82.48%,大于持续组54.9%、进展组40.91%(P<0.001);消退组菌群正常密集度、多样性分别为91.98%和93.43%,高于其它两组(持续组81.37%、66.67%;进展组36.36%、50%),差异均有统计学意义(P<0.001);3组pH值构成比(30.66%、32.35%、22.73%)和正常Nugent评分(59.85%、50.98%、36.36%)差异无统计学意义(P>0.05)。结论临床上给予LSIL/CINI年轻患者乳杆菌治疗,可改善阴道微生态,提高宫颈病变转归率,值得推广。

Objective To observe the clinical efficacy of Lactobacillus to promote the regression of low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia 1(LSIL/CINI) by maintaining vaginal microecological balance in young women.Methods A total of 261 young patients with pathological diagnosis of LSIL/CINI who were treated in the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2018 to December 2019 were selected as the research subjects.They were randomly divided into a medication group of 125 cases and an observation group of 136 cases.The medication group was given Lactobacillus treatment, and the observation group was not given any treatment.The regression of cervical lesions was compared at 6 months and 12 months follow-up.Results The regression rates of the medication group at 6 months and 12 months follow-up were 29.6% and 58.1%,respectively, which were significantly higher than 20.6% and 47.8% of the observation group(P<0.001);Of the 261 LSIL/CINI patients, 137 had regressed, 102 had persistent lesions, and 22 had progressed after 12 months of follow-up.The proportion of normal vaginal flora in the regression group was 82.48%,higher than that in the persistent group(54.9%),and the progression group(40.91%)(P<0.001);The normal density and diversity of the microflora in the regression group were 91.98% and 93.43%,respectively, which were higher than those in the other two groups(81.37% and 66.67% in the persistent group;36.36% and 50% in the progressive group),and the differences were statistically significant(P<0.001);There was no significant difference in pH composition ratio(30.66%,32.35%,22.73%) and normal Nugent score(59.85%,50.98%,36.36%) among the three groups(P>0.05).Conclusion Clinical treatment of Lactobacillus in young patients with LSIL/CINI can improve vaginal microecology and improve the prognosis rate of cervical lesions, which is worthy of promotion.