从“滋阴补肾论”中药方六味地黄汤对细菌性阴道炎(阴虚内热型)疗效、阴道菌群、免疫功能影响探究

Influence of "Nourishing Yin and Tonifying Kidney Theory" Prescription Liuwei Dihuang Decoction(六味地黄汤) on Curative Effect,Vaginal Flora and Immune Function of Patients with Bacterial Vaginitis(Yin Deficiency and Internal Heat Type)

目的 观察细菌性阴道炎(阴虚内热型)采取从“滋阴补肾论”中药方六味地黄汤治疗效果。方法 纳入细菌性阴道炎(阴虚内热型)患者107例(2019年5月—2021年7月收治),将纳入的107例患者以随机数字表法分成参照组与治疗组,参照组53例患者,采取甲硝唑片+苯扎溴铵溶液外阴清洗治疗,治疗组54例患者甲硝唑片+苯扎溴铵溶液外阴清洗+中药方六味地黄汤治疗,数据观察:疗效、细菌学效果、治疗前后中医证候积分(阴道灼感、白带量少、外阴瘙痒、心烦易怒、头晕眼花、口干尿赤等)变化、症状消失时间(白带减少、外阴瘙痒、阴道疼痛等)、血清C反应蛋白(CRP)及白介素4(IL-4)、白介素6(IL-6)水平变化、阴道微生态情况及阴道菌群分布情况、阴道免疫细胞功能变化、性生活质量(FSFI)评分变化、不良反应。结果 参照组患者治疗总有效率为96.30%(52/54),治疗组患者治疗总有效率为83.02%(44/53)(P<0.05)。治疗组患者细菌清除率(96.30%,52/54)高于参照组(83.02%,44/53),细菌再感染率(0.00%)低于参照组(7.55%,4/53)(P<0.05)。治疗组患者症状消失时间(白带减少、外阴瘙痒、阴道疼痛等)均比参照组短(P<0.05)。比较两组患者治疗前中医证候积分(阴道灼感、白带量少、外阴瘙痒、心烦易怒、头晕眼花、口干尿赤等)、CRP及IL-4、IL-6水平、阴道微生态情况及阴道菌群分布情况、阴道免疫细胞功能指标、FSFI评分等指标(P>0.05),治疗后两组患者中医证候积分(阴道灼感、白带量少、外阴瘙痒、心烦易怒、头晕眼花、口干尿赤等)、CRP及IL-4、IL-6水平、阴道微生态情况及阴道菌群分布情况、阴道免疫细胞功能指标、FSFI评分等指标均改善,与参照组比较,治疗组治疗后中医证候积分(阴道灼感、白带量少、外阴瘙痒、心烦易怒、头晕眼花、口干尿赤等)、CRP及IL-4、IL-6水平、阴道微生态情况及阴道菌群分布情况、阴道免疫细胞功能指标、FSFI评分等指标更佳(P<0.05)。治疗组见1例恶心,参照组见1例头晕,1例呕吐(P<0.05)。结论 细菌性阴道炎(阴虚内热型)采取从“滋阴补肾论”中药方六味地黄汤治疗效果佳,安全可靠,患者阴道菌群情况及阴道免疫功能改善,值得应用。

Objective To observe the effect of Liuwei Dihuang Decoction(六味地黄汤) in the treatment of bacterial vaginitis(Yin deficiency and internal heat type).Methods A total of 107 patients with bacterial vaginitis(Yin deficiency and internal heat type) were included(admitted from May 2019 to July 2021).The patients were divided into the reference group and the treatment group by random number table method.In the reference group,53 patients were treated with metronidazole tablets+benzalkonium bromide solution vulva cleaning.In the treatment group,54 patients were treated with metronidazole tablets+benzalkonium bromide solution vulva cleaning+Liuwei Dihuang Decoction.The efficacy,bacteriological effect,changes of traditional Chinese medicine syndrome scores before and after treatment(vaginal burning,less leucorrhea,pruritus vulvae,irritability,dizziness,dry mouth and red urine,etc.),time for symptoms to disappear(reduced leucorrhea,pruritus vulvae,vaginal pain,etc.),serum C-reactive protein(CRP),interleukin 4(IL-4),interleukin 6(IL-6),vaginal microecology,vaginal microflora distribution,vaginal immune cell function,female sexual function index(FSFI) score and adverse reactions were observed.Results The total effective rate was 96.30%(52/54) in the treatment groupand 83.02%(44/53) in the reference group(P0.05).After treatment,traditional Chinese medicine syndrome scores(vaginal burning,less leucorrhea,genital pruritus,irritability,dizziness,dry mouth and urine redness,etc.),levels of CRP,IL-4 and IL-6,vaginal microecology and vaginal microflora distribution,vaginal immune cell function index,FSFI score and other indicators were improved in two groups.Compared with those of the reference group,in the observation group,traditional Chinese medicine syndrome scores(vaginal burning,less leucorrhea,genital pruritus,irritability,dizziness,dry mouth and urine redness,etc.),levels of CRP,IL-4 and IL-6,vaginal microecology and vaginal microflora distribution,vaginal immune cell function index,FSFI score and other indicators were better(P<0.05).There was 1 case of nausea in the treatment group,1 case of dizziness and 1 case of vomiting in the reference group(P<0.05).Conclusion For bacterial vaginitis(Yin deficiency and internal heat type),the effect of Liuwei Dihuang Decoction from “nourishing Yin and tonifying kidney theory” is good,safe and reliable,and the patients’ vaginal flora and vaginal immune function can be improved.It is worthy of application.