文章摘要
参榆外洗剂联合克霉唑栓对单纯湿热下注型外阴阴道假丝酵母菌病中医证候、阴道微生态及灌洗液炎症因子的影响
The effect of Shenyu external lotion combined with clotrimazole suppository on vaginal microecology and inflammatory factors of lavage fluid in vulvovaginal candidiasis with simple damp-heat downward type.
投稿时间:2024-04-12  修订日期:2024-04-12
DOI:
中文关键词: 参榆外洗  克霉唑栓  外阴阴道念珠菌病  阴道微生态  细胞因子
英文关键词: shenyu lotion  Clotrimazole Suppositories  vulvovaginal candidiasis  Vaginal microecology  Lavage fluid cytokines
基金项目:浙江省中医药科技计划项目(项目编号:2023ZL316)
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中文摘要:
      【】 目的 探讨参榆外洗剂联合克霉唑栓对单纯湿热下注型外阴阴道假丝酵母菌病中医证候、阴道微生态及灌洗液炎症因子的影响。 方法 选取2022年12月至2023年12月在我院门诊首次未经治疗的单纯性湿热下注型外阴阴道假丝酵母菌病患者共90例,采用完全随机对照的设计方法进行随机分组,分成试验组(常规西医治疗的基础上加用参榆外洗剂)和对照组(常规西医治疗)各45例,分别治疗前和治疗后7天后进行中医证侯疗效评分及记录不良反应,治疗后3月随访复发率,留取阴道分泌物和阴道灌洗液标本,测定阴道微生态系统评分(PH值、清洁度、乳酸杆菌的分级、菌群密集度、菌群多样性、优势菌、白细胞酯酶、部分门冬酰胺蛋白酶和乙酰氨基葡糖苷酶)和阴道灌洗液炎症因子变化(IL-2、IL-6、INF-γ和TNF-α)。 结果   1)中医证候疗效评分及不良反应、复发率:试验组患者中医疗效治疗评分总有效率为97.78%,高于常规组患者88.89%,两者比较,P<0.05,试验组患者无不良反应,复发率试验组仅2.22%,对照组为11.11%,两者比较,P<0.05。 2)阴道微生态变化:治疗前,两组评分无差异(P﹥0.05),治疗后,与对照组相比,试验组阴道微生态评分较治疗前降低,P <0.05。3)阴道灌洗液炎症因子(IL-2、IL-6、INF-γ和TNF-α)变化 :治疗后,试验组患者阴道灌洗液炎症因子IL-2、TNF-α水平较对照组明显降低(P <0.05), IL-6较对照组有所升高(P <0.05),而INF-γ两组比较无明显改变。结论 临床采用参榆外洗剂联合克霉唑栓治疗纯湿热下注型外阴阴道假丝酵母菌病有助于改善患者医证候评分、阴道微生态指标及灌洗液细胞因子水平,无不良反应,复发率低,提高临床治疗效果,值得临床推广。
英文摘要:
      【】 Objective To explore the effect of Shenyu external lotion combined with clotrimazole suppository on vaginal microecology and inflammatory factors of lavage fluid in vulvovaginal candidiasis with simple damp-heat downward type.  Methods A total of 90 patients with mycotic vaginitis admitted from December 2022 to December 2023 were divided into control group and observation group by random numerical method, with 45 cases in each group. The experimental group was treated with Shenyu external  lotion combined with Lactobacillus vaginal capsul and the control group was treated with Lactobacillus vaginal capsules. The TCM syndrome score, adverse reactions, the recurrence rate was followed up for 3 months after treatment, and the vaginal discharge and vaginal lavage fluid samples were collected. Vaginal microecosystem score (including PH value, cleanliness, grading of Lactobacillus, density of flora, diversity of flora, dominant bacteria, leukocyte esterase, part of asparaginase and acetylglucosaminidase) and changes of inflammatory factors (IL-2, IL-6, INF-γ and TNF-α) in vaginal lavage fluid were measured . Results   1)TCM syndrome score, adverse reactions and recrrrent rate:The total effective rate of TCM treatment score in the experimental group was 97.78%, which was higher than that of the conventional group (88.89%),P<0.05. There were no adverse reactions in the experimental group. The recurrent rate of was 2.22% in the experimental group and 11.11% in the control group (P<0.05).   2) Changes in vaginal microecology: Before treatment, there was no difference between the two groups (P>0.05). After treatment, compared with the control group, the vaginal microecological score of the experimental group was lower than that before treatment(P<0.05). 3) Changes of inflammatory factors (IL-2, IL-6, INF-γ and TNF-α) in vaginal lavage fluid: After treatment, The levels of inflammatory factors IL-2 and TNF-α in vaginal lavage fluid in the experimental group were significantly lower than those in the control group (<0.05), IL-6 was higher than that in the control group (P<0.05), INF-γ had no significant change between the two groups. Conclusions Shenyu external lotion combined with clotrimazole suppository in the treatment of vulvovaginal candidiasis with pure damp-heat injection can help to improve the TCM syndrome score, vaginal microecological indicators and the level of some cytokines in lavage fluid, without adverse reactions, lower recurrent rate and improve the therapeutic effect, which is worthy of clinical application.
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