文献类型：期刊文献

中文题名：中药序贯疗法联合克霉唑阴道膨胀栓治疗复发性外阴阴道假丝酵母菌病脾虚夹湿热证临床研究

英文题名：Clinical Study on Sequential Therapy of Chinese Medicine Combined with Clotrimazole Vaginal Swelling Suppositories in the Treatment of Recurrent Vulvovaginal Candidia?sis with Syndrome of Spleen Deficiency and Damp-Heat

作者：张瑞芳[1];武权生[2];王玮[1]

第一作者：张瑞芳

机构：[1]甘肃中医药大学附属医院,甘肃兰州730030;[2]甘肃中医药大学,甘肃兰州730030

第一机构：甘肃中医药大学第二附属医院

年份：2025

卷号：57

期号：14

起止页码：96

中文期刊名：新中医

外文期刊名：New Chinese Medicine

基金：甘肃省中医医疗质量控制中心项目(002106001-2024)。

语种：中文

中文关键词：复发性外阴阴道假丝酵母菌病;脾虚证;湿热证;龙胆泻肝汤;完带汤;克霉唑阴道膨胀栓;阴道微生态;炎症因子

外文关键词：Recurrent vulvovaginal candidiasis;Spleen deficiency syndrome;Damp-heat syndrome;Longdan Xiegan Decoction;Wandai Decoction;Clotrimazole Vaginal Swelling Suppositories;Vaginal microecology;Inflammatory factors

摘要：目的:观察中药序贯疗法联合克霉唑阴道膨胀栓治疗复发性外阴阴道假丝酵母菌病(RVVC)脾虚夹湿热证的临床疗效。方法:选取2023年5月—2024年5月在甘肃中医药大学附属医院就诊的60例RVVC脾虚夹湿热证患者,采用随机数字表法分为对照组和研究组各30例。对照组予以克霉唑阴道膨胀栓治疗,连续治疗2周。研究组在对照组基础上给予中药序贯疗法治疗(经前口服龙胆泻肝汤1周,经后口服完带汤2周)。比较2组外阴阴道症状体征(VSS)评分、阴道微生态指标、血清炎症因子及复发率。结果:治疗后,2组VSS评分均较治疗前降低,研究组VSS评分低于对照组,差异均有统计学意义(P<0.05)。2组pH值4.0~4.4、清洁度Ⅰ~Ⅱ度、菌群密集度Ⅱ~Ⅲ级、优势菌为乳杆菌及过氧化氢酶阴性占比均较治疗前升高,研究组上述5项阴道微生态指标占比均高于对照组,差异均有统计学意义(P<0.05)。2组血清白细胞介素-6(IL-6)、γ-干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平均较治疗前降低,研究组血清IL-6、IFN-γ、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后14天、1个月,2组复发率比较,差异均无统计学意义(P>0.05)。治疗后3个月、6个月,研究组复发率均低于对照组,差异均有统计学意义(P<0.05)。结论:中药序贯疗法联合克霉唑阴道膨胀栓在缓解RVVC脾虚夹湿热证患者的症状体征、恢复阴道微生态、降低炎症因子水平和复发率方面均优于单独使用克霉唑阴道膨胀栓治疗。
Objective:To observe the clinical efficacy of sequential therapy of Chinese medicine combined with Clotrimazole Vaginal Swelling Suppositories in the treatment of recurrent vulvovaginal candidiasis(RVVC)with the syndrome of spleen deficiency and damp-heat.Methods:Sixty patients with RVVC of the syndrome of spleen deficiency and damp-heat who visited the Affiliated Hospital of Gansu University of Chinese Medicine from May 2023 to May 2024 were selected and divided into the control group and the study group by the random number table method,with 30 cases in each group.The control group was treated with Clotrimazole Vaginal Swelling Suppositories for two consecutive weeks.The study group was given sequential therapy of Chinese medicine on the basis of the control group(oral Longdan Xiegan Decoction for one week before menstruation and oral Wandai Decoction for two weeks after menstruation).The Vulvovaginal Symptoms and Signs(VSS)scores,vaginal microecological indexes,serum inflammatory factors and recurrence rate were compared between the two groups.Results:After treatment,the VSS scores of both groups were lower than those before treatment,and the VSS scores of the study group were lower than those of the control group,with differences being significant(P<0.05).The proportions of pH value of 4.0-4.4,cleanliness of gradeⅠ-Ⅱ,microbial density of gradeⅡ-Ⅲ,dominant bacteria of Lactobacillus and negative catalase in both groups were higher than those before treatment,and the proportions of the above five vaginal microecological indexes in the study group were higher than those in the control group,with differences being significant(P<0.05).The levels of serum interleukin-6(IL-6),interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α)in both groups were lower than those before treatment,and the levels of serum IL-6,IFN-γ,and TNF-αin the study group were lower than those in the control group,with differences being significant(P<0.05).At 14 days and one month after treatment,there were no significant differences in the recurrence rate between the two groups(P>0.05).At three months and six months after treatment,the recurrence rate of the study group was lower than that of the control group,with differences being significant(P<0.05).Conclusion:Sequential therapy of Chinese medicine combined with Clotrimazole Vaginal Swelling Suppositories is superior to the use of Clotrimazole Vaginal Swelling Suppositories alone in relieving the symptoms and signs of patients with RVVC of the syndrome of spleen deficiency and damp-heat,restoring the vaginal microecology,reducing the levels of inflammatory factors and the recurrence rate.