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目的对300例细菌性阴道病(Bacterial Vaginosis,BV)患者随机使用甲硝唑(100例)、乳杆菌活菌制剂定君生(100例)及甲硝唑联合定君生(100例),观察乳杆菌在阴道内定植情况及用药前后阴道内微生物多样性的变化,为临床治疗细菌性阴道病提供实验依据。方法分别提取300例BV患者用药前和用药后的阴道微生物总基因组DNA,以德氏乳杆菌16S rDNA特异性引物进行PCR,检测患者用药后德氏乳杆菌在阴道内的定植情况。以细菌16S rRNA V3区通用引物进行PCR,扩增产物进行变性梯度凝胶电泳(DGGE),对所得指纹图谱进行分析,研究用药对微生态变化的影响状况。结果甲硝唑治疗组用药前后均没有德氏乳杆菌检出;定君生治疗组用药后德氏乳杆菌检出率为54%;甲硝唑联合定君生治疗组用药后德氏乳杆菌检出率为76%。甲硝唑治疗组用药后微生物多样性显著降低,微生物群结构失衡;定君生治疗组用药后微生物多样性有所降低,微生物群结构无显著差异;甲硝唑联合定君生治疗组用药后微生物多样性降低,但较前两组有所增加,微生物群结构差异无统计学意义。结论甲硝唑显著降低BV患者阴道微生物多样性,引起微生态失衡;定君生对BV患者阴道微生态的影响明显小于甲硝唑;定君生的使用有利于甲硝唑干预后阴道微生物多样性的恢复和微生态平衡的重建。
Objective To investigate the efficacy and safety of metronidazole (100 cases), Lactobacillus active preparation (100 cases), and metronidazole combined with prednisone (100 cases) in 300 patients with Bacterial Vaginosis (BV) Lactobacillus observed intravaginal colonization and changes in vaginal microbial diversity before and after treatment for clinical treatment of bacterial vaginosis provide experimental evidence. Methods The total genomic DNA of vaginal microorganisms in 300 patients with BV before and after drug administration were respectively extracted. PCR was carried out using 16S rDNA specific primer of Lactobacillus delbrueckii to detect the colonization of Lactobacillus delbrueckii in the vagina. PCR was carried out using the universal primers of bacterial 16S rRNA V3 region. The products of amplification were subjected to denaturing gradient gel electrophoresis (DGGE). The fingerprint of the obtained fingerprints was analyzed to study the influence of the drugs on the micro-ecological changes. Results Metronidazole treatment group before and after treatment did not detect Lactobacillus delbrueckii; Dingjun treatment group after treatment with Lactobacillus delbrueckii was 54%; metronidazole combined Dingjun treatment group after treatment with Lactobacillus delbrueckii The detection rate was 76%. Metronidazole treatment group after treatment significantly reduced microbial diversity, microbial structure imbalance; Dingjun treatment group after treatment microbial diversity decreased, the structure of the microbiota no significant difference; metronidazole combined with Dingjun treatment group after treatment Microbial diversity decreased, but increased compared with the previous two groups, but there was no significant difference in microbial population structure. Conclusions Metronidazole significantly reduces vaginal microbial diversity in BV patients and causes microecological imbalance. The effect of Dingjunsheng on vaginal microecology in patients with BV is significantly less than that of metronidazole. The use of Ding Jun students is beneficial to the diversity of vaginal microorganisms after metronidazole intervention Sexual restoration and microecological balance reconstruction.