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目的:探讨治疗复发性外阴阴道假丝酵母菌病(RVVC)的合适方法。方法:将106例RVVC患者分为A、B两组。A组54例,首月克霉唑栓500 mg每晚阴道给药,连用1周,同时氟康唑150 mg顿服,72 h加服1次,夫妇同服;次月起克霉唑栓500 mg阴道给药,每周1次,连用6个月。B组52例,首月治疗方法同A组,次月起克霉唑栓500 mg阴道给药,每周1次,同时氟康唑150 mg顿服,每周1次,连用6个月。结果:治疗3个月结束时,假丝酵母菌转阴率A组为87.0%,B组为88.5%;治疗6个月结束时,A组为83.3%,B组为80.8%,两组间转阴率差异无统计学意义(P>0.05)。治愈率、无效率和复发率A组分别为61.1%、20.4%和7.4%,B组分别为65.4%、19.2%和3.9%,两组间差异均无统计学意义(P>0.05)。肝功能损害、胃肠道反应和局部反应发生率A组分别为0、1.9%和13.0%,B组分别为13.5%、17.3%和15.4%,两组间肝功能损害、胃肠道反应发生率差异有统计学意义(P<0.05),局部反应发生率差异无统计学意义(P>0.05)。结论:克霉唑栓阴道用药配合首月加服氟康唑,治疗方法简单、副作用小,是目前治疗RVVC较为有效的措施。
Objective: To explore a suitable method for the treatment of recurrent vulvovaginal candidiasis (RVVC). Methods: 106 RVVC patients were divided into A and B groups. A group of 54 patients, the first month of clotrimazole suppository 500 mg per night vaginal administration, once a week, while fluconazole 150 mg Dayton clothing, 72 h plus 1, the same with the couple; the next month clotrimazole suppositories 500 mg vaginal administration, once a week, once every 6 months. Group B, 52 cases, the first month of treatment with the same group, the next month clotrimazole suppository 500 mg vaginal administration, once a week, while fluconazole 150 mg Dayton clothing, once a week, once every 6 months. Results: At the end of 3 months of treatment, Candida albicans negative rate was 87.0% in group A and 88.5% in group B; at the end of 6 months of treatment, 83.3% in group A and 80.8% in group B, There was no significant difference in negative conversion rate (P> 0.05). The cure rate, inefficiency and relapse rate were 61.1%, 20.4% and 7.4% respectively in group A and 65.4%, 19.2% and 3.9% in group B, respectively. There was no significant difference between the two groups (P> 0.05). The incidence of hepatic impairment, gastrointestinal reaction and local reaction were 0, 1.9% and 13.0% in group A, 13.5% in group B, 17.3% and 15.4% in group B, respectively. Liver function impairment and gastrointestinal reaction occurred in both groups (P <0.05). There was no significant difference in the incidence of local reactions between two groups (P> 0.05). Conclusion: Clotrimazole suppository vaginal medication with the first month plus fluconazole treatment is simple, small side effects, is the treatment of RVVC more effective measures.