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目的初步探讨阴道用乳杆菌活菌联合抗真菌药物在治疗重度外阴阴道假丝酵母菌病(VVC)和预防其复发中的临床作用。方法选取2012年1月至2012年12月就诊于柳州市人民医院确诊为重度VVC的患者共118例,随机分为研究组59例,对照组59例,对照组于第1、第4天阴道放克霉唑阴道片0.5g,联合口服伊曲康唑胶囊0.2 g,qd,连用7 d;研究组上述治疗后阴道继续放阴道用乳杆菌活菌0.25 g,qn,连用14 d;分别于停药后7~14 d、28~35 d及2个月复查,观察近期、远期疗效及是否有复发。结果停药后7~14 d,研究组有效率为91.53%,对照组效率为86.44%,两组比较差异无统计学意义(P>0.05);停药后28~35 d,研究组有效率为98.21%,对照组效率为87.75%,两组比较差异有统计学意义(P<0.05);2个月后随访,研究组复发率为0%,对照组为10.53%,两组比较差异有统计学意义(P<0.05)。结论重度VVC在抗真菌治疗后给予阴道放乳杆菌活菌可提高远期疗效,减少复发。
Objective To investigate the clinical effect of vaginal Lactobacillus combined with antifungal agents in the treatment of severe vulvovaginal candidiasis (VVC) and prevention of recurrence. Methods A total of 118 patients diagnosed as severe VVC from January 2012 to December 2012 in Liuzhou People’s Hospital were randomly divided into study group (59 cases) and control group (59 cases). The control group was on the 1st and 4th days Put clotrimazole vaginal tablets 0.5g, combined oral itraconazole capsules 0.2 g, qd, once every 7 d; the study group after treatment vaginal continued to live vaginal Lactobacillus 0.25 g, qn, once every 14 d; Seven to 14 days after discontinuation, 28 to 35 days and 2 months review, observe the short-term, long-term efficacy and whether there is recurrence. Results The effective rate was 91.53% in the study group and 86.44% in the control group after 7 to 14 days of withdrawal. There was no significant difference between the two groups (P> 0.05) (98.21%) in the control group and 87.75% in the control group, with significant difference between the two groups (P <0.05). After 2 months of follow-up, the recurrence rate was 0% in the study group and 10.53% in the control group Statistical significance (P <0.05). Conclusions Severe VVC given live vaginal Lactobacillus after antifungal treatment can improve long-term efficacy and reduce recurrence.