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目的:探讨治疗外阴阴道假丝酵母菌病(VVC)的药物对阴道常见乳杆菌生长的影响。方法:VVC患者随机分为3组,分别应用咪康唑(咪康唑组)、伊曲康唑(伊曲康唑组)、制霉菌素栓(制霉菌素组)进行治疗,治疗前、后分别进行乳杆菌Nugent评分,治疗后观察患者症状缓解时间、阴道pH值、乳杆菌数量及H2O2阳性乳杆菌的检出率等。结果:患者症状缓解时间、总有效率3组间差异无统计学意义(P>0.05)。3组乳杆菌Nugent评分均较治疗前有所降低,且伊曲康唑组乳杆菌Nugent评分显著高于咪康唑组和制霉菌素组,差异有统计学意义(P<0.05)。咪康唑组、伊曲康唑组、制霉菌素组中H2O2阳性的乳杆菌分别占30.0%、60.0%和25.0%,差异有统计学意义(P<0.05),伊曲康唑组H2O2阳性的乳杆菌的检出率显著高于其余2组,差异有统计学意义(P<0.05)。结论:伊曲康唑治疗VVC疗效确切,对阴道乳杆菌生长的影响较小,有助于维护阴道正常菌群,是一种治疗VVC较理想的抗真菌药物。
Objective: To investigate the effect of drugs for the treatment of vulvovaginal candidiasis (VVC) on the growth of common vaginal bacteria. Methods: The patients with VVC were randomly divided into three groups. The patients were treated with miconazole (miconazole group), itraconazole (group) and nystatin suppository (nystatin group) After Lactobacillus Nugent score were observed after treatment of patients with symptoms, vaginal pH value, the number of lactobacilli and H2O2-positive lactobacilli detection rate. Results: There was no significant difference in symptom relief time and total effective rate between the three groups (P> 0.05). The Nugent score of three lactobacilli groups was lower than that before treatment, and the Nugent score of itraconazole group was significantly higher than that of miconazole group and nystatin group (P <0.05). Miconazole group, itraconazole group and nystatin group accounted for 30.0%, 60.0% and 25.0%, respectively, with significant difference (P <0.05), and H2O2-positive in itraconazole group The detection rate of Lactobacillus was significantly higher than the other two groups, the difference was statistically significant (P <0.05). Conclusion: The clinical efficacy of itraconazole in the treatment of VVC is relatively low, which has little effect on the growth of Lactobacillus vaginalis and helps to maintain the normal vaginal flora. It is an ideal antifungal agent for the treatment of VVC.