双唑泰栓治疗阴道炎326例分析

1 临床资料1.1 资料来源:自1988年9月至12月,来我院及外院等五个医院妇产科门诊就诊的阴道炎患者.1.2 用药方法:经化验(取阴道分泌物涂片用革兰氏染色法及悬滴法)明确病原菌的阴道炎病人,于每周1、3、5来诊者为用药组,共326例,投双唑泰栓治疗.于2、4、6来诊者为对照组共133例,对照组一律按阴道炎的种类,分别使用灭滴灵栓,克霉唑栓,洗必泰拴单一药物.所有栓剂统一规格,均由同一药厂提供.每晚上一枚,置于阴道后穹窿处,7天为一疗程.停药后第一次月经干净后3～5天定为复查日期.1.3 疗效判定标准:(1)痊愈:①自觉症状消失.②白带恢复正常.③阴道粘膜充血消失.④病原体     

妇宁生物液治疗霉菌性阴道炎疗效观察

我们自 1999年 2～ 8月采用妇宁生物液治疗霉菌性阴道炎 143例 ,取得较好效果 ,现将结果报道如下。1　临床资料1 1　观察对象　本院门诊病人 ,年龄 2 9～ 5 5岁 ,符合以下条件 :①症状及体征 :白带增多 ,呈白色凝乳状或豆渣样 ,外阴阴道瘙痒、粘膜充血。②实验室检查 :阴道分泌物涂片查见白色念珠菌。1 2　用药要求　①治疗期间 ,禁用其它药物 ,禁用包括肥皂在内的各种洗剂。②治疗期间禁止性生活。1 3　用药方法　用阴道冲洗器将妇宁生物液一次性注入阴道内。每日 1次 ,10天为一疗程 ,然后停止 7～ 10天再进行下一个疗程 ,一般治疗三个疗程…     

复方沙棘籽油栓治疗阴道炎的疗效观察

目的 探讨中药制剂复方沙棘籽油栓治疗念珠菌、老年性、滴虫性阴道炎的疗效。方法 对103名患阴道炎(念珠菌、滴虫及老年性阴道炎)的患者,每天清洁外阴后,阴道上复方沙棘籽油栓药1枚,7d为1个疗程,一般用药2个疗程为宜。结果 复方沙棘籽油栓对念珠菌阴道治愈率为88.6％,1个月后复发率为15.4％。对滴虫性阴道炎治愈率为89.5％,对老年性阴道炎治愈率为60％,有效率为97.5％。结论 复方沙棘籽油栓具有抗菌、杀虫、消炎、止痒的作用,适用于各种类型阴道炎的治疗。     

干扰素栓治疗宫颈糜烂112例疗效观察

目的为了观察干扰素栓(奥平)治疗宫颈糜烂的临床疗效,对112例宫颈糜烂的患者进行了治疗.方法阴道给药,隔日1粒,12粒为1个疗程,于用药后1个月、2个月和3个月观察疗效.结果症状改善率达85.55%～89.41%,总有效率达87.50%.结论干扰素栓治疗宫颈糜烂简便、易行,疗效可靠.     

纳米银治疗萎缩性阴道炎临床效果观察

目的:观察纳米银对萎缩性阴道炎的治疗效果及安全性。方法:将268例萎缩性阴道炎患者随机分为纳米银组134例和雌三醇软膏组134例。纳米银组给予纳米银治疗(每天1支抗菌凝胶3g,6天为1个疗程),雌三醇软膏组每天给予雌三醇软膏0.5g阴道用药,7天为1个疗程。停药后1周复查。结果:纳米银组有效率为85%,雌三醇软膏组的治愈率83%。结论:纳米银治疗萎缩性阴道炎效果确切。     

纳米银治疗萎缩性阴道炎临床效果观察

目的:观察纳米银对萎缩性阴道炎的治疗效果及安全性。方法:将268例萎缩性阴道炎患者随机分为纳米银组134例和雌三醇软膏组134例。纳米银组给予纳米银治疗(每天1支抗菌凝胶3g,6天为1个疗程),雌三醇软膏组每天给予雌三醇软膏0.5g阴道用药,7天为1个疗程。停药后1周复查。结果:纳米银组有效率为85%,雌三醇软膏组的治愈率83%。结论:纳米银治疗萎缩性阴道炎效果确切。     

外阴阴道念珠菌病的真菌学研究及治疗

目的研究引起外阴阴道念珠菌病(vulvovaginalcnadidiasis,VVC)的真菌种类的变迁,评价口服伊曲康唑及阴道应用硝酸咪康唑治疗VVC的疗效.方法对1998年3月至1999年8月在我院门诊就诊的123例VVC患者阴道分泌物进行真菌培养并将其随意分为口服伊曲康唑组(50例)和阴道应用硝酸咪康唑组(73例).用药后1周和4周进行随诊.结果①白色念珠菌为引起VVC的主要病原,占82.1%(101/123例),其次为近平滑念珠菌(4.88%)及热带念珠菌(4.88%).②口服伊曲康唑组和阴道应用硝酸咪康唑组用药后1周的治愈率分别为88.0%和82.2%(P＞0.05),用药后4周的治愈率分别为86.7%和89.6%(P＞0.05).③白色念珠菌所致VVC的治愈率明显高于非白色念珠菌所致VVC的治愈率,分别为88.1%和68.2%,P＜0.05.结论白色念珠菌仍为VVC的主要病原,口服伊曲康唑和阴道应用硝酸咪康唑治疗VVC均有较好疗效,对白色念珠菌所致VVC的治疗效果好于治疗非白色念珠菌所致VVC.     

异位妊娠保守性治疗54例临床观察

随着阴道B超及腹腔镜诊断的应用和测定血β-HCG水平,80%的异位妊娠可在未破裂前作出诊断,为保守治疗提供了条件。我们观察了54例甲氨蝶呤(MTX)配伍米非司酮联合中药保守治疗异位妊娠过程中患者的临床表现、病情变化、转归过程及用药疗程等,现报告如下。1资料与方法1.1一般资料2     

肾内科住院患者抗菌药物应用的临床分析

目的调查我院肾内科住院患者抗菌药物的应用情况,评价我院住院患者抗菌药物应用的合理性。方法在我院2009年1月-2010年12月肾内科住院患者病历中每月按随机抽取10份,共计240份,对肾内科抗菌药物的应用情况编制调查表然后进行统计分析。结果我院肾内科住院患者的抗菌药物使用率为53.75%,经验用药比例高达88.65%;围术期用药疗程不当,用药疗程1 d～24 d,平均6.2 d,用药疗程≤24 h的7例,占2.92%,用药疗程≤48 h的22例,占9.17%.结论我院肾内科的住院患者在抗菌药物应用上基本合理。     

硝呋太尔制霉素阴道软胶囊治疗女性阴道炎的临床观察

目的：观察硝呋太尔制霉素阴道软胶囊治疗女性阴道炎的疗效与安全性。方法：对120例不同类型的阴道炎患者采取硝呋太尔制霉素阴道软胶囊局部应用,疗程一周,随访3个月,观察临床疗效与不良反应。结果：治疗1周后,120例患者痊愈112例（93％）,显效8例（％）,总有效率为99％,随访期间复发为12例,复发率10％,未发现严重不良反应,患者无不适症状,结论：硝呋太尔制霉素阴道软胶囊治疗女性阴道炎安全有效,用药时间短,起效快,治愈后不易复发,临床效果好。     

Betamethasone cream for the treatment of pre-pubertal labial adhesions

PURPOSE: We evaluated the efficacy of 0.05% betamethasone cream for the treatment of pre-pubertal labial adhesions. METHODS: We retrospectively reviewed the records of 19 children with labial adhesions who were treated with betamethasone cream from 6/2001 to 3/2003. Children were treated with 1 to 3 courses of twice-daily 0.05% betamethasone cream for 4 to 6 weeks. Successful lysis of adhesions was assessed by clinical exam or parental phone contact and outcomes were defined as: (1) success--complete separation of labia, (2) partial success--greater than 75% separation, (3) progression to surgical lysis, and (4) lost to follow-up. RESULTS: Nineteen patients with an average age of 58 months (range 12 to 132 months) were treated. Four of the 19 patients had never been treated previously and 1 had been treated previously with surgical lysis of adhesions only. Fourteen of the 19 patients had been previously treated with conjugated estrogen (Premarin) cream. Two of these fourteen patients had also undergone surgical lysis of adhesions. Severity of adhesions ranged from 33% to 99% labial closure. Betamethasone cream was successful in treating 13/19 (68%) pre-pubertal labial adhesions. Eleven (85%) of these 13 patients had complete resolution of labial adhesions with 1 course of treatment, 1 (7.5%) had resolution with 2 courses of treatment and 1 (7.5%) had resolution with 3 courses of treatment. One patient had a partial success with 3 courses of betamethasone cream. Two (11%) patients underwent surgical lysis of adhesion after 1 and 2 courses of betamethasone cream respectively. Three (16%) patients were lost to follow-up. Average follow-up was 7 months (range 1-24 months). No adverse outcomes or untoward effects were noted in any of the patients treated. CONCLUSIONS: Betamethasone 0.05% cream appears to be a safe and effective treatment of pre-pubertal labial adhesions as primary therapy or in patients that have failed previous therapies and it may avoid the undesirable side effects of breast budding and hyperpigmentation that can be associated with Estrogen creams.     

A comparative study of safety and efficacy of continuous low dose oestradiol released from a vaginal ring compared with conjugated equine oestrogen vaginal cream in the treatment of postmenopausal urogenital atrophy

Objective To compare the safety, efficacy and acceptability of a continuous low dose oestradiol releasing vaginal ring with conjugated equine oestrogen vaginal cream in the treatment of postmenopausal urogenital atrophy.
Design An open, parallel, comparative multicentre trial.
Setting Sydney and Melbourne, Australia.
Participants and Interventions One hundred and ninety-four postmenopausal women with symptoms and signs of urogenital atrophy were randomised on a 2:1 basis to 12 weeks of treatment with an oestrogen vaginal ring versus an oestrogen cream.
Main outcome measures and results Equivalence (95% CI) was demonstrated between the two treatments for relief of vaginal dryness and dyspareunia, resolution of atrophic signs, improvement in vaginal mucosal maturation indices and reduction in vaginal pH. No significant difference was demonstrated in endometrial response to a progestogen challenge test and equivalence was demonstrated in the incidence of intercurrent bleeding episodes. The vaginal ring was significantly more acceptable than the cream (   P < 0.0001  ), and was preferred to the cream (   P < 0.001  ).
Conclusion With equivalent efficacy and safety and superior acceptability to vaginal cream, the low dose oestradiol vaginal ring is an advance in vaginal delivery systems for the treatment of urogenital atrophy.     

Comparison of pharmacokinetics of a conjugated equine estrogen preparation (premarin) and a synthetic mixture of estrogens (C.E.S.) in postmenopausal women

OBJECTIVE: To compare the pharmacokinetics and relative bioavailabilities of key estrogen components of Premarin (Wyeth-Ayerst, Canada) with those of a generic conjugated estrogen preparation, C.E.S. (synthetic mixture of estrogens; ICN, Montreal, Canada) in healthy postmenopausal women. METHODS: We conducted a randomized, single-dose, two-treatment, three-period crossover study in 41 postmenopausal women. After an oral dose (2 x 0.625 mg) of Premarin or C.E.S., plasma concentrations of unconjugated and total estrone (E(1)), equilin (Eq), 17beta-estradiol (17beta-E(2)), 17beta-dihydroequilin (17beta-Eq), Delta(8)-esterone (Delta(8)-E(1)) and Delta(8),17beta-estradiol (Delta(8),17beta-E(2)) were measured over 72 hours using gas chromatography and mass spectroscopy. RESULTS: After administration of C.E.S., E(1), Eq, and 17beta-Eq appeared in blood at a significantly faster rate (lower t(max)) than after Premarin. The rapid appearance of estrogens after C.E.S. was associated with significantly higher (14-61%) C(max) values. In contrast to the high C(max) values, the area under the curve (AUC)(infinity) of unconjugated and total Eq, and 17beta-Eq were significantly lower after C.E.S., whereas those of E(1) were significantly higher. Although, the t(max) values for 17beta-E(2) were lower and the C(max) values higher after C.E.S., only the C(max) of unconjugated 17beta-E(2) was significantly different after Premarin. Unconjugated and total Delta(8)-E(1) and its main metabolite, Delta(8),17beta-E(2), were detectable in plasma only after administration of Premarin. The geometric mean ratio (GMR) (C. E.S./Premarin) of bioavailability parameters indicated that all C(max) and t(max) values for the unconjugated and total E(1), Eq, 17beta-E(2), and 17beta-Eq fell outside the regulatory requirement that the 90% confidence intervals of GMRs of two products be within 80% and 125%. Similarly, with the exception of total E(1) and total Eq, none of the AUC(t) or AUC(alpha) of the remaining estrogens meets the required regulatory standards of bioequivalence. CONCLUSIONS: C.E.S. is not bioequivalent to Premarin. Because C.E.S. also is not pharmaceutically equivalent to Premarin, it cannot be assumed to be therapeutically equivalent. Until long-term clinical trials with C.E.S. demonstrate its efficacy, extrapolation of the long-term benefits described for Premarin to C.E.S. would be risky and questionable.     

Preliminary evaluation of a vaginal cream containing lactoferrin in the treatment of vulvovaginal candidosis

AIM: The objective of the study is to verify the clinical effectiveness of a cream containing lactoferrin in the treatment of acute vulvovagininal candidiasis. METHODS: The study enrolled 34 patients aged 25-45 years and preenting signs and symptoms of acute vulvovaginal candidiasis. The patients have been treated with a cream containing lactoferrin 4%, 5 g of cream in vagina and 2 cm applied on the vulva twice a day for 7 days. At the end of the treatment the patients a clinical and microscopical examination was performed in order to evaluate the effectiveness of the therapy. RESULTS: The results obtained showed that 27 women completely recovered, 5 showed a good improvement and only 2 women were still suffering from vulvovaginitis at the end of treatment. CONCLUSION: From the data of our study, a cream containing lactoferrin seems to be clinically effective in the treatment of acute vulvovaginal candidiasis, with a good response on all the characteristic symptoms of this infection.     

Effect of raloxifene on the response to conjugated estrogen vaginal cream or nonhormonal moisturizers in postmenopausal vaginal atrophy

OBJECTIVE: To study the effect of raloxifene on the response to conjugated estrogen cream or nonhormonal moisturizer in postmenopausal women with preexisting signs of vaginal atrophy. METHODS: Postmenopausal women with preexisting and untreated vaginal atrophy were enrolled in this parallel, placebo-controlled, randomized study. A total of 187 women were randomized to four treatment groups: daily oral raloxifene (60 mg per day) or a placebo in a double-blind manner plus one application of conjugated estrogen cream (0.5 g) or one applicator full of nonhormonal moisturizer, open label. The conjugated estrogen cream or nonhormonal moisturizer was applied daily for the first 2 weeks, and then twice weekly thereafter for 3 months. Efficacy of treatment regimens on signs and symptoms of vaginal atrophy was evaluated by monitoring objective and subjective parameters. RESULTS: Signs and symptoms of vaginal atrophy improved in all four treatment groups. Raloxifene did not diminish the magnitude of improvement when administered with either vaginal preparation. Conjugated estrogen cream produced a statistically greater improvement in signs (P <.05) but not in individual symptoms or overall satisfaction relative to nonhormonal moisturizer. CONCLUSION: Postmenopausal women with evidence of preexisting vaginal atrophy may use either low-dose conjugated estrogen cream or nonhormonal moisturizer to treat the atrophy concurrently with raloxifene (60 mg per day).     

Randomized clinical trial of intrapartum clindamycin cream for reduction of group B streptococcal maternal and neonatal colonization

Objective: In a randomized trial, we sought to determine whether 2% clindamycin cream administered intravaginally during labor to group B streptococcal-colonized pregnant women without risk factors would decrease maternal and neonatal colonization.Methods: The eligible women were randomized to receive either cream or no treatment. Two hours after treatment or admission, the patients were tested with rectal and vaginal cultures. The neonates of the study patients were also tested.Results: Of women randomized to cream, 5 of 5 remained positive and 2 (33%) of their 6 neonates were positive. Of 4 randomized to no treatment, 3 (75%) remained positive and 1 (25%) of 4 neonates was positive.Conclusions: Intravaginal 2% clindamycin cream was ineffective in reducing colonization with group B streptococci.     

小剂量雌激素对绝经后骨质疏松症的治疗

目的:探讨减半剂量雌激素联合孕激素和钙剂对绝经后骨质疏松症的防治作用。方法:138例绝经2年以上因骨痛就诊的妇女。①测定用药前血性激素,血、尿骨代谢生化,并与20例未绝经的正常妇女相比较;②绝经者随机分为3组(每组46例),A组给予倍美力0.625mg+安宫黄体酮2mg+钙尔奇D1g/d,B组给予倍美力0.3mg+安宫黄体酮2mg+钙尔奇D1g/d,C组给予安慰剂+钙尔奇D1g/d,均连续用药2年。在用药前、用药后6个月、12个月、24个月分别测定血骨钙素(BGP)、碱性磷酸酶(BAP)、I型羧基末端终肽(CICP)、比林二酚(Pyd)、尿钙(Ca)、肌酐(Cr)、IL-6;行双光子(DEXA)测定骨密度(BMD),并超声测定子宫内膜及钼靶摄片了解乳房情况。结果:①与未绝经组比,绝经后血清E2、BGP、BMD值下降(P<0.05),血FSH、LH,尿Pyd/Cr、Ca/Cr比值增高(P<0.05)。②3组对象用药后3个月,骨痛均有不同程度改善;A组和B组用药后1年骨密度有明显提高,而C组在1年后骨密度呈下降趋势。3组对象治疗过程中均未发现子宫内膜的异常增厚。用药6个月时骨代谢生化指标及血清IL-6水平就有显著下降。结论:绝经后妇女中,小剂量雌、孕激素加钙剂能防治骨质疏松症的发生。     

Primary small cell carcinoma of the vagina

BACKGROUND: Primary vaginal small cell carcinoma is extremely rare, with a total number reported in English-language journals to date of 23. Most patients die of the disease within 2 years of diagnosis from metastatic disease. CASE: A 69-year-old woman presented with vaginal spotting while on Premarin. She was subsequently diagnosed with Stage I (T1N0M0) small cell carcinoma of the vagina. She underwent concurrent chemoradiation and then brachytherapy for persistent disease. Due to residual disease after the brachytherapy, surgical resection was planned but aborted because of metastatic disease. CONCLUSIONS: Of the three reported cases treated with concurrent chemoradiation, ours is the first case reported with persistent local disease after therapy. Extrapolating from the available clinical trials from lung carcinoma, concurrent chemoradiation as a primary treatment approach should still be considered.     

Plasma levels of oestrone, oestradiol and gonadotrophins in postmenopausal women after oral and vaginal administration of conjugated equine oestrogens (Premarin).

Peripheral plasma from five postmenopausal women was analyzed for oestrone and oestradiol during 48 hours after administration of 1.25 mg Premarin (conjugated equine oestrogen) orally and vaginally. Oestrone and oestradiol were separated on columns of Sephadex LH 20 before radioimmunoassay. Administration of 1.25 mg of Premarin produced a marked increase in plasma oestrone levels and 24 hours after treatment the oestrone levels were still above follicular phase levels. The plasma pattern of oestradiol was similar but the elevation was less pronounced. The biological activity of Premarin as indicated by depressed gonadotrophin levels was similar with the intravaginal and oral routes of administration.     

Butoconazole nitrate 2% for vulvovaginal candidiasis. New, single-dose vaginal cream formulation vs. seven-day treatment with miconazole nitrate. Gynazole 1 Study Group

OBJECTIVE: To compare the safety and efficacy of a single vaginal dose of a butoconazole nitrate 2% bioadhesive, sustained-release cream* (butoconazole 1-BSR) with a seven-day schedule of miconazole nitrate vaginal cream 2% (miconazole 7). STUDY DESIGN: The clinical trial was conducted according to a randomized, parallel, investigator-blind, multicenter study design. The patients self-administered the respective creams to the posterior vaginal fornix. Two hundred twenty-three patients started the trial and were analyzed for safety. A total of 205 patients qualified for efficacy analysis, 101 receiving butoconazole 1-BSR and 104 using miconazole 7. Patients receiving butoconazole 1-BSR inserted one applicator full of medication once. Those assigned to receive miconazole 7 inserted one applicator full daily for seven days. Patients were evaluated 7-10 and 30 days after completion of therapy. RESULTS: Butoconazole 1-BSR rapidly relieved the signs and symptoms of vulvovaginal candidiasis. The proportion of patients with severe symptoms declined from the pretreatment 20% to 6% on the 1st day, to 3% on the 4th day, and to 2-1% on the 5th-7th day after single-dose application. Eight to ten days after treatment completion, clinical symptoms regressed in 92%, and fungal cultures were negative in 87% of patients. At the 30-day posttreatment visit, 88% of patients remained clinically cured, and 74% had negative fungal cultures. In the miconazole 7 group, the proportion of patients with severe symptoms declined from 23% to 19% after the first dose; thereafter, symptom relief proceeded more rapidly. Eight to ten days after treatment completion, clinical symptoms regressed in 92% and fungal cultures were negative in 87% of patients. At the 30-day follow-up examination, 86% patients were clinically cured, and 77% were culture negative. After single-dose butoconazole 1-BSR, severe symptoms receded faster than after the first dose of miconazole 7, and the difference was statistically significant (P = .01). In all other efficacy parameters, the differences between the two groups were not statistically significant. Neither treatment regimen caused significant adverse events. CONCLUSIONS: This clinical trial demonstrated that butoconazole 1-BSR is an effective and safe alternative to longer-term therapy with miconazole nitrate (seven days) for vulvovaginal candidiasis.