硝呋太尔制霉菌素阴道软胶囊联合阴道用乳杆菌活菌胶囊治疗妊娠期外阴阴道假丝酵母菌病的疗效观察

目的通过观察硝呋太尔制霉菌素阴道软胶囊联合阴道用乳杆菌活菌胶囊治疗妊娠期外阴阴道假丝酵母菌病(VVC)的有效性及复发情况,探讨更理想的治疗方案。方法将112例妊娠期VVC的患者随机分为两组。观察组63例,用硝呋太尔制霉菌素阴道软胶囊联合阴道用乳杆菌活菌胶囊治疗,对照组49例,单用硝呋太尔制霉菌素阴道软胶囊治疗,观察比较两组治疗结束后有效率及治疗结束后30d的复发率。结果治疗结束后观察组有效率为96.82%,对照组为95.91%,两组比较差异无统计学意义(P0.05),复发率观察组为3.44%,对照组为14.64%,两组比较差异有统计学意义(P0.05)。结论硝呋太尔制霉菌素阴道软胶囊联合阴道用乳杆菌活菌胶囊治疗妊娠期VVC疗效好,复发率低,安全可靠。     

国产硝呋太尔制霉素阴道软胶囊治疗阴道炎的临床研究

目的 评价国产硝呋太尔制霉素阴道软胶囊治疗滴虫性阴道炎、细菌性阴道病、外阴阴道念珠菌病的临床疗效和安全性。方法 随机盲法平行对照多中心临床试验，进口麦咪康帕阴道栓为对照药。结果 有效病例为滴虫性阴道炎62例、细菌性阴道病65例、外阴阴道念珠菌病65例，各适应证的试验组及对照组受试者的临床症状、体征及妇科实验检查在用药前后均有明显改善（P〈0．01），各适应证的总有效率为90．0％～96．8％，试验组与对照组的疗效相似（P〉0．05），无严重不良事件发生，对肝肾功能血尿常规等均无影响，仅个别患者有轻微的阴道局部的刺激症状。结论 临床试验结果提示，国产硝呋太尔制霉素阴道软胶囊是一种可供选择的、能用于治疗细菌性阴道病、滴虫性阴道炎及外阴阴道念珠菌病的阴道局部药物。     

定君生联合制霉菌素治疗外阴阴道假丝酵母菌病临床观察

<正>外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)复发率高,因此需研究一种简便、有效且效果持久的治疗方法。我们应用定君生与制霉菌素联合治疗外阴阴道假丝酵母菌病,疗效满意,现报道如下。1资料与方法1.1研究对象2006年1月至6月在聊城市人民医院门诊确诊为外阴阴道假丝酵母菌病患者共200例,年龄22～55     

抗白色假丝酵母菌IgY的应用研究

目的探讨抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染的治疗作用,及抗白色假丝酵母菌IgY泡腾片的安全性和对外阴阴道假丝酵母菌病的治疗效果。方法2001年5月至2003年5月于南昌大学医学院免疫学教研室应用抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染进行保护性研究;观察抗白色假丝酵母菌IgY泡腾片对新西兰兔的急性皮肤刺激试验、阴道局部黏膜刺激试验的结果及对外阴阴道假丝酵母菌病患者的临床效果。结果(1)小鼠阴道冲洗液白色假丝酵母菌培养结果(菌落数)抗白色假丝酵母菌IgY中剂量组与制霉菌素阳性对照组之间差异无显著性意义(0.3947±0.3265对0.3336±0.4634)。(2)新西兰兔试验部位皮肤、阴道黏膜及周围皮肤无红斑、水肿等,全身情况未见异常;阴道黏膜亦未见病理改变。(3)抗白色假丝酵母菌IgY泡腾片对外阴阴道假丝酵母菌病有效率88.9%,与硝酸咪康唑栓对照组(82.5%)比较差异无显著性意义。结论抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染有明显的保护作用;抗白色假丝酵母菌IgY泡腾片对皮肤、阴道黏膜无刺激作用;对外阴阴道假丝酵母菌病有很好的治疗效果。     

伊曲康唑治疗外阴阴道假丝酵母菌病804例临床分析

外阴阴道假丝酵母菌病（又称外阴阴道念珠菌病，vulvovagina[candidiasis，VVC）是一种以白念珠菌为主的酵母菌引起的机会性真菌感染，超过75％妇女一生中至少患过一次外阴阴道假丝酵母菌病。治疗VVC常用的方法是阴道局部使用抗真菌药，如咪康唑、克霉唑、制霉菌素，但局部用药的方法对一些复发性VVC及中重度VVC疗效并不满意。本文采用单独口服抗真菌药物伊曲康唑治疗广东和广西两省非初发VVC或中重度VVC共804例患者，取得较好的疗效，现报告如下。     

双唑泰栓治疗妊娠期外阴阴道假丝酵母菌病临床观察

外阴阴道假丝酵母菌病是由假丝酵母菌引起的外阴阴道炎症，是最常见的外阴阴道炎症之一。我院于2005年1月1日-2006年12月1日使用双唑泰栓治疗妊娠期外阴阴道假丝酵母菌病（VVC）取得较好疗效，现报告如下。     

3种方法治疗外阴阴道假丝酵母菌病的疗效分析

目的:探求一种既能短期缓解外阴阴道假丝酵母菌病临床症状,又能延长药物疗效的较理想方案。方法:通过3种不同方法治疗210例外阴阴道假丝酵母菌病,其中A组采用硝酸咪康唑栓,B组:聚维酮碘擦洗加硝酸咪康唑栓,C组:聚维酮碘擦洗加硝酸咪康唑栓加干扰素栓。在治疗后第3天、7天及1月、2月、3月、6月月经干净3-7天回访,观察临床疗效及微生物学指标。结果:用药3天时,A组与B组、C组总有效率比较,差异有非常显著性(P<0.01);第7天时,3组间差异无显著性(P>0.05)。治疗1月后随访,微生物学指标各组之间差异均有显著性(P<0.05);2月时,A组与B、C组之间差异有显著性(P<0.05);治疗3月、6月时,A、B组与C组之间差异有显著性(P<0.05)。结论:在首诊时采用聚维酮碘棉棒擦洗外阴、阴道,能迅速缓解外阴阴道假丝酵母菌病的症状,促进其他药物起效。而加用干扰素栓则能提高阴道局部免疫力,短期内可提高外阴阴道假丝酵母菌病原体的清除率。     

朗依治疗妊娠期外阴阴道假丝酵母菌病150例疗效观察

外阴阴道假丝酵母菌病发病率较高,有些患者反复发作,身心受到严重影响.反复发作的原因有妊娠、糖尿病等.妊娠期孕妇体内雌孕激素水平增高,阴道酸碱度适宜假丝酵母菌生长,故孕妇外阴阴道假丝酵母菌病发病率较高且反复发作,较难治疗.为预防分娩时感染新生儿及发生其他合并症,应积极予以治疗.近年我院门诊应用朗依治疗孕期外阴阴道假丝酵母菌病150例,疗效良好,现报告如下.     

火山蕨矿泉水煎液对外阴阴道假丝酵母菌病疗效观察的报告

目的:探讨火山蕨矿泉水煎液对外阴阴道假丝酵母菌病的疗效。方法:180例患者随机分为两组,对照组90例予制霉菌素(米克定)栓剂治疗,观察组90例给予火山蕨矿泉水煎液治疗。结果:对照组总有效率92.22%,复发率17.78%;观察组总有效率91.11%,复发率5.56%。两组总有效率仅差1.11%,比较无显著性差异,但观察组的治愈率和显效率均比对照组高,尤其是观察组复发率较低(P<0.05)。结论:火山蕨矿泉水煎液治疗外阴阴道假丝酵母菌病费用低、纯天然、无任何副作用,疗效显著。     

复发性外阴阴道假丝酵母菌病的菌种及药物敏感性分析

目的:研究复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidia-sis,RVVC)的致病菌种和药敏结果。方法:对2006年~2009年收治的RVVC患者547例行阴道分泌物真菌培养并做药敏试验。结果:真菌培养阳性率80.6%;441例阳性患者中387例(87.8%)为白色假丝酵母菌,49例(11.1%)为光滑假丝酵母菌,5例(1.1%)为克柔假丝酵母菌;药物敏感试验显示,制霉菌素敏感率96.2%,克霉唑89.0%,氟康唑79.2%,伊曲康唑54.0%,咪康唑敏感率48.6%。结论:白色假丝酵母菌是RVVC的主要致病菌,RVVC患者的首选治疗药物为制霉菌素。     

Lifetime changes in the vulva and vagina

The morphology and physiology of the vulva and vagina change over a lifetime. The most salient changes are linked to puberty, the menstrual cycle, pregnancy, and menopause. The cutaneous epithelia of the mons pubis, labia, and clitoris originate from the embryonic ectoderm and exhibit a keratinized, stratified structure similar to the skin at other sites. The mucosa of the vulvar vestibule, which originates from the embryonic endoderm, is non-keratinized. The vagina, derived from the embryonic mesoderm, is responsive to estrogen cycling. At birth, the vulva and vagina exhibit the effects of residual maternal estrogens. During puberty, the vulva and vagina acquire mature characteristics in a sequential fashion in response to adrenal and gonadal maturation. A trend to earlier pubertal onset has been observed in Western developed countries. In women of reproductive age, the vaginal mucosa responds to steroid hormone cycling, exhibiting maximal thickness and intracellular glycogen content at mid-cycle. Vulvar skin thickness remains unchanged but menstrual cycle-associated changes in ortho- and parakeratosis occur at the cytological level. The vulva and vagina further adapt to the needs of pregnancy and delivery. After menopause, tissue atrophy ensues. Post-menopausal changes in skin barrier function, skin hydration, and irritant susceptibility have been observed on exposed skin but not on the vulva. Nevertheless, older women with incontinence are at increased risk for developing incontinence dermatitis. A combination of factors, such as tissue atrophy, slower dissipation of excess skin hydration, shear forces associated with limited mobility, and lower tissue regeneration capacity increase the risk of morbidity from incontinence dermatitis in older women.     

Extensive vulva cancer with enormous tumor of the vagina

The following is a case report documenting a 53-year old patient with extremely advanced vulva cancer (stage IV). The patient needed urgent operative treatment because of massive bleeding from large tumor located inside and out of the vagina. The prime step was to stop tumor hemorrhage, perform cystotomy and decompression of the urinary bladder and exteriorization of artificial anus. Second operation was a conventional oncologic procedure, which contained: radical vulectomy, hysterosalpingo-oophorectomy, cystectomy with excision of the urethra, the excision of almost the entire vagina, lymphadnectomy of the left inguinal lymph nodes and iliac lymph nodes. In spite of the surgical treatment, the patient died at the fourth day after the second operation.     

Prophylactic topical 5-fluorouracil following treatment of human papillomavirus-associated lesions of the vulva and vagina

Ninety patients were studied in a controlled, randomized fashion to evaluate the effectiveness of topical 5-fluorouracil in reducing the recurrence rate of human papillomavirus-associated lesions of the vulva and vagina. Following complete ablation of the lesions by one or more treatment modalities, 45 patients applied a single dose of 5% 5-fluorouracil cream biweekly to the vagina and/or vulva for at least six months. Forty-five patients used no prophylactic 5-fluorouracil cream. Patients in both groups were comparable with regard to race, age, and immune status, as well as the number, location, duration, clinical appearance, histology, and prior treatment of the lesions. Six patients (13%) with 5-fluorouracil prophylaxis and 17 (38%) without additional treatment (P less than .01) developed recurrent lesions during a follow-up time of nine to 22 months (mean = 14.4 months). Maintenance therapy with 5-fluorouracil was most effective in women with multiple lesions, multiple organ involvement, or with a depressed immune system.     

An immunohistochemical study of androgen, oestrogen and progesterone receptors in the vulva and vagina

Objective Tomap potential sites of sex steroid action in the human vulva.
Methods Monoclonal antibodies to androgen, oestrogen and progesterone receptors were used to stainfrozen sections of vulval skin, vagina and suprapubic skin. A scoring system was devised to comparereceptor distribution in the epidermis and dermis of skin with vaginal epithelium and stroma.
Results Androgen receptors were seen in epidermal keratinocytes, sebaceous glands, sweat glands, hairfollicles and dermal fibroblasts of skin, and epithelial cells and stromal fibroblasts of the vagina. Androgen receptor scores were significantly higher in the epidermis of labia majora and minora thanin vaginal epithelium. Oestrogen receptors were seen in basal and suprabasal cells of vaginalepithelium and epidermis of labia minora but were restricted to basal keratinocytes in true skin.They were seen in stromal fibroblasts and vaginal smooth muscle, and dermal fibroblasts of theskin. Oestrogen receptors were highest in vaginal epithelium and stroma, and lowest insuprapubic skin. Progesterone receptors were seen in vaginal epithelium, fibroblasts and smoothmuscle but not in the vulva. There was no evidence of significant differences in androgen oroestrogen receptor staining in the vulva of pre- or postmenopausal women.
Conclusion The transition from vagina to vulva is marked by an increase in androgen and a decrease inoestrogen and progesterone receptors. This distribution of receptors would indicate a limited role foroestrogen creams on the vulva.     

Immunohistochemical localization of estrogen receptors in the vulva and vagina

A rat monoclonal antibody against human estrogen receptor (ER) was used to localize nuclear ER in frozen tissue sections with the peroxidase-antiperoxidase technique. Premenopausal and postmenopausal vaginal, vulvar and nongenital skin was examined. ER was demonstrated in some but not all of the nuclei of basal and suprabasal differentiated epithelial cells of the vagina. ER was seen in the fibroblasts and smooth muscle, but not in the vessel endothelium, of the underlying stroma. ER was demonstrated in epidermal keratinocytes and dermal fibroblasts of the vulva and perineum, hair and non-hair bearing, but at a much lower frequency than in the vagina. Specific ER staining was not detected in the majority of skin specimens for extragenital sites. These findings have implications for the hormonal regulation of the vulva and for the use of estrogen cream in managing vulvar conditions.     

Evaluation of Cicatridine efficacy in healing and repairing process of uterine cervix, vagina and vulva--open no-randomized clinical study

PURPOSE: The aim of the study was to evaluate the efficacy of Cicatridine application in healing and repairing process after operative procedures concerning uterine cervix, vagina and vulva and after brachytherapy due to cervical and endometrial cancer. We also analyzed Cicatridine effect on vaginal athrophical signs in post-menopausal women. PATIENTS AND METHODS: The examined group consist of 319 women. They were divided into 2 arms. The active arm concerns 213 women who used Cicatridine, while controlled one consists of 106 women. The effect of treatment was estimated after 6 weeks and 3 months by the visual inspection of the cervix and vagina. We also analyzed the subjective filling of patients bound to sexual intercourses by using of Visual Analogue Scale (0%--no effect; 100%--disappearance of pathological symptoms). RESULTS: In active arm according to control one the reparation of cervix was more often: after surgery procedures (respectively after 6 weeks 93% vs 70%; after 3 months 99% vs 89%) and after brachytherapy (respectively after 3 months 86% vs 0%). In brachytherapy group the lack of discomfort during sexual intercourses was also more often in active arm (respectively 55% vs 0%). In postmenopausal women reduction of symptoms associated with atrophic vaginitis was observed only in active group (respectively after 6 weeks 43% vs 0%; after 3 months 57% vs 0%). In the group of patients after ephisiotomy due to delivery the relief of discomfort during sexual intercourses was also more often in active arm respectively 94% vs 25%). CONCLUSION: Cicatridine causes fast healing of cervix after gynecological procedures. It influences improvement of atrophical, inflammatory and after radiation therapy effects which improve quality of life and comfort of vagina after brachytherapy due to cervical and endometrial cancer. Cicatridine causes similar effect in vagina of post-menopausal women as locally used estrogens. Cicatridine also causes the feeling of relief and comfort in vagina after delivery as well as fast healing after episiotomy.     

The evaluation of the sentinel node successfully conducted in a case of malignant melanoma of the vagina

BACKGROUND: The sentinel node biopsy has been established as a standard procedure in many types of cancer. To date, only one case was reported for successful detection of the sentinel node using a radiopharmaceutical-directed mapping technique in malignant melanoma of the vagina. CASE: An 81-year-old woman developed malignant melanoma arising from the lower third of the vagina. She underwent local resection of the tumor and exploration of the sentinel node using blue dye. The sentinel node was detected successfully in the groin, and was negative for metastasis. Intra-cavity irradiation was given as an adjuvant therapy. CONCLUSION: In view of relative ease and minimal trauma, sentinel node mapping could be a routine procedure in malignant melanoma arising from the vagina or vulva.     

Primary cancer of the vagina and indications for therapy: on the basis of 52 cases

The authors studied 52 cases of primary cancer of the vagina, 7 stage I, 23 stage II, 7 stage III, and 15 stage IV. For every one primary cancer of the vagina they found 58 cancers of the cervix, 6 cancers of the endometrium, 5 cancers of the ovary, and 4 cancers of the vulva. The extent of these cancers at the time of the first examination is explained by their clinical latency. Treatment was by radiotherapy (radium therapy and telecobaltotherapy) with or without surgery. At present the 5-year survival rate is 23.8 percent. The use of high-energy therapy should lead to a distinct improvement in the results.     

细菌性阴道病患者与健康妇女阴道乳杆菌生态学特征的比较

目的:观察健康妇女与细菌性阴道病患者阴道内乳杆菌属内各种乳杆菌在阴道中分布的差异。方法:利用微生态学研究方法,调查45例健康妇女和40例细菌性阴道病患者阴道乳杆菌的分布,鉴定阴道内乳杆菌,比较阴道乳杆菌产生过氧化氢的能力。结果:健康妇女阴道内乳杆菌检出率和平均活菌数量对数值明显高于细菌性阴道病患者(P<0.01),健康妇女阴道内优势乳杆菌是嗜酸乳杆菌(35%,7·68±1.41)、德氏乳杆菌(7·5%,8.06±0.83)和乳酸乳杆菌(7·5%,8.07±1·51),其大多数产生H2O2能力较强;健康妇女阴道内产H2O2乳杆菌的分离率明显高于细菌性阴道病患者(P<0.01)。结论:H2O2阳性的乳杆菌是健康妇女阴道乳杆菌的重要成员,在防治细菌性阴道病发生中起重要作用。     

The use of lasers in treating condyloma acuminatum

Seventy-eight patients with condyloma acuminatum (51 with a lesion in the vulva, 11 in the uterine cervix, 1 in the vagina, 15 in multiple sites) have been treated by using three types of laser beam. The period to obtain epithelization after first treatment at the vulva, cervix and vagina was 4.4 +/- 1.8, 5.2 +/- 1.1 and 4.1 +/- 0.6 weeks (Mean +/- SD) respectively. The cure rates at the 10th week after first treatment and after first treatment during the follow-up periods between 10 weeks and 63 months were 78.2% (61/78) and 70.5% (55/78), respectively. The latter cure rates for each lesion were 70.3% in the vulva, 84.2% in the cervix and 72.7% in the vagina. In the recurrent group (62.5%), the incidence of partners with the disease was significantly higher (p less than 0.05) than that in the non-recurrent group (26.3%). No significant complication due to the therapy was found during or after treatment. This clinical study indicates that laser therapy is a useful method of treatment for condyloma acuminatum because of the short term healing with less complications and good cure rates.