ATP-红外生物效应技术治疗重度外阴阴道假丝酵母菌病疗效观察

目的:观察ATP-红外生物效应技术对重度外阴阴道假丝酵母病(SVVC)患者的治疗效果。方法:采用前瞻性随机对照研究方法,共有153例SVVC患者完成观察。治疗组77例,采用ATP-红外生物效应治疗技术,1次/天,共2次;治疗后阴道内放置硝酸咪康唑栓400 mg/天,共6天。对照组76例,阴道内放置硝酸咪康唑栓400 mg/天,共6天。开始治疗后,患者每天记录自觉症状及不良反应,停药后3天、30天复查,进行疗效评价。结果:①治疗组治疗起效时间为(0.7±0.6)h,对照组为(19.3±8.8)h,差异具有统计学意义(P<0.01)。治疗后第1～4天,治疗组患者症状自评分下降幅度明显大于对照组,差异具有统计学意义(P<0.01)。②停药后3天,治疗组和对照组临床有效率分别为90.91%和73.68%,真菌学转阴率分别为96.10%和85.53%,总有效率分别为89.61%和69.74%,差异均具有统计学意义(P<0.05)。③停药后30天,治疗组和对照组临床有效率分别为94.80%和68.42%,真菌学转阴率分别为96.10%和82.89%,总有效率分别为92.21%和64.47%,差异均具有统计学意义(P<0.01)。结论:ATP-红外生物效应技术可快速缓解SVVC患者的自觉症状,有效提高其近期及远期疗效,使患者的生活质量提升,是治疗SVVC的有效方法。     

止痒洗剂联合妇炎消生物敷料栓治疗妊娠合并外阴阴道假丝酵母菌病临床研究

目的:观察止痒洗剂联合妇炎消生物敷料栓治疗妊娠合并外阴阴道假丝酵母菌病(Vulvovaginal candidiasis,VVC)的临床疗效。方法:选取2012年8月—2015年8月本院收治的70例妊娠合并VVC患者,随机分为研究组和对照组,每组各35例。对照组给予妇炎消生物敷料栓治疗,研究组在对照组的基础上联合止痒洗剂。观察两组患者临床症状体征改善情况、临床疗效及复发情况。结果:研究组外阴瘙痒、外阴红肿、阴道充血改善率分别为97.1%、85.7%、82.9%,对照组分别为88.6%、71.4%、74.3%,两组患者临床症状体征改善情况比较,差异均有统计学意义(P0.05)。研究组有效率为88.6%,对照组有效率为60.0%,两组患者临床疗效比较,差异具有统计学意义(P0.05)。研究组复发率为2.9%,对照组复发率为14.3%,两组患者复发率比较,差异具有统计学意义(P0.05)。结论:止痒洗剂联合妇炎消生物敷料栓能够有效改善妊娠合并VVC患者的临床症状,降低复发率。     

克霉唑与咪康唑对重度外阴阴道假丝酵母菌病乳杆菌属的影响

目的探讨克霉唑与咪康唑治疗重度外阴阴道假丝酵母菌病的疗效及对阴道乳杆菌属的影响。方法将90例确诊为重度外阴阴道假丝酵母菌病的患者随机分为2组,各45例,分别给予克霉唑阴道片500 mg,阴道置入,间隔3 d序贯治疗或咪康唑阴道栓400 mg,阴道置入,1次/d,共7 d;记录治疗第7天的治愈率,比较两组治疗前、停药后第14天和第28天阴道乳杆菌属的数量。结果治疗第7天,克霉唑阴道片组的治愈率为42.2%,明显高于咪康唑组的15.6%,差异有统计学意义;但第14天后克霉唑组的痊愈率为95.6%,咪康唑组为91.1%,2组的治愈率差异无统计学意义;用药后第14天,阴道乳杆菌属平均活菌数量对数值克霉唑组为6.46±1.68,咪康唑组为6.42±1.59,与用药前5.53±1.54、5.56±1.50相比,2组均有增加,但差异无统计学意义;用药后第28天,克霉唑组为7.02±1.50,咪康唑组为6.21±1.44,差异有统计学意义(P<0.05)。结论克霉唑阴道片能更快地消除症状达到治愈,而且有辅助阴道乳杆菌属生长的作用,可作为外阴阴道假丝酵母菌病,局部用药的首选药物。     

Formulation,stability study and preclinical evaluation of a vaginal cream containing curcumin in a rat model of vulvovaginal candidiasis

Owing to the growing resistance among isolates of Candida species to usual antifungal agents and the well‐known therapeutic potential of curcumin, the purpose of this study was to develop and validate a vaginal formulation containing this substance and to evaluating its effectiveness in the treatment of experimental vulvovaginal candidiasis. Curcumin was incorporated in a vaginal cream in three concentrations (0.01%, 0.1% and 1.0%). The different concentrations of the cream and its controls were intravaginally administered in an immunosuppressed rat model to evaluate the efficacy in the treatment of experimental vulvovaginal candidiasis. Samples of the cream were also subjected to centrifugation and physical stability tests and an analytical method for quantification of curcumin was validated based on HPLC. The formulation was stable and the HPLC method could be considered suitable for the quantitative determination of curcumin in the cream. After 6 days of preclinical study, the number of infected animals was 1/6 in all groups treated with curcumin vaginal cream and the fungal burden showed a progressive reduction. Reduction in the inflammatory infiltrate was observed in the group treated with 1.0% cream. Vaginal cream containing curcumin could be considered a promising effective antifungal medicine in the treatment of vulvovaginal candidiasis.     

完带汤化裁联合西药治疗复发性外阴阴道假丝酵母菌病的Meta分析

目的 系统评价完带汤化裁联合西药治疗复发性外阴阴道假丝酵母菌病（recurrent vulvovaginal candidiasis,RVVC）的有效性和安全性。方法 检索CNKI、Sinomed、WanFang、VIP、PubMed、Embase、Cochrane Library等数据库,筛选完带汤化裁联合西药治疗RVVC的临床随机对照研究,用RevMan5.3软件进行数据分析。结果 共纳入10个研究,病例1075例。Meta分析结果显示：完带汤化裁联合西药治疗RVVC有效率高于单纯西药,且可降低复发率,改善阴道微生态,两组比较有统计学差异。结论 完带汤化裁联合西药治疗RVVC具有良好效果。     

6~8岁青春发育早期女性外阴阴道感染特征分析

目的探讨6~8岁青春发育早期女性外阴阴道的感染特征及其与季节的关系。方法回顾性分析540例6~8岁青春发育早期女性外阴阴道感染状况,分析其不同年龄段、不同季节细菌性阴道病(BV)发生率、炎症发生率、优势菌异常率和假丝酵母菌外阴阴道病(VVC)发生率的差异。结果青春发育早期女性BV发生率、炎症发生率、优势菌异常率、VVC发生率分别为38.52%、16.85%、23.33%、1.11%;BV发生率高于VVC发生率,两者比较差异有统计学意义(P<0.05);优势菌异常中革兰阳性球菌检出102例(80.95%),革兰阴性杆菌检出24例(19.05%),两者比较差异有统计学意义(P<0.05)。不同年龄段BV发生率和炎症发生率差异无统计学意义(P>0.05);6岁组的优势菌异常率高于8岁组,差异有统计学意义(P=0.0127)。秋季的BV发生率和优势菌异常率低于其他季节,差异有统计学意义(P<0.05)。结论青春发育早期女性外阴阴道感染以BV为主;优势菌异常中以革兰阳性球菌检出为主;随着年龄的增长,BV发生率和炎症发生率无明显变化。     

Local hormone therapy for genitourinary syndrome of menopause in breast cancer patients: is it safe?

The genitourinary syndrome of menopause (GSM) is a frequent complaint among breast cancer (BC) survivors that lead to an important affection of their quality of life (QoL). Lifestyle measures such as smoking cessation or regular sexual activity are usually insufficient to significantly improve GMS and although therapies such as lubricants and polycarbophil moisturized gels are considered first-line therapies to alleviate symptoms of vulvovaginal atrophy, these non-hormonal options are not able to reverse atrophy once it occurs. Instead, this complaint is corrected by local estrogens. The estrogen vaginal treatment usually used to treat GSM, is an issue of concern in this group due to the possible negative effect over the BC outcomes. On the other hand, the worsening of QoL in these patients due to symptoms related to GSM can lead to discontinuation of hormone adjuvant therapies and therefore must be addressed properly.

The goal of this review is to contribute to health care professionals to make an informed decision to care for their BC patients.     

康妇特栓两种方法治疗外阴阴道念珠菌病的临床观察

【目的】了解康妇特栓两种不同方法治疗外阴阴道念珠菌病（VVC）的疗效及不良反应。【方法】对2005年1月至2005年10月间来本院门诊就诊的单纯性VVC患者120例,随机分成A、B两组。A组：康妇特栓每晚塞阴道1次,1次1粒,连续6d;B组：康妇特栓每天塞阴道2次,早晚各1次,1次1粒,连续3d。于停药后3～7d及月经干净后3d内进行随访,对两组病人的疗效、不良反应等进行对比分析。【结果】A、B两组治疗VVC的总有效率分别为96．43％及96．23％,痊愈率分别为71．43％及67．92％。两组间疗效及不良反应比较,差异无显著性（P〉0．05）。首次用药至自我感觉症状明显缓解的时间≤2d者B组占77．36％,A组占67．86％,B组起效较A组快,但差异无显著性（P〉0．05）。【结论】康妇特栓两种方法治疗VVC疗效及不良反应无差异。康妇特栓是一个安全有效治疗外阴阴道念珠菌病的药物。     

阴道固有免疫因子TLR4和HD5与复发性外阴阴道假丝酵母菌病的相关性研究

目的通过对阴道局部固有免疫特点的研究,探讨复发性外阴阴道假丝酵母菌病(RVVC)的发病机制。方法采用酶联免疫吸附试验测定30例外阴阴道假丝酵母菌病(VVC)患者(VVC组)、24例RVVC患者(RVVC组)及26例健康妇女(对照组)的宫颈阴道灌洗液Toll样受体4(TLR4)及人防御素5(HD5)的水平。结果 VVC组、RVVC组妇女宫颈阴道灌洗液中,TLR4含量明显高于对照组,差异均有统计学意义(t分别=4.41、7.19,P均<0.05),但VVC组TLR4含量虽然高于RVVC组,但差异无统计学意义(t=1.04,P>0.05);VVC组、RVVC组HD5浓度高于对照组,但差异无统计学意义(t分别=1.03、1.57,P均>0.05)。结论阴道局部免疫环境TLR4异常可能是VVC、RVVC发作的主要原因之一,HD5可能与VVC、RVVC的发病无关系。