5-硝基咪唑类药物治疗细菌性阴道病的临床疗效比较

目的 评价5-硝基咪唑类药物口服和联合用药治疗细菌性阴道病的疗效和副作用,从而为病人提供经济有效的治疗方法.方法 开放的随机前瞻性的研究,将278例有细菌性阴道病的病人分成8组:(1)口服甲硝唑缓释片,每次750 mg,每天1次,连续使用7 d.(2)口服甲硝唑缓释片,每次750 mg,每天1次,连续使用7 d,同时阴道用替硝唑栓,每天250 mg,连续使用7 d.(3)口服替硝唑,每次1 g,首次加倍,每日1次,连服3 d.并使用阴道用替硝唑栓,每天250 mg,连续使用7 d.(4)口服替硝唑,每次1 g,首次加倍,每日1次,连服3 d.(5)口服奥硝唑3 d,每天2次,每次500mg并使用阴道用替硝唑栓,每天250 mg,连续使用7 d.(6)口服奥硝唑3 d,每天2次,每次500 mg.(7)以单一剂量口服塞克硝唑2 g并使用阴道用替硝唑栓,每天250 mg,连续使用7 d.(8)一次性口服塞克硝唑2 g.结果 药物联合使用病人的临床治愈率范围为80.00%～86.11%,仅仅口服用药病人的临床治愈率范围56.76%～62.50%.几种5.硝基咪唑类药物口服和阴道联合用药的疗效与仅仅口服用药疗效差异有统计学意义,口服用药组之间和联合用药组之间疗效差异都无统计学意义.结论 甲硝唑、替硝唑、奥硝唑、塞克硝唑口服合并替硝唑阴道用药疗效比单独口服好.甲硝唑、替硝唑、奥硝唑、塞克硝唑之间疗效差异无统计学意义,从耐药性及长期用药的安全性和依从性来看,奥硝唑和塞克硝唑具有优势.

Efficacy of 5-nitroimidazole derivatives in trcatment of bacterial vaginosis

Objective To evaluate the efficacy and adverse effects of 5-nitroimidazole derivatives in treatment of bacterial vaginosis (BV). Methods 278 BV patients were randomly divided into 8 groups to be treated with (1) oral metronidazole sustained release tablet 750 mg/day for 7 days, (2) oral metronidazole sustained release tablet 750 mg/day for 7 days and vaginal tinidazlole 250 mg for 7 days, (3) oral tinidazlole 1 g/day for 3 days (2 g for the first dose), (4) oral tinidazlole 1 g/day for 3 days (2 g for the first dose), (5) oral ornidazole 2 x 500 mg/day for 3 days and vaginal tinidazlole 250 mg for 7 days, (6) oral ornidazole 2 × 500 mg/day for 3 days, ( 7 ) oral secnidazole 2 g in a single dose and vaginal tinidazlole 250 mg for 7 days, and (8) oral seenidazole 2 g in a single dose. Results The clinical cure rates of the oral administration groups were 56. 76% - 62. 50%, all significantly lower than those of the oral/vaginal combination groups (80. 00% -86. 11% , all P < 0. 05 ). There was nit significantly difference in efficacy level among the only oral treatment groups and the oral/vaginal combination groups (all P>0.05). Conclusion Combination of oral and vaginal administration of 5-nitroimidazole derivatives is more effective in treatment of BV than oral administration only.