常用抗假丝酵母菌药物对阴道常见乳杆菌生长影响的研究

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。

Influence of Common Antifungal Drugs on Growth of Common Vaginal Lactobacilli

Objective: To study the influence of common antifungal drugs for vulvovaginal candidiasis(VVC) on the vaginal common Lactobacilli.Methods: A total of 60 VVC patients were randomly divided into 3 groups: miconazole group(n=20),itraconazole group(n=20) and nystatin group(n=20).Before treatment,Nugent score of the Lactobacilli was carried out.And after treatment,the time of symptom relief,vaginal pH value,numbers of Lactobacilli and detection rate of H2O2-generating Lactobacilli were observed and analyzed.Result: There was no significant difference in the time of symptom relief and total effective rate(P>0.05).The Nugent score of lactobacillus decreased after treatment,and there was a significant difference on the Nugent score of Lactobacilli among the 3 groups(P<0.05).The detection rates of H2O2-generating Lactobacilli in miconazole group,itraconazole group and nystatin group were 30.0%,60.0% and 25.0%,respectively,there was a significant difference among them(P<0.05).And the detection rate of H2O2-generating Lactobacilli in itraconazole group was significantly higher than that in miconazole group and nystatin group(P<0.05).Conclusion: Itraconazole was effective for the treatment of VVC,and had relatively less influence on the growth of H2O2-generating Lactobacilli,and it can contribute to maintain vaginal normal microflora,and could be an ideal antifungal drug for VVC treatment.