细菌性阴道病的诊治研究

对211例细菌性阴道病(BV)患者及200名正常育龄妇女自愿受检者取阴道侧壁分泌物涂片,革兰氏染色,油镜(×100)下观察5～8个视野寻找线索细胞。记录涂片中乳酸杆菌、白细胞、上皮细胞、球菌数目,从而确定阴道清洁度、阴道液质量,进行氨试验,探讨BV患者生态环境的变化。对于确诊的211例BV患者分别采用碘氧碘溶液与阴康宁治疗。治疗1或2个疗程后复查:停药28～35天后观察疗效。77.73％的BV患者乳酸杆菌缺失与对照组比较差异明显。根据Spiegeal涂片分级,BV患者无Ⅰ级,而对照组175例占87.5％。碘氧碘组治愈率为96.26％,阴康宁组为71.15％,差异有显著性(P<0.01)。结论:除线索细胞是诊断细菌性阴道病具有特征性指标外,阴道乳酸杆菌的缺失这一特征不容忽视。除传统的甲硝唑外,用碘氧碘溶液治疗细菌性阴道病效果显著。

The Diagnosis and Treatment of Bacterial Vaginosis

To study the clinical manifestation and treatment of bacterial vaginosis. Methods; Vaginal discharge samples taken from 211 patients with BV and 200 healthy women at childbearing age were screened by Gram-stained vaginal smears, which were under microscopic observation within 5~8 fields of vision to look for clue cells and to record the amount of lactobacillus,leukocyte,epithelium cells and coccus in order to decide degree of vaginal cleanness. The smears' were graded with Spiegeal method and in the meanwhile,the pH value and quality of vaginal discharge were measured,and the positive amine test was carried out to study the ecological environment changes in BV patients. The 211 diagnosed BV patients were divied into two groups,and one group was treated with the combination of potassium iodide,hydrogen peroxide solution,and iodine(IOI group),and another with Yinkangning(a preparation of metronidazole). A check-up followed after one or two courses of treatment and curative effects were observed 28~35 days after medical treatment. Result:77.3% of the BV patients were cleared of vaginal lactobacillus,and there was a significant difference between BV patients and healthy controls. It was found by grading the smears with Spiegeal method that grade I was absent in IOI group while 175 of 200 cases(87.5% )in the control group belonged to grade I. The IOI group had a cure rate of 96.26% while the metronidazole group had only 71.15% . Conclusion: The IOI treatment was an effective treatment for BV besides the traditional treatment with metronidazole.