健脾利湿法联合西药治疗复发性外阴阴道假丝酵母菌病的临床观察(1)
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[摘要] 目的 探讨健脾利湿法联合西药治疗脾虚型复发性外阴阴道假丝酵母菌病的临床应用及疗效。方法 选取来本院就诊复发性外阴阴道假丝酵母菌病患者38例，实际完成研究34例，将来患分成两组，对照组16例，治疗组18例，比较两组患者治疗前后阴道症状体征的评分、假丝酵母菌、pH值、清洁度及乳酸杆菌等的差异。结果 治疗组在临床症状与体征评分、阴道假丝酵母菌转阴率、阴道分泌物清洁度等方面均有治疗效果，且较对照组有优势；而对阴道内pH值、乳酸杆菌治疗效果及优势不明显。结论 健脾利湿法联合西药治疗复发性外阴阴道假丝酵母菌病，在临床症状与体征改善、假丝酵母菌转阴率方面有明显优势，临床可以大力推广。
[关键词] 脾虚型；复发性外阴阴道假丝酵母菌病；健脾利湿法；疗效
[中图分类号] R711.31 [文献标识码] A [文章编号] 1674-4721(2012)02(c)-0107-03
Clinical observation of wet the spleen method combined western medicine treatment of recurrent vulvovaginal candidiasis candida disease
PANG Zhuochao WU Suzhen
Department of Gynecology, the Hospital of TCM in Guangdong Province, Foshan 528000, China
[Abstract] Objective To explore invigorating spleen clearing damp method combined western medicine treatment of recurrent vulvovaginal candidiasis in clinical application and curative effect. Methods Chose 38 cases of recurrent vulvovaginal candidiasis patients. 34 patients had actual completed the study, they were divided into two groups: 16 cases in control group, 18 cases in treatment group. Compared the two groups of patients before and after treatment of vaginal symptoms and signs score, candida mycoderma bacteria, pH value, cleanness and lactic acid bacteria differences. Results The treatment group in clinical symptoms and signs score, and false vaginal yeast silk shade rate, vaginal cleanness were treatment effect, and a control group had the advantage. But for vagina pH value, lactobacillus treatment effect and advantage was not obvious. Conclusion Invigorating spleen clearing damp method therapy of type of insufficiency of the spleen recurrent vulvovaginal candidiasis, in clinical symptoms and signs of improvement, candida mycoderma bacteria turn into negative rate has obvious advantages, it can be popularized strongly in clinical.
[Key words] Type of insufficiency of the spleen; Recurrent vulvovaginal candidiasis; Invigorating spleen clearing damp method; Curative effect
外阴阴道假丝酵母菌病(又称外阴阴道念珠菌病)1年发作4次及以上，被称为复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidiasis，RVVC)。RVVC的病因及发病机制复杂，相对外阴阴道假丝酵母菌病，RVVC较少见，但因发作频繁，症状反复，其影响更为严重。由于RVVC顽固难愈、病因复杂以及对妇女身心的严重影响，已成为临床上研究的难点和热点。笔者对RVVC患者采用健脾利湿中药组方，拟完带汤为基础方辨证加减，配合西药规范治疗，并进行临床对照观察，现报道如下：
1 资料与方法
1.1一般资料
自2010年7月~ 2011年5月的11个月里，本院(佛山市中医院)门诊共收入RVVC的患者38例，将来患随机分为两组，即治疗组与对照组，每组患者19例。治疗前症状体征评分治疗组平均8.84分，对照组平均10.79分(P > 0.05)。所有患者样本检测阴道假丝酵母菌均为阳性。pH值方面，治疗组11例正常，8例异常，对照组12例正常，7例异常(P > 0.05)。清洁度方面，治疗组9例为Ⅲ度，10例为Ⅳ度，对照组6例为Ⅲ度，13例为Ⅳ度，两组患者均为异常。两组患者乳杆菌均为阴性。以上指标治疗前均无显著性差异，具有可比性。
根据第7版《妇产科学》中提到的“确诊VVC——具有阴道炎症状或体征的妇女阴道分泌物中找到假丝酵母菌的芽生孢子或假菌丝；确诊RVVC——1年内VVC发作4次或以上”为西医诊断标准[1] ......
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