中西药合剂康妇特栓治疗外阴阴道念珠菌病61例疗效观察
【摘要】 目的 观察康妇特栓治疗外阴阴道念珠菌病（vulvovaginal candidiasis ,VVC）的实际效果。方法 对我院门诊确诊为VVC 及混合感染性阴道炎61例患者，随机分为康妇特栓组和达克宁栓组进行比较。结果 两组第1疗程后的治愈率，康妇特栓组41.94%，明显好于达克宁栓组16.67%，P0.05，差异有显著性。但第2疗程后及总治愈率两组之间差异无显著性（P0.05）。结论 中西药合剂康妇特栓可作为治疗VVC 局部用药的首选药物。但混合感染的治愈需要相对长的疗程。对支原体的治疗使其转阴有一定难度，但可缓解由其造成的阴道症状，彻底治愈混合感染性阴道炎有赖于联合应用其他抗生素。
【关键词】 念珠菌；支原体；炎性细胞；阴道炎；康妇特栓；达克宁栓。
Clinical observation of 61 patients with vulvovaginal candidiasis by treatment of confort pessaries compound medicament synthesized by Chinese traditional medicine and western medicine。
【Abstract】 Objective To observe the factual therapeutic effect of confort pessaries compound suppository synthesized by medicament Chinese traditional medicine and western medicine. Methods 61 patients in our hospital with vulvovaginal candidiasis were randomly divided into confort pessaries and miconazole group. Whereafter, the therapeutic effect of them were compared. Results After the first period of treatment, the cure rate of confort pessaries was 41.94% , which markedly excelled that of miconazole group(16.67%) and there was significant difference between them (P0.05). But there was no significant difference in total cure rate between them (P0.05) after the second period of treatment. Conclusion Confort pessaries compound suppository synthesized by medicament Chinese traditional medicine and western medicine could be used as the preferred medicine to treat vulvovaginal candidiasis. But hybrid infections need longer time. There were some difficulties in curing the infection of mycoplasma, but it could relieve the symptom induced by the infection. So it depended to be associated with other antibiotic to cure hybrid infective colpitis.
【Key words】 candida;mycoplasma;colpitis;inflammatory cell;confort suppository;miconazole suppository。
阴道炎是妇科门诊的常见病，随着广谱抗生素的广泛应用，性传播疾病的增加, 阴道炎尤其是外阴阴道念珠菌病（VVC ）的发病呈上升趋势。并且混合感染、复发性阴道炎的患者增多，这为临床治疗工作带来了一定困难。因此，各种治疗阴道炎的药物应运而生，疗效不一。现就中西药合剂康妇特栓的临床应用效果进行分析和评价。
1 资料与方法。
1.1 一般资料 患者均为来自我院2004年4～7月的门诊病例，根据临床症状、体征及细菌学检查，确诊为单纯VVC (50例)、念珠菌合并支原体(6例)、念珠菌合并炎性细胞(5例)混合感染性阴道炎，共计61例。随机分为两组：康妇特栓组31例，年龄24～76岁，平均42岁；达克宁栓组30例，年龄21～58岁，平均41岁。两组发病高峰均在30～50岁之间，占78.69%。30岁年龄50岁的发病总计占21.31%。两组患者的病程同样，最短2天，最长2年多。两组治疗前复发病例均为7例。
1.2 诊断标准 VVC的诊断参照《外阴阴道念珠菌病诊治规范》［1］， 以实验室检查为主要诊断依据。直接高倍镜检，看见芽孢和菌丝者，确诊为单纯VVC 。如同时镜检看见大量炎性细胞或支原体培养阳性，即诊断为混合感染性阴道炎。
1.3 药物 康妇特栓〔由中加合资太阳石(唐山)药业有限公司提供〕为中西药合剂的广谱杀菌栓剂，主要成分氯苯咪唑硝酸盐、莪术油、冰片等。达克宁栓〔西安杨森制药有限公司产品(比利时)〕400mg/枚，含硝酸咪康唑。
1.4 方法 两组每晚分别将康妇特栓和栓达克宁栓1枚放入阴道内，连续6天为1个疗程。两组均于第7天停药，第8天复查。痊愈者再继续巩固治疗1个疗程。有效或无效者开始实行第2个疗程。第2个疗程结束后，检查及处理原则均同第1个疗程。所有痊愈者均于月经后随诊。如症状、体征、实验室检查又不正常，即诊断为复发。
1.5 疗效判定 痊愈： 症状、体征均消失，镜检未见芽孢和菌丝及炎性细胞。有效： 症状、体征明显减轻，镜检(+)。无效 ： 症状、体征、实验室检查均无改变。
1.6 统计学处理 采用χ2检验。