基于阴道菌群变化机制研究龙胆泻肝汤治疗细菌性阴道炎的临床效果OA
Effect of Longdan Xiegan Decoction(龙胆泻肝汤)in Treatment of Bacterial Vaginitis Based on Mechanism of Vaginal Flora Changes
目的 基于阴道菌群变化机制研究龙胆泻肝汤治疗细菌性阴道炎的临床效果.方法 将2023年6月-2024年6月医院治疗的96例细菌性阴道炎患者作为研究对象,遵循随机、对照原则分为观察组和对照组,每组48例.对照组采用甲硝唑联合克痒舒洗液治疗,观察组在对照组基础上增加龙胆泻肝汤治疗,4周为1个疗程.比较两组患者的疗效,中医证候积分(主症阴道灼感、白带异常、外阴瘙痒)变化,阴道微环境状态(阴道pH值、阴道清洁度),阴道菌群分布及不良反应.结果 观察组总有效率95.83%(46/48),显著高于对照组81.25%(39/48),差异有统计学意义(P<0.05).治疗后,两组患者主症阴道灼感、白带异常、外阴瘙痒积分均显著下降(P<0.05),并且观察组以上各症状评分均低于对照组(P<0.05).治疗后,两组阴道pH值均降低(P<0.05)、阴道清洁度正常率增高(P<0.05),观察组阴道pH值低于对照组、阴道清洁度正常率高于对照组(P<0.05).治疗后,两组患者的阴道优势菌群乳杆菌分布增加(P<0.05),类杆菌、肠杆菌、白念珠菌分布减少(P<0.05),并且观察组乳杆菌分布多于对照组(P<0.05),而类杆菌、肠杆菌、白念珠菌分布少于对照组(P<0.05).两组患者均无严重不良反应.结论 龙胆泻肝汤治疗细菌性阴道炎的效果满意,能够显著改善患者的阴道微环境及阴道菌群分布状况,从而缓解机体各种证候,提高疗效,是安全、有效的用药方案.
Objective To study the clinical effect of Longdan Xiegan Decoction(龙胆泻肝汤)in the treatment of bacterial vaginitis based on the mechanism of vaginal flora changes.Methods Ninety-six patients with bacterial vaginitis treated in the hospital from June 2023 to June 2024 were selected as the research objects.According to the principle of randomization and con-trol,they were divided into observation group and control group,with 48 cases in each group.The patients in the control group were treated with metronidazole combined with Keyangshu Lotion(克痒舒洗液),and the observation group was treated with Longdan Xiegan Decoction on the basis of the control group,4 weeks as a course of treatment.The efficacy,traditional Chinese medicine syndrome scores(main symptoms of vaginal burning sensation,abnormal leucorrhea,vulva pruritus),vaginal microenvi-ronment status(vaginal pH value,vaginal cleanliness),vaginal flora distribution and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 95.83%(46/48),which was significantly higher than 81.25%(39/48)of the control group,the difference was statistically significant(P<0.05).After treatment,the scores of vagi-nal burning,leucorrhea abnormality and vulva pruritus in the two groups were significantly decreased(P<0.05),and the scores of the above symptoms in the observation group were lower than those in the control group(P<0.05).After treatment,the vagi-nal pH values of the two groups decreased(P<0.05),and the normal rate of vaginal cleanliness increased(P<0.05).The vagi-nal pH value of the observation group was lower than that of the control group,and the normal rate of vaginal cleanliness was high-er than that of the control group(P<0.05).After treatment,the distribution of Lactobacillus in the vaginal dominant flora of the two groups increased(P<0.05),and the distribution of Bacteroides,Enterobacter and Candida albicans decreased(P<0.05).The distribution of Lactobacillus in the observation group was more than that in the control group(P<0.05),while the distribu-tion of Bacteroides,Enterobacter and Candida albicans was less than that in the control group(P<0.05).There were no serious adverse reactions in both groups.Conclusion The effect of Longdan Xiegan Decoction in the treatment of bacterial vaginitis is sat-isfactory.It can significantly improve the vaginal microenvironment and vaginal flora distribution of the patients,so as to alleviate various syndromes of the body and improve the curative effect.It is a safe and effective medication regimen.
高吟;李文婷;杨艳琳;胡锡池;张立红
无锡市中医医院,江苏无锡 214000南京中医药大学第一临床医学院,江苏南京 211880无锡市中医医院,江苏无锡 214000无锡市第二人民医院,江苏无锡 214000无锡市中医医院,江苏无锡 214000
医药卫生
细菌性阴道炎龙胆泻肝汤甲硝唑克痒舒洗液阴道微环境阴道菌群
bacterial vaginitisLongdan Xiegan Decoction(龙胆泻肝汤)metronidazoleKeyangshu Lotion(克痒舒洗液)vaginal microenvironmentvaginal flora
《中华中医药学刊》 2026 (5)
54-57,4
国家自然科学基金面上项目(82374346)南京中医药大学校自然科学基金项目(XZR2023)
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