湿热体质论文清热止带汤治疗湿热体质型复发性外阴阴道假丝酵母菌病的临床疗效观察（DOC）

湿热体质论文清热止带汤治疗湿热体质型复发性外阴阴道假丝酵母菌病的临床疗效观察（DOC） 湿热体质论文:清热止带汤治疗湿热体质型复发性外阴阴道假丝酵母菌病的临床疗效观察 【中文摘要】探讨湿热体质型复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidiasis, RVVC)经中药口服(清热止带汤)、阴道擦洗、置药(凯妮汀阴道片)以及健康教育等方式治疗的有效性以及复发率。资料与方法:收集我院妇科门诊确诊为湿热体质型复发性外阴阴道假丝酵母菌病的患者60例。将符合纳入标准的对象按随机数字法随机分为治疗组、对照组各30例。治疗过程分为强化治疗和巩固治疗两个阶段。具体方法如下,强化治疗阶段:治疗组,配合中药口服,予阴道擦洗、凯妮汀阴道片阴道置药等方式治疗;对照组,只予阴道擦洗、凯妮汀阴道片阴道置药等治疗。强化治疗结束后停药3天,查阴道分泌物,真菌转阴者进入巩固治疗阶段,即每个月月经干净后第3天开始用药,巩固治疗为期3个月。未转阴者不再按上述方法治疗,并计为无效。在治疗期间两组患者均给予健康教育。观察两组患者治疗前后的临床症状、体征、阴道分泌物检查以及体质等的变化以及追踪随访期间复发情况,并进行统计学分析,探讨治疗复发性外阴阴道假丝酵母菌病的有效方法。结果:1.治疗前两组研究对象在年龄、病程、体质原始分数等方面进行比较无显著性差异(P>0.05)。2.强化治疗后,两组各出现1例无效(真菌未转阴),其余58例患者进入巩固治疗阶段。3.治疗有效率的比较:全部疗程结束后,治疗组与对照组两组总有效率相当,经统计学分析无显著性差异 (P>0.05)。4.治疗组治疗前后体质分数比较有显著差异(P0.05)。5. 复发率的比较:两组全部疗程结束后1个月对照组复发1例,治疗组 无复发,两者经统计学分析无显著差异(P>0.05);结束后2个月治疗 组复发1例,对照组复发1例,两者经统计学分析无显著差异 (P>0.05);结束后3个月治疗组复发1例,对照组复发5例,复发率比 较有显著差异(P<0.05),表明治疗组复发率低于对照组。结论:复发 性外阴阴道假丝酵母菌病的治疗,目前多采用综合治疗的方法,强调 在抗真菌治疗的同时,注意恢复患者的阴道微环境及提高机体免疫 力。本研究通过中药口服、阴道擦洗、凯妮汀阴道片阴道置药以及健 康教育等方式,发挥中医药的优势和特色,有效改善RVVC患者的症 状、体征,降低远期复发率,临床疗效满意,提高患者生活质量,并且能 在一定程度上改善患者的体质状态,对于临床应用有参考价值。因样 本数量少,观察时间短,其结果有待更大样本、更长时间的观察以得到 更准确的结论。 【英文摘要】:This research is about Recurrent Vulvovaginal Candidiasis with Damp-Heat Constitutiont curing by vaginal scrub,oral Chinese medicine(QingReZhiDai Decoction),Canesten vaginal Tablet and Health Education,in order to explore the effectiveness and relapse rate.Methods:Selecting 60 cases who has been diagnosed as Recurrent Vulvovaginal Candidiasis with Damp-Heat Constitutiont,then choose the inclusion criteria of the objects who were randomly divided into treatment group and control group,each group with 30 cases.Treatment process is divided into two phases,intensive therapy and consolidation therapy.Here’s how,intensive therapy:treatmentl group,take with oral Traditional Chinese medicine(QingReZhiDai Decoction),vaginal scrub,Canesten vaginal Tablet and Health Education.control group:just take vaginal scrub,Canesten vaginal Tablet and Health Education.3 days after discontinuation intensive therapy referral, examination of vaginal secretions with negative mycology entered a consolidation stage of treatment, the monthly period beginning 3 days after a clean drug, consolidation period of 3 months. Not negative no longer treated as above, and counted as invalid. During treatment patients were given health education.To observe the patients’ symptoms, signs,vaginal discharge and constitution change before and after these treatment,and relapse rate during the follow-up,then to conduct statistical analysis to explore the effective methods of curing RVVC.Results:1.Before the treatment,each group in age course and Physical raw scores were no significant differences(P>0.05).2.After intensive treatment,1 patient in each group appears invalid (fungi not negative) and the remaining 58 patients entered a consolidation stage of treatment.3.Comparison of efficacy:after all the treatment, the effective rate between treatment group and control group is equivalent,statistical analysis showed no significant difference(P>0.05).4.Physical scores before and after treatment, there was significant difference (P 0.05). 5.Comparison of relapse rate during the follow-up:Consolidate the two groups 1 month after treatment in control group 1 case of relapse, the treatment group had no recurrence, statistical analysis showed no significant difference (P,0.05).The two groups after 2 months of consolidation therapy, treatment group 1 case of recurrence,1 case of recurrence of the control group, statistical analysis showed no significant difference (P>0.05). The two groups 3 months after consolidation therapy in the treatment group relapsed in 1 case, the control group 5 cases of recurrence, relapse rate were significantly different (P< 0.05), indicating that the recurrence rate of the treatment group than the control group.Conclusions:Recurrent vulvovaginal candidiasis treatment, the current approach to use more comprehensive treatment, emphasizing the anti-fungal treatment, attention restoration in patients with vaginal micro-environment and improve immunity. In this study, oral medicine, vaginal scrub set Canesten vaginal tablets vaginal drug and health education, etc., to play the advantages and characteristics of Traditional Chinese Medicine, improve RVVC the symptoms, signs and reduce the long-term recurrence rate, clinical results were satisfactory, improve the quality of life, and to a certain extent, improve the patient’s physical state, a valuable reference for clinical application. Due to small sample size, short duration, the results of the sample to be larger and more long-term observation to more accurate conclusions. 【关键词】湿热体质 复发性外阴阴道假丝酵母病 中药治疗 复 发 【英文关键词】Damp-Heat Constitution Recurrent Vulvovaginal Candidiasis Traditional Chinese Medicine Treatment Relapse 【目录】清热止带汤治疗湿热体质型复发性外阴阴道假丝酵母菌 病的临床疗效观察 中文摘要 4-6 Abstract 6-7 前言 8-9 资料与方法 9-13 结果 13-15 分析与讨论 15-21 结论 21-22 参考文献 22-24 致谢 24-25 附录 25-28 文献综述 28-33 参考文献 31-33 作者简历 33