目的 研究氟康唑聯(lián)合克霉唑陰道片治療念珠菌陰道炎的臨床療效。方法 選取2012年9月—2014年5月鞍鋼集團總醫(yī)院收治的念珠菌陰道炎患者150例,隨機分為氟康唑組、克霉唑組、聯(lián)合治療組,每組50例。氟康唑組口服氟康唑片,3片/次,1次/d?？嗣惯蚪M睡前給予克霉唑陰道片,置于陰道深部,每個療程用藥1次。聯(lián)合治療組給予氟康唑和克霉唑陰道片,用法用量同前。3組均以連續(xù)7 d為1個療程,每月重復1個療程,共治療3個療程。治療后,對3組患者的臨床療效進行評價,同時比較3組瘙癢、灼燒、白帶異常、異常分泌物消失時間,炎癥因子(IL-2、IL-8、IL-13)和復發(fā)率。結(jié)果 治療后,氟康唑組、克霉唑組、聯(lián)合治療組總有效率分別為76.0%、70.0%、92.0%,聯(lián)合治療組的總有效率顯著高于其他兩組,差異均有統(tǒng)計學意義(P < 0.05)。聯(lián)合治療組瘙癢、灼燒、白帶異常、分泌物異常的消失時間均顯著短于氟康唑組和克霉唑組,差異均有統(tǒng)計學意義(P < 0.05)。治療后,3組IL-2、IL-8、IL-13均較治療前顯著降低,同組治療前后差異有統(tǒng)計學意義(P < 0.05);治療后,聯(lián)合治療組低于以上兩組,差異均有統(tǒng)計學意義(P < 0.05)。聯(lián)合治療組治療后2、4、6個月復發(fā)率分別為2.0%、4.0%及8.0%,均低于氟康唑組及克霉唑組,差異均有統(tǒng)計學意義(P < 0.05)。結(jié)論 氟康唑聯(lián)合克霉唑陰道片治療念珠菌陰道炎具有較好的臨床療效,可較快緩解患者的臨床癥狀和體征,降低復發(fā)率,值得臨床推廣應(yīng)用。

Objective To investigate the efficacy of fluconazole combined with Clotrimazole Vaginal Tablets in treatment of candida vaginitis. Methods Patients (150 cases) with candida vaginitis in Ansteel Group Hospital from September 2012 to May 2014 were randomly divided into fluconazole, clotrimazole, and combined treatment groups. Each group had 50 cases. Patients in fluconazole group were po administered with Fluconazole Tablets, 3 tablets/time, once daily. Patients in clotrimazole group were given Clotrimazole Vaginal Tablets, deep into the vagina, 1 tablet each of the courses. Patients in the combined treatment group were given Fluconazole Tablets and Clotrimazole Vaginal Tablets, and the usage and dosage was the same to other two groups. Continuous 7 d was as one course of treatment, and the patients were repeated a course of a month, and they were treated for three courses of treatment. After treatment, the clinic efficacies in three groups were evaluated, while disappear times of itching, burning, leucorrhea anomalies, and abnormal secretions, inflammatory cytokines (IL-2, IL-8, IL-13), and recurrence rates were compared. Results After treatment, the clinic efficacies on the patients in the fluconazole, clotrimazole and combined treatment groups were 76.0%, 70.0%, and 92.0%, and the clinic efficacy in the combined treatment group was higher than those in other two groups with the significant difference (P < 0.05). Disappear times of itching, burning, leucorrhea anomalies, and abnormal secretions in the combined treatment group were shorter than those in other two groups with the significant difference (P < 0.05). After treatment, IL-2, IL-8, and IL-13 in three groups were significantly reduced, and the differences were statistically significant before and after treatment in the same group (P < 0.05). And these indicators in combined treatment group were lower than those in other two groups, with significant differences between two groups (P < 0.05). Recurrence rates of the combined treatment group in 2, 4, and 6 months after treatment were 2.0%, 4.0% and 2.0%, respectively, and were lower than those in fluconazole and clotrimazole groups with significant differences between two groups (P < 0.05). Conclusion Fluconazole combined with Clotrimazole Vaginal Tablets has a good clinical efficacy in treatment of candida vaginitis, and can quickly relieve clinical signs and symptoms, and can reduce the recurrence rate, which is worth clinical promotion.