抗菌素联合益生菌协同Kegel训练治疗老年性阴道炎疗效观察
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摘要
目的观察抗菌素联合益生菌同时协同Kegel训练治疗老年性阴道炎的疗效。方法将2015年1月至2018年1月在南通大学附属海安医院妇产科就诊的120例老年性阴道炎患者按照随机数表法分为三组各40例,所有患者均口服复方甲硝唑片,每晚阴道置入双唑泰泡腾片,连共10 d。A组无补充治疗,B组加服益生菌治疗,连续10 d,C组患者在B组治疗基础上行Kegel训练。分别于停药1周后观察临床症状、体征及白带情况,并于1个月、3个月和6个月门诊复查,统计6个月总复发率。结果 A组、B组和C组患者的治疗总有效率分别为75.0%、95.0%和100.0%,B组和C组的总有效率高于A组,差异均有统计学意义(P<0.05);门诊复查6个月,A组、B组和C组患者的复发率分别为87.5%、44.7%和20.0%,A组最高,C组最低,差异均有统计学意义(P<0.05)。结论抗生素联合益生菌同时行Kegel训练治疗老年性阴道炎不仅疗效显著,且能明显降低复发率。
Objective To observe the clinical efficacy of antibiotics and probiotics combined with Kegel training in the treatment of senile vaginitis. Methods A total of 120 patients with senile vaginitis who were admitted to the Department of Gynecology and Obstetrics at Hai'an Hospital Affiliated to Nantong University from January 2015 to January 2018 were randomly divided into three group, with 40 cases in each group. All patients were treated with peros Metronidazole tablets, and the Metronidazole Clotrimazole and Chlorhexidine Acetate vaginal effervescent tablets were placed in vagina every night; the period of treatment was 10 days. group A had no supplementary treatment; group B received oral probiotics treatment for 10 consecutive days; group C underwent Kegel training on the basis of treatment in group B. The clinical symptoms, signs and leukorrhea were observed after 1 week of withdrawal, and outpatient review was performed at 1 month, 3 months, and 6 months after withdrawal. The total relapse rate after 6 months was counted.Results The total effective rates in group A, group B and group C was 75.0%, 95.0% and 100.0%, respectively. The total effective rate of group B and group C was respectively higher than that of group A, both differences were statistical significance(P<0.05). After 6 months of outpatient review, the total relapse rate in group A, group B and group C was87.5%, 44.7% and 20.0%, respectively, with the highest in group A and the lowest in group C; the differences of the three groups were statistical significance(P<0.05). Conclusion Antibiotics and probiotics combined with Kegel training in the treatment of senile vaginitis is not only effective, but also significantly reduces the relapse rate.
Objective To observe the clinical efficacy of antibiotics and probiotics combined with Kegel training in the treatment of senile vaginitis. Methods A total of 120 patients with senile vaginitis who were admitted to the Department of Gynecology and Obstetrics at Hai'an Hospital Affiliated to Nantong University from January 2015 to January 2018 were randomly divided into three group, with 40 cases in each group. All patients were treated with peros Metronidazole tablets, and the Metronidazole Clotrimazole and Chlorhexidine Acetate vaginal effervescent tablets were placed in vagina every night; the period of treatment was 10 days. group A had no supplementary treatment; group B received oral probiotics treatment for 10 consecutive days; group C underwent Kegel training on the basis of treatment in group B. The clinical symptoms, signs and leukorrhea were observed after 1 week of withdrawal, and outpatient review was performed at 1 month, 3 months, and 6 months after withdrawal. The total relapse rate after 6 months was counted.Results The total effective rates in group A, group B and group C was 75.0%, 95.0% and 100.0%, respectively. The total effective rate of group B and group C was respectively higher than that of group A, both differences were statistical significance(P<0.05). After 6 months of outpatient review, the total relapse rate in group A, group B and group C was87.5%, 44.7% and 20.0%, respectively, with the highest in group A and the lowest in group C; the differences of the three groups were statistical significance(P<0.05). Conclusion Antibiotics and probiotics combined with Kegel training in the treatment of senile vaginitis is not only effective, but also significantly reduces the relapse rate.
引文
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[5] HUMMELEN R, FERNANDES AD, MACKLAIM JM, et al. Deep sequencing of the vaginal microbiota of women with HIV[J]. Plos One, 2012, 5(8):e12078.
[6]安瑞芳,曾宪玲.阴道微生态诊治的最新进展[J].中国实用妇科和产科杂志, 2017, 33(8):787-791.
[7] HAN C, WU W, FAN A, et al. Diagnostic and therapeutic advancements for aerobic vaginitis[J]. Arch Gynecol Obstet, 2015, 291(2):251-257.
[8] BODEAN O, MUNTEANU O, CIRSTOIU C, et al. Probiotics:a helpful additional therapy for bacterial vaginosis[J]. J Med Life, 2013, 6(4):434-436.
[9] PENDHARKAR S, BRANDSBORG E, HAMMARSTR?M L, et al.Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection[J]. BMC Infect Dis, 2015, 78(5):255.
[10]刘朝晖.阴道微生态临床治疗策略探讨[J].中国实用妇科和产科杂志, 2017, 33(8):782-785.
[11]程芳,杨云洁,史文静,等.盆底肌康复对预防复杂性外阴阴道假丝酵母菌病及复发性细菌性阴道病复发的疗效研究[J].中国实用妇科和产科杂志, 2017, 33(5):522-525.
[12]李环,龙腾飞,李丹彦,等.产后盆底康复流程第三部分——产后盆底康复措施及实施方案[J].中国实用妇科和产科杂志, 2015, 31(6):522-529.
[13]张琴,陈思路. 2005-2015年我国老年性阴道炎药物治疗疗效的Meta分析[J].上海预防医学, 2016, 28(12):895-898.
[14]马乐,刘娟,李环,等.产后盆底康复流程第一部分——产后盆底康复意义及基本原则[J].中国实用妇科和产科杂志, 2015, 31(5):314-321.
[2]朗景和.重视盆底康复治疗提高女性生活质量[J].中国实用妇科与产科杂志, 2008, 24(8):563-563.
[3] SRINIVASAN S, LIU C, MITCHELL CM, et al. Temporal variability of human vaginal bacteria and relationship with bacterial vaginosis[J]. PLoS One, 2010, 5(4):e10197.
[4] REID G, YOUNES JA, VAN HC, et al. Microbiota restoration:natural and supplemented recovery of hunan mircobial communities[J].Nat Rev Microbiol, 2011, 9(1):27-38.
[5] HUMMELEN R, FERNANDES AD, MACKLAIM JM, et al. Deep sequencing of the vaginal microbiota of women with HIV[J]. Plos One, 2012, 5(8):e12078.
[6]安瑞芳,曾宪玲.阴道微生态诊治的最新进展[J].中国实用妇科和产科杂志, 2017, 33(8):787-791.
[7] HAN C, WU W, FAN A, et al. Diagnostic and therapeutic advancements for aerobic vaginitis[J]. Arch Gynecol Obstet, 2015, 291(2):251-257.
[8] BODEAN O, MUNTEANU O, CIRSTOIU C, et al. Probiotics:a helpful additional therapy for bacterial vaginosis[J]. J Med Life, 2013, 6(4):434-436.
[9] PENDHARKAR S, BRANDSBORG E, HAMMARSTR?M L, et al.Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection[J]. BMC Infect Dis, 2015, 78(5):255.
[10]刘朝晖.阴道微生态临床治疗策略探讨[J].中国实用妇科和产科杂志, 2017, 33(8):782-785.
[11]程芳,杨云洁,史文静,等.盆底肌康复对预防复杂性外阴阴道假丝酵母菌病及复发性细菌性阴道病复发的疗效研究[J].中国实用妇科和产科杂志, 2017, 33(5):522-525.
[12]李环,龙腾飞,李丹彦,等.产后盆底康复流程第三部分——产后盆底康复措施及实施方案[J].中国实用妇科和产科杂志, 2015, 31(6):522-529.
[13]张琴,陈思路. 2005-2015年我国老年性阴道炎药物治疗疗效的Meta分析[J].上海预防医学, 2016, 28(12):895-898.
[14]马乐,刘娟,李环,等.产后盆底康复流程第一部分——产后盆底康复意义及基本原则[J].中国实用妇科和产科杂志, 2015, 31(5):314-321.