目的 探讨克痒舒洗液联合双唑泰栓治疗外阴阴道假丝酵母菌病的临床疗效。方法 选取2019年4月—2020年4月在汝州市第一人民医院进行治疗的80例外阴阴道假丝酵母菌病患者为研究对象，根据就诊顺序分为对照组（40例）和治疗组（40例）。对照组给予双唑泰栓，睡前将1枚送入阴道深处，1次/d；治疗组在对照组基础上给予克痒舒洗液，每次33 mL，用66 mL温水稀释后放入100 mL冲洗器内，冲洗阴道，1次/d。两组均进行7 d治疗。观察两组的临床疗效，比较两组治疗前后相关评分、血清学指标、阴道菌群指标的变化情况。结果 治疗后，治疗组总有效率97.50%，显著高于对照组的80.00%（P<0.05）。治疗后，两组临床症状评分显著降低，而QLQ-C30评分均显著升高（P<0.05）；治疗后，治疗组临床症状评分显著低于对照组，而QLQ-C30评分显著高于对照组（P<0.05）。治疗后，两组血清白细胞介素-6（IL-6）、白细胞介素-13（IL-13）、人单核细胞趋化蛋白-1（MCP-1）、肿瘤坏死因子-α（TNF-α）较治疗前显著降低，但白细胞介素-12（IL-12）水平显著升高（P<0.05）；但治疗后，治疗组这些血清学指标优于对照组（P<0.05）。治疗后，两组患者菌落≥1/2面积率、阴道菌群纠正率均较治疗前显著提高（P<0.05）；治疗后，治疗组患者这些阴道菌群指标显著优于对照组（P<0.05）。结论 克痒舒洗液联合双唑泰栓治疗外阴阴道假丝酵母菌病具有较好的临床疗效，可有效改善患者相关症状，纠正阴道菌群紊乱，改善机体血清细胞因子水平，提高患者生活质量，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Keyangshu Lotion combined with Metronidazole, Clotrimazole and Chlorhexidine Acetate Suppositories in treatment of vulvovaginal candidiasis. Methods 80 Patients with vulvovaginal candidiasis who were treated in the First People's Hospital of Ruzhou from April 2019 to April 2020 were selected as the research objects, and they were divided into control group (40 cases) and treatment group (40 cases) according to the order of treatment. The control group was given Metronidazole, Clotrimazole and Chlorhexidine Acetate Suppositories, put 1 tablet deep into the vagina before going to bed, once daily. The treatment group was given Keyangshu Lotion on the basis of the control group, 33 mL each time diluted with 66 mL warm water and then put into a 100 mL rinser to rinse the vagina, once daily. Both groups received treatment for 7 days. The clinical efficacy of the two groups was observed, and the changes of relevant scores, serological indexes and vaginal microflora indexes before and after treatment were compared between the two groups. Results After treatment, the total effective rate of 97.50% in the treatment group was significantly lower than 80.00% in the control group (P<0.05). After treatment, the clinical symptom scores of the two groups were significantly decreased, while the QLQ-C30 scores were significantly increased (P<0.05). After treatment, the clinical symptom score of the treatment group was significantly lower than that of the control group, while the QLQ-C30 score was significantly higher than that of the control group (P<0.05). After treatment, the levels of interleukin-6 (IL-6), interleukin-13 (IL-13) and human monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor (TNF-α) in the two groups were significantly lower than those before treatment, but the level of interleukin-12 (IL-12) was significantly higher in the two groups (P<0.05). However, after treatment, these serological indicators in the treatment group were superior to those in the control group (P<0.05). After treatment, the bacterial colony ≥ 1/2 area rate and the correction rate of vaginal microflora in both groups were significantly increased compared with those before treatment (P<0.05). After treatment, these vaginal microflora indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Keyangshu Lotion combined with Metronidazole, Clotrimazole and Chlorhexidine Acetate Suppositories has good clinical effect in treatment of vulvovaginal candidiasis, and can effectively improve the related symptoms, and can correct the disturbance of vaginal flora, and improve the serum cytokine levels, and improve the life quality of patients, which has a certain clinical application value.

R984

河南省医学科技攻关计划项目（201702366）