目的 研究氟康唑联合克霉唑阴道片治疗念珠菌阴道炎的临床疗效。方法 选取2012年9月—2014年5月鞍钢集团总医院收治的念珠菌阴道炎患者150例,随机分为氟康唑组、克霉唑组、联合治疗组,每组50例。氟康唑组口服氟康唑片,3片/次,1次/d。克霉唑组睡前给予克霉唑阴道片,置于阴道深部,每个疗程用药1次。联合治疗组给予氟康唑和克霉唑阴道片,用法用量同前。3组均以连续7 d为1个疗程,每月重复1个疗程,共治疗3个疗程。治疗后,对3组患者的临床疗效进行评价,同时比较3组瘙痒、灼烧、白带异常、异常分泌物消失时间,炎症因子(IL-2、IL-8、IL-13)和复发率。结果 治疗后,氟康唑组、克霉唑组、联合治疗组总有效率分别为76.0%、70.0%、92.0%,联合治疗组的总有效率显著高于其他两组,差异均有统计学意义(P < 0.05)。联合治疗组瘙痒、灼烧、白带异常、分泌物异常的消失时间均显著短于氟康唑组和克霉唑组,差异均有统计学意义(P < 0.05)。治疗后,3组IL-2、IL-8、IL-13均较治疗前显著降低,同组治疗前后差异有统计学意义(P < 0.05);治疗后,联合治疗组低于以上两组,差异均有统计学意义(P < 0.05)。联合治疗组治疗后2、4、6个月复发率分别为2.0%、4.0%及8.0%,均低于氟康唑组及克霉唑组,差异均有统计学意义(P < 0.05)。结论 氟康唑联合克霉唑阴道片治疗念珠菌阴道炎具有较好的临床疗效,可较快缓解患者的临床症状和体征,降低复发率,值得临床推广应用。

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.