目的 观察苦参凝胶联合聚甲酚磺醛治疗阴道假丝酵母菌病的临床疗效。方法 纳入2021年6月—2022年6月在武汉中西医结合骨科医院诊治的150例外阴阴道假丝酵母菌病患者，按照数字表法随机分为对照组和治疗组，每组各75例。对照组患者使用聚甲酚磺醛阴道栓，首先清洗外阴，然后以1∶80～1∶100稀释的浓缩液冲洗阴道，睡前放入阴道栓1枚，1次/2 d。治疗组在对照组基础上使用苦参凝胶，睡前推入阴道深处。聚甲酚磺醛栓使用后第2天晚上使用苦参凝胶。两组患者均连续治疗15 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状改善时间、阴道内pH值和菌群密度、阴道内细菌密集度和阴道分泌物炎性因子白细胞介素-8（IL-8）、IL-6和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组患者总有效率明显高于对照组（96.00% vs 86.67%，P<0.05），复发率低于对照组（5.33%vs 16.00%，P<0.05）。治疗后，治疗组患者白带减少、外阴瘙痒、外阴疼痛及阴道黏膜充血症状改善时间短于对照组（P<0.05）。治疗后，两组阴道内pH≤4.5患者例数高于同组治疗前，且治疗后治疗组患者pH≤4.5患者例数显著高于对照组（P<0.05）。治疗后，两组1级和2级细菌密集度明显升高，而3级和4级明显降低（P<0.05），且治疗组1级细菌密集度明显高于对照组，2级明显低于对照组（P<0.05）。治疗后，两组阴道分泌物IL-8、IL-6和TNF-α水平明显降低（P<0.05），且治疗组患者炎症因子水平均低于对照组（P<0.05）。结论 苦参凝胶联合聚甲酚磺醛治疗外阴阴道假丝酵母菌病的临床效果更好，具有更好的抗菌、抗炎作用，还可改善患者性生活疼痛症状，临床复发率低。

Objective To observe the clinical efficacy of Kushen Gel combined with polycresol sulfonaldehyde in treatment of vaginal candida. Methods Patients (150 cases) with vaginal candida in Wuhan Orthopaedic Hospital of Integrated traditional Chinese and Western Medicine from June 2021 to June 2022 were divided into control group and treatment group according to the numerical table method, with 75 cases in each group.. Patients in the control group were treated with Policresulen Vaginal Suppository, firstly, the vulva was washed, and then the vagina was rinsed with a concentrated solution of 1:80-1:100, one vaginal suppository was placed before going to bed, once every 2 d. Patients in the treatment group were administered with Kushen Gel on the basis of the control group, pushed into the depths of the vagina before going to bed, and the gel was used after the Policresulen Vaginal Suppository. Patients in two groups were treated for 15 d. After treatment, the clinical evaluation was evaluated, and the improvement time of clinical symptom, pH value and bacterial population density in vagina, bacterial density in vagina, levels of inflammatory factors IL-8, IL-6 and TNF-α in vaginal secretions in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (96.00% vs 86.67%, P < 0.05), and the recurrence rate was lower than that of the control group (5.33% vs 16.00%, P < 0.05). After treatment, the improvement time of symptom in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the number of patients with vaginal pH ≤ 4.5 in 2 groups was higher than before, and after treatment, the number of patients with pH ≤ 4.5 in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the bacterial concentration of grade 1 and 2 in the two groups was significantly increased, while that of grade 3 and 4 was significantly decreased (P < 0.05), and the bacterial concentration of grade 1 in the treatment group was significantly higher than that of the control group, while that of grade 2 was significantly lower than that of the control group (P < 0.05). After treatment, the levels of IL-8, IL-6 and TNF-α in vaginal secretion in two groups were significantly decreased (P < 0.05), and the level of inflammatory factors in the treatment group was lower than that in the control group (P< 0.05). Conclusion Kushen Gel combined with policresulen in treatment of vaginal candida has better clinical effect in the treatment of vulvovaginal candidiasis, with better antibacterial and anti-inflammatory effects, but also can improve the symptoms of sexual pain, and the clinical recurrence rate is low.

R984