目的 观察保妇康栓联合化学药常规治疗细菌性阴道炎临床疗效及其对细菌耐药性的影响。方法 选取本院2020年1月—2022年12月就诊的168例细菌性阴道炎患者，采用类随机方法，对患者进行编号，并且以交替的方式分配到观察组和对照组，两组各84例患者。对照组采用化学药常规治疗（0.1%苯扎溴铵溶液外阴清洗+甲硝唑片口服），观察组在化学药常规治疗基础上加用保妇康栓。疗程均为14 d。观察两组患者治疗后临床疗效，比较两组治疗前后的临床症状评分、阴道灌洗液炎症因子水平、甲硝唑耐药率情况、阴道分泌物pH值及分泌物细菌数。治疗结束后1个月随访两组患者性生活质量，治疗结束后3个月随访两组患者复发率。结果 治疗后观察组显效率为72.62%，总有效率为94.05%，均显著高于对照组的显效率（51.19%）和总有效率（84.52%），差异具有统计学意义（P＜0.05）。治疗后，两组组患者临床症状评分与治疗前比较均显著改善（P＜0.05），且治疗后观察组4项临床症状评分均显著低于对照组（P＜0.05）；治疗后两组阴道灌洗液白细胞介素-6（interleukin-6，IL-6）和肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）水平均显著下降，且观察组IL-6、TNF-α水平显著低于对照组（P＜0.05）。治疗后，与对照组比较，观察组产生甲硝唑耐药的菌株为5株，显著低于对照组的15株（P＜0.05）。治疗后，观察组pH值下降至3.8～4.5的正常水平，阴道恢复正常的酸性环境。两组患者治疗结束后1个月，性生活质量较治疗前显著改善，与对照组相比，观察组性生活质量改善更好（P＜0.05）。治疗结束后3个月，对照组患者细菌性阴道炎复发24例，复发率28.57%，显著高于观察组（8例，9.5%），差异具有统计学意义（P＜0.05）。两组患者治疗过程中出现的不良反应主要为恶心、呕吐和腹部绞痛等。两组患者不良反应发生率无显著差异。结论 保妇康栓联合化学药常规治疗细菌性阴道炎临床疗效显著，能有效减少耐药菌的产生，并显著降低复发率，值得临床推广应用。

Objective To observe the clinical efficacy of Baofukang Suppository (保妇康栓) combined with conventional chemical drugs in the treatment of bacterial vaginitis and its influence on bacterial resistance. Methods A total of 168 patients admitted to our hospital from January 2020 to December 2022 were selected. They were randomly divided into control group and treatment group, with 84 cases in each group. The control group received conventional Western medicine treatment (0.1% benzalkonium bromide solution for vulva cleaning + metronidazole tablets orally), and the treatment group received Baofukang Suppository on the basis of Western medicine conventional treatment. The course of treatment was 14 d. The clinical efficacy of two groups of patients was observed, and the clinical symptom scores and clinical efficacy of the two groups of patients before and after treatment, the level of inflammatory factors in vaginal lavage fluid, the metronidazole resistance rate, pH value and bacterial count of vaginal secretions were compared. The quality of sexual life of the two groups was followed up one month after the treatment, and the recurrence rate of the two groups was followed up three months after the treatment. Results The observation group had a significant rate of 72.62%, and the total effective rate was 94.05%, which were significantly higher than the significant rate (51.19%) and the total effective rate (84.52%) of the control group, the difference was statistically significant (P < 0.05). The scores of clinical symptoms of the two groups of patients were significantly improved after treatment (P < 0.05). Compared with the control group, the scores of four clinical symptoms in the observation group after treatment were significantly lower than those in the control group (P < 0.05). The levels of IL-6 and TNF-α of the two groups of patients after treatment were decreased significantly, and the levels of IL-6 and TNF-α in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, compared with the control group, there were five metronidazole-resistant strains in the observation group, which was significantly lower than the 15 strains in the control group (P < 0.05); The pH value of the observation group dropped to a normal level of 3.8—4.5, the vagina returned to a normal acidic environment. One month after the end of treatment, the quality of sexual life of the two groups of patients was significantly improved compared with that before treatment. Compared with the control group, the quality of sexual life of the observation group improved better (P < 0.05). In addition, 24 cases of bacterial vaginitis recurred in the control group three month after the end of treatment, with a recurrence rate of 28.57%, which was significantly higher than that in the observation group (8 cases, 9.5%) (P < 0.05). The main adverse reactions during the treatment of the two groups of patients were nausea, vomiting and abdominal cramps. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Baofukang suppository combined with conventional chemical medicine has a significant clinical effect in the treatment of bacterial vaginitis. It can effectively reduce the production of drug-resistant bacteria and significantly reduce the recurrence rate. It is worthy of widespread clinical promotion.

R285.64