摘要
目的探讨复发性外阴阴道假丝酵母菌病（Recurrent vulvovaginal candidiasis，RVVC）的合理、有效的治疗方案。方法选择96例确诊为复发性外阴阴道假丝酵母菌病的患者，性伴侣常规做龟头分泌物真菌培养，将96例患者随机分成两个治疗组，A组口服伊曲康唑0．1gBid×7d为1疗程，下次月经干净后2～3d开始重复治疗，连续6个疗程；B组：在A组基础上同时用克霉唑栓0．15g阴道上药Qd×10d，连续6个疗程，每次月经干净后2～3d开始治疗。性伴侣龟头分泌物真菌培养阳性者，同时口服抗真菌药物治疗。治疗完成后第4、8、12、24周进行临床及真菌观察评定疗效。结果96例性伴侣中有10例有龟头炎或包皮过长，这10例性伴侣其龟头分泌物真菌培养均为阳性，而另86例其性伴侣无龟头炎或包皮过长，性伴侣龟头分泌物培养只有2例偶见真菌。二种治疗方法结果分析：（1）A、B二个治疗组治疗4周后治愈率比较其x^2=0，P〉0．05，差异无显著意义；（2）A与B比较8周后的治愈率，x^2=8．98，P〈0．01，差异有显著意义；（3）A与B比较24周后复发率，x^2=26．50，P〈0．01，差异有显著意义。结论RVVC不是一种性传播性疾病，但其性伴侣有龟头炎、包皮过长时必须服药治疗，如果性伴侣没有包皮过长及龟头炎时，则无需同时治疗。小剂量、长时间口服伊曲康唑及口服加阴道用药治疗RVVC近期均有较好的疗效，但远期疗效，联合用药优于单纯口服药物。
Objective To explore the reasonable and effective treatment program of recurrent vulvovaginal candidiasis （ RVVC ） bier.hods A total of 96 women with RVVC were randomly divided into two treatment groups .Group A took single-dose oral itraconazole capsule 0.1 × Bid for 7 days course of treatment; on the basis of group A, group B were treated with clotrimazole suppositories 0.15 via vaginamedication.The two groups would continue to consolidate the treratment for 6 courses after 2-3days menstruation. Sex- ual partners balanop-osthitis secretions were given anti-fungal treatment with fungal culture positive. The assessment of curative effect were at the end of 4th, 8th, 12th, 24th week treatment. Results Of 10 sexual partners with balanitis or redundant prepuce was fungi positive.Another sexual partners of 86 without balanitis or redundant prepuce were only 2 cases found fungal. There were no statistical differernce between group A, B after 4weeks（x^2=0, P〉0.05 ） .A group was more efficient than B group after 8 weeks（ X^ 2=8.98, P〈 0.01 ）. There were statistical differernce between group A, B after 24 weeks recurrent （ x^ 2=26.50, P〈 0.01 ）. Conclusions RVVC is not sexually transmitted.If their sexual companions have balanitis or redundant prepuce , RVVC can be transmitted through sexual life ; So it is necessary for sexual partners to treatment at the same time. Reversely, it is not. Low-dose and prolonged oral itraconazole and combination treatment were effective in short-time, but the long-term effect, the combi- nation was better than oral drugs.
出处
《国际医药卫生导报》
2010年第3期267-269,共3页
International Medicine and Health Guidance News
基金
基金项目：广东省社会发展领域科技资助项目（53050）
