Clinical Observation On Treatment Of Damp-heat Vulvovaginal Candidiasis With Jiawei Zhidai Decoction Combined With Nystatin Suppository

Objective:To observe the clinical therapeutic effect of Jiawei Zhidai Decoction combined with nystatin vaginal suppository in the treatment of vulvovaginal candidiasis(VVC)with damp-heat downward injection,and to provide medication basis for the clinical treatment of VVC with oral Chinese medicine combined with external use of western medicine,reduce the recurrence rate,explore the advantages of the combination of Chinese and western medicine in the treatment of VVC,but also for the prevention and treatment of the disease to provide a certain TCM syndrome differentiation thinking.Methods:According to the randomized control method,74 patients with VVC who met the inclusion criteria in the Department of Obstetrics and Gynecology of Gansu Hospital of Traditional Chinese Medicine from September 2019 to August 2020 were collected and randomly divided into two groups according to the order of patient treatment.The control group was treated with nystatin vaginal suppository,and one piece was placed in the deep vagina before bedtime,once a night;The observation group was treated with modified Zhidai decoction on the basis of the control group,1 dose per day,twice a day in the morning and evening.Both groups were treated for 2 weeks,lactobacillus quantification,vaginal cleanliness,VVC score,total score of TCM syndrome and Candida test results were collected one week after treatment.and the recurrence was collected after 3 month of treatment to evaluate the curative effect.Result:1.There were significant differences in lactobacillus quantification,vaginal cleanliness,VVC score,total score of TCM syndrome and candida test results between the two groups before and after treatment(P<0.05),indicating that both treatments could improve lactobacillus quantification,vaginal cleanliness,VVC score,TCM syndrome and Candida examination results.2.After treatment,the total effective rate of TCM syndromes in the treatment group and the control group were 94.6% and 81.08%,respectively,with statistical difference(P<0.05),indicating that the total efficacy of TCM syndromes in the treatment group was better than that in the control group.After treatment,there was no statistically significant difference in the improvement of the three syndromes of hypochromatism,bitter mouth and sticky mouth,and small abdominal pain between the two groups(P>0.05).The other TCM syndromes were statistically different(P<0.05),indicating that the treatment group had no significant effect on hypochromatism,bitter mouth and sticky mouth,and small abdominal pain,and the efficacy of the other single syndromes was better than that of the control group.3.After treatment,the results showed that the negative rate was 89.2% and the positive rate was 10.8% in the treatment group.In the control group,the negative rate was 86.5%,and the positive rate was 13.5%.There was no statistical difference in the negative conversion rate of candida between the two groups(P>0.05),indicating that the treatment methods in the two groups had the same effect in the treatment of negative conversion of candida.4.After treatment,the comprehensive efficacy of the treatment group and the control group was 91.89 % and 86.49 %,respectively,with statistical difference(P<0.05),indicating that the comprehensive efficacy of the treatment group in the treatment of VVC with damp-heat injection was better than that of the control group.5.The recurrence rate of the two groups of patients with VVC was evaluated.After 3month,the recurrence rate of the treatment group was 11.77 %,and that of the control group was 34.38 %,with statistical difference(P<0.040),indicating that the treatment group was more effective in reducing the recurrence rate.6.During the treatment,74 patients had no adverse reactions related to the drugs used for treatment,and the safety indicators were within the normal reference range,and there was no abnormal change.Conclusion:1.The total efficacy of Jiawei Zhidai Decoction combined with nystatin vaginal suppository in the treatment of VVC with damp-heat downward injection was better than that of single nystatin vaginal suppository.2.There was no significant difference in the negative conversion rate of VVC Candida between Jiawei Zhidai Decoction combined with nystatin vaginal suppository and single nystatin vaginal suppository in the treatment of damp-heat type.3.Jiawei Zhidai Decoction can improve the TCM syndrome of VVC patients with damp-heat downward injection and reduce the recurrence rate.