| Purpose:1.To systematically evaluate the clinical efficacy of oral administration of traditional Chinese medicine in the treatment of vulvovaginal candida disease,and provide evidence support for the application of oral administration of traditional Chinese medicine in this disease.2.To observe the clinical efficacy of Fuzheng Antibacterial Decoction combined with clotrimazole vaginal tablet in the treatment of simple vulvovaginal candidiasis caused by dampness and depression of spleen deficiency,and to provide clinical experience for the application of traditional Chinese medicine in this disease.Methods:1.Computer retrieval China hownet,journal of Chinese service platform,a database of ten thousand,PubMed and the Cochrane Library from the Library to literature in November2020,according to the discharge standard,collect controlled clinical trials of traditional Chinese medicine internal and treat VVC according to Cochrane manual evaluation of literature quality,application RevMan5.3 Meta analysis software.And through the frequency statistical analysis of commonly used oral Chinese medicine in the treatment of VVC medication characteristics.2.A total of 72 patients who met the diagnostic criteria of traditional Chinese and western medicine were collected from the gynecological outpatient department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from November2019 to December 2020,and were divided into experimental group(n = 36)and control group(n = 36)according to the serial number and random number table.The control group was given clotrimazole vaginal tablet for external use,1 tablet/time,single dose;The experimental group was additionally given Fuzheng Antibacterial Decoction for 14 days.Records patients related vulva vagina candida disease grading,vaginal micro ecological index situation and situation of TCM syndrome integral,relapse after three months,and the adverse reactions,using SPSS 21.0 statistical analysis,evaluation of patients with fungal overcast rate,vaginal micro ecological improvement and syndromes curative effect,three months relapse and drug safety.Result:1.Meta-analysis: 33 studies with a total of 3922 subjects were included.Chinese medicine internal medicine or Chinese medicine internal and combined with western medicine treating vulva vagina candida disease,compared with the pure western medicine,the fungi turn rate,clinical cure rate and total effective rate and symptom integral,vaginal itching,abnormal leucorrhea,total clinical symptoms and signs score,vaginal discharge time,IFN-gamma level,IL-6,IL-8 levels,total serum levels of inflammatory cytokines and one/two/three/a six-month recurrence rate advantages are more obvious(P < 0.05);They were also found to have similar therapeutic effects on efficacy,improvement rate,total score of symptoms and signs,improvement time of vulvae pruritus,and levels of TNF-α and IL-4(P > 0.05).No obvious adverse reactions were found in the included literatures.The most common traditional Chinese medicine used are tonifying qi and invigorating spleen,clearing heat and dampness,and enhancing water and dampness.The frequency of single drugs for smoothing liver,cooling blood and promoting blood circulation is also high.2.Therapeutic effect observation:(1)Negative conversion rate: the negative conversion rate of the experimental group was 74.19%,and that of the control group was 82.76%,there was no significant difference between the two groups(P > 0.05).(2)Vaginal microecology:there was no significant difference between the two groups after treatment(P > 0.05).(3)TCM syndrome scores: After treatment,TCM syndrome scores of both groups were improved to a certain extent(P < 0.05).The improvement in scores of "genital pruritus","tiredness and lethargy","laxity and loose stool" and "TCM secondary symptoms" in experimental group was significantly better than that in control group(P < 0.05).Three months later,the scores of TCM syndromes in the test group were significantly improved(P < 0.05),and the scores of "underlying texture","primary symptom of TCM","lethargy","laxity and loose stool","mental fatigue and lazy speech","secondary symptom of TCM" and "TCM syndromes" in the test group were significantly improved than those in the control group(P < 0.05).(4)Efficacy: After treatment,the efficacy of "TCM secondary symptoms" and "TCM syndromes" in the experimental group was significantly better than that in the control group(P < 0.05),and the efficacy of "TCM main symptoms" was similar(P > 0.05).Three months later,the therapeutic effects of "TCM main symptoms","TCM secondary symptoms" and "TCM syndromes" in the experimental group were better than those in the control group(P < 0.05).(5)Total effective rate: After treatment,the total effective rate of "tiredness and drowsiness","lack of appetite and loose stool","Shentianzhilyan" and "TCM subsyndrome" in experimental group was significantly better than that in control group(P < 0.05),and the remaining parts was equivalent(P > 0.05).Three months later,the total effective rates of "white or yellow face","tiredness and drowsiness","laxity and loose stool","mental fatigue and lazy speech" and "TCM subsyndrome" in experimental groups were significantly better than those in control group(P < 0.05),and the remaining parts was equivalent(P > 0.05).(6)Relapse: After three months,the recurrence rate of the experimental group was 4.8%,and that of the control group was 17.4%.There was no significant difference between the two groups(P > 0.05).(7)Safety: There was no obvious adverse reaction during the treatment and follow-up.Conclusion:1.Meta-analysis suggests Chinese medicine internal medicine or Chinese medicine internal and combined with western medicine treating vulva vagina candida disease,compared with conventional western medicine,can further improve the clinical curative effect,improve patients with symptoms and signs,promote the inflammatory factor levels,reduce long-term recurrence rate,good security,deserves further standardized application,provide a higher level of evidence to support;The traditional Chinese medicines commonly used in clinical VVC are mainly spleen invigorating,heat clearing and clearing damp,which are mostly combined with liver regulating qi drugs and blood activating and cooling drugs.2.Fuzheng Antibacterial Decoction combined with clotrimazole vaginal tablet in the treatment of simple vulvovaginal candidiasis caused by wet injection of spleen deficiency can achieve a higher fungal negative conversion rate and a lower long-term recurrence rate,and can significantly improve the early and long-term TCM syndromes.3.Compared with Bictrimazole vaginal tablets,Fuzheng antibacterial soup combined with clotrimazole vaginal tablets has more advantages in terms of total effective rate,early/long-term secondary symptoms of traditional Chinese medicine,curative effect of TCM syndromes,and long-term curative effect of primary symptoms of traditional Chinese medicine.4.Fuzheng Antibacterial Decoction combined with clotrimazole Vaginal Tablet in the treatment of simple vulvovaginal candidiasis caused by wet injection of spleen deficiency is effective and safe,which is worthy of further study and application. |
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