Clinical Study On The Effect Of Integrated Traditional Chinese And Western Medicine On Vaginal Microecology In RVVC Patients With Spleen Deficiency Syndrome

Objective:To explore the clinical therapeutic effect and microecological mechanism of treating recurrent vulvovaginal candidiasis（RVVC）with spleen deficiency syndrome by combining traditional Chinese and western medicine.In this study,the combination of internal and external treatment of traditional Chinese medicine with Guqi Lishi Decoction decoction combined with external washing formula,combined with conventional antifungal treatment of spleen deficiency RVVC by clotrimazole suppository of western medicine,Observe the differences in the integral changes of TCM syndromes and local physical signs,the changes of vaginal micro-ecology before and after treatment,clinical efficacy,recurrence,and time for symptom improvement,and explore the mechanism of the treatment of combined traditional Chinese and western medicine on the vaginal micro-ecology of RVVC patients with spleen deficiency syndrome,analyzed its therapeutic effect,provide more efficient,standardized and safe treatment methods for the prevention and treatment of RVVC.Method:The 72 patients who met the criteria were randomly divided into two groups.The control group was given clotrimazole suppository vaginal injection,and continuous use for 1 week was the first course of treatment;On this basis,the study group added oral administration of Guqi Lishi decoction and external washing formula to smoke sitz bath,and used continuously for 1 week as the first course of treatment.After 3 days of discontinuation of the drug,the vaginal discharge was retested,and the fungus turned negative patients continued to be treated for 2 courses as consolidation therapy,and began to start after menstruation was clean,and the dose and method used were the same as the first course of treatment.The changes in the scores and microecological detection indexes,symptom improvement time,total effective rate,and recurrence of traditional Chinese medicine and western medicine were compared between the two groups,and statistical comparison was carried out.Result1.Comparison of TCM syndrome points:The points and total scores of TCM symptoms and total points before and after treatment in the study group were significantly different（P<0.05）.In addition to less breath,lazy speech,fatigue,lethargy,less intake,and loose stool,the comparative differences in the symptom points and total points groups were statistically significant（P<0.05）.Comparison between groups:there were curative effects in improving the volume,color,quality,odor and vulvar itching in both groups（P<0.05）.The study group had better efficacy in improving subband volume,subband texture and vulvar itching（P<0.05）.The study group was superior to the control group in improving some syndromes of spleen deficiency（mental fatigue,anorexia and loose stool）,and the difference was statistically significant（P<0.05）.2.Comparison of local signs:both groups had efficacy in improving local vaginal signs,and the study group had better efficacy in improving vaginal mucosal hyperemia and edema and secretion volume（P<0.05）.3.Comparison of vaginal microecology:（1）The efficacy of the two groups was not significant in improving PH value,β-glucuroniderase and sialidase（P>0.05）;（2）In terms of improving cleanliness and H₂O₂,both groups had efficacy,the study group was better than the control group（P<0.05）;（3）In terms of improving Vaginobacillus,there was no significant difference in Vaginobacillus after treatment in the control group（P>0.05）,and the treatment of Vaginobacillus in the study group increased significantly,and the efficacy was significant（P<0.05）;（4）In improving leukocyte esterase,acetylglucosasidase and coagulase,both groups had curative effects,and the efficacy was comparable（P>0.05）.4.Comparison of clinical efficacy:2 patients in the study group after treatment were ineffective（2/33,6.06%）,31 patients were effective（31/33,93.94%）,6 patients in the control group were ineffective（6/32,18.75%）,and 26 patients were effective（26/32,81.25%）,and the total effective rate of the study group was higher（P<0.05）.5.Patients who were effective in treatment were followed up for 3 months,and the recurrence rate of 3.22%（1/31）in the study group was significantly lower than that in the control group of 26.92%（7/26）,the difference is statistically significant（P<0.05）.6.Comparison of clinical symptom improvement time:The improvement time of clinical symptoms（vulvar itching pain,dysuria,excessive amount of belt,etc.）in the study group was shorter than that of the control group（P<0.05）.7.During the treatment and follow-up of the two groups,there was no local irritation,no rash,dizziness,gastrointestinal reactions（such as nausea,vomiting,diarrhea,etc.）,and no abnormalities in liver and kidney function tests.Conclusion1.Guqi Lishi decoction combined with external washing formula and clotrimazole suppository have good clinical efficacy in the treatment of spleen deficiency RVVC.2.Guqi Lishi decoction combined with external washing formula and clotrimazole suppository can significantly reduce the TCM symptoms and vaginal local signs and total points of patients with spleen deficiency RVVC,and improve the symptoms and signs of patients.3.Guqi Lishi decoction combined with external washing formula TCM internal and external treatment can improve vaginal cleanliness,promote H₂O₂to Yin,increase the number of vaginal bacilli,sterilize and accelerate the repair of damaged vaginal mucosa,thereby improving the vaginal microecology of RVVC patients.4.The combination of traditional Chinese and Western medicine treatment of Guqi Lishi decoction combined with external washing formula and clotrimazole suppository can shorten the time of uncomfortable symptoms such as itching and painful urination in patients.