The Study Of Syndrome Manifestation Characteristics Of TCM In Recurrent Vulvovaginal Candidiasis And The Level Of Cytokines In Vaginal Lavage Fluid Of Women With RVVC

Objectives:In this study, by investigating clinical manifestations of women with recurrent vulvovaginal candidiasis (RVVC) to investigate their traditional Chinese medicine (TCM) syndrome manifestations characteristic and related factors, in order to help to prevent this disease relapse. To measure the concentration of interferon gamma (IFN-γ), interleukin-4(IL-4) and IL-12in the vaginal lavage fluid (VLF) of healthy women and women with RVVC. To investigate the level of vaginal concentration of cytokines and vaginal local immunity in RVVC.Methods:A case control study was conducted to compare RVVC group (166cases) with normal group (166cases). Collect cases from out patient department of the first affiliated hospital of Guangzhou University of Chinese Medicine, in Apirl2011to March2012, all of the women filled up "recurrent vulvovaginal candidiasis characteristics of cases Collected Syndrome Table" which designed by meself. VLF samples were obtained between April2011and September2011from23healthy women in their luteal stage and46women with RVVC in remission, of which23cases were in follicular phase and23cases were in their luteal stage. Concentration of IL-4, IL-12and IFN-γ were measured using enzyme-linked immunosorbent assay kits.Result:1.Women in sexual maturity period more likely suffer from RVVC, most patients have many bad living habits, such as wearing tignt pants、likes to eat spicy food、sedentary lifestyle. 2. Most of the RVVC patients have many systemic symptom such as depression or irritability, lumbar pain, forgetfulness, menstrual or premenstrual breast tenderness, dizziness, fatigue and other symptoms. Symptoms in the distribution of attack and remission period was no significant difference (P>0.05)3. RVVC tongue like a greasy coating of tongue is pink, pale tongue, dark tongue, white, red tongue, greasy, red tongue tip side white fur, red tongue, white tongue is pink with thin yellow tongue is pink with thin white tongue edge sharp red, greasy moss is more common; the tongue is pink with thin white tongue as mainly seen in the RVVC patients with remission, compared with the exacerbation of the distribution of the difference was statistically significant (P<0.05). and red tongue tip side moss the greasy mainly seen in the RVVC patients with exacerbation of the distribution of the remission statistically significant difference (P<0.05). Mostly RVVC patients pulse veinlets, moisten pulse, thin string pulse, slippery pulse, thin pulse slippery pulse, taut pulse, but no significant difference in the distribution of attack and remission (P>0.05).4.Concentrations of IL-12and IFN-γ in the VLF of women with RVVC in luteal phase were significantly higher than in the control group only in remission (P<0.05).There is no difference between the follicular phase and the luteal phase in the concentration of these cytokines(P>0.05). The level of IL-4and IFN-γ/IL-4among the three groups were not statistically different (P0.05).Conclusion:1. The occurrence of RVVC can be affected by the climate, diet and unhealthy living habits.2. The tongue and pulse of RVVC patients reflects the hot and humid during the attack period, but the tongue and pulse of patients in the remission period reflects mixed sign of both Deficiency and Empirical.3. In the process of the disease, the pathogenesis of liver, spleen, kidney and other internal organs function disorders is its internal conditions, while the Stagnation of wet evil is the central link for the occouring.4. IL-4、IL-12and IFN-γ may be involved in defending against invasion by RVVC-related microorganism, these results suggest that there is a partial T cell dysregulation in RVVC which may be exacerbated during the luteal stage correlating with the risk of clinical infection. More advanced clinical designs are required to detect the normal protective vaginal response to albicans.