| BackgroundVulvovaginal candidiasis is a common gynecological vulvovaginal inflammatory disease.Western medicine believes that the disease is caused by candida infection.The main reason for the occurrence and recurrence of VVC is the destruction of vaginal microecological balance and the failure to restore after the destruction.Westem medicine treatment of VVC is mainly through oral or local use of anti-fungal drugs,the curative effect is positive.However,when anti-fungal drugs kill the pathogenic bacteria,they fail to timely repair the unbalanced flora status,which often leads to the recurrence of VVC and affects the prognosis.Therefore,it is necessary to actively seek for a supplementary and alternative drug that can remove pathogenic bacteria and eliminate clinical symptoms in time without destroying the normal vaginal microecology,restoring the imbalance of bacterial flora,and avoiding the risk of recurrence and drug resistance to the greatest extent,which has become a hot spot in the research of gynecological reproductive tract infectious diseases.At present,probiotics and traditional Chinese medicine(TCM)are the main research subjects in microecology.This disease in traditional Chinese medicine attribution"leukorrheal diseases",vaginal itch" category,the etiology is " damp evil”,but also with"Heat evil,"Insect pathogenic".Syndrome differentiation of viscera is closely related to spleen and kidney.The pathogenesis is dampness pathogen damages the Chong Channel and Ren Channel,Ren Channl is not solid,The pulse is out of control.Traditional Chinese medicine treatment of this disease,in the improvement of VVC subband abnormalities,vaginal itching,vaginal mucosa congestion and other clinical symptoms and local signs of positive effect.When combined with western medicine,it can shorten the treatment time and reduce the reports of recurrence.Based on the current microecological research background,whether Chinese medicine can inhibit the growth of pathogenic bacteria by affecting the vaginal microecological flora,so as to reduce the recurrence is worth more studies to confirm.On outpatient service,the empirical prescription of Sen bai fumigation and bath recipe combined with fluconazole was used to treat VVC,which syndrome differentiation was definitely of damp-heat staining type.Based on the existing pharmacological research and clinical basis,we propose whether the traditional Chinese medicine shenbai fumigation prescription can exert the protective effect of its combined drug by affecting the microflora of VVC vaginal microecology.ObjectivesTo observe the effect of Shenbaixunyu decoction on the regulation of VVC vaginal flora and short-term recurrence rate.which is composed of ku Sen,huang bai,cangzhu,shechuangzi,bohe,chuanjiao,etc.This study preliminarily discussed the effect of Shenbaixunyu decoction on VVC vaginal flora,providing a reference for the clinical treatment of VVC.MethodA total of 46 patients with VVC,which were in line with western medicine diagnosis and met the requirements of TCM syndrome differentiation for syndrome of dampness-heat diffusing downward.The patients were divided into the experimental group(fumigation with traditional Chinese medicine+fluconazole)and the control group(fumigation with warm water+fluconazole),with 23 cases in each group.Both groups were given fluconazole 150 mg on the first and fourth days.The experimental group was fumigation and washing of vulva once a day with Shenbaixunyu decoction,and the control group was washing of vulva with warm water once a day for a course of 7 days.General data were collected before treatment,VVC score and TCM symptoms and signs score were performed,and PH value,Nugent score,semi-quantitative lactobacillus,lactobacillus grade,dominant bacteria morphology and other indicators related to the micro-ecology of vaginal secretions before treatment were detected.VVC score,TCM symptoms and signs score,efficacy evaluation of mycology negative conversion rate and re-examination of microecological indicators were conducted within 3-7 days after drug withdrawal,and short-term recurrence rate and re-evaluation of microecological indicators were conducted within 3-7 days after the end of the next menstrual period.Results1.Clinical efficacy:the two groups showed significant efficacy in terms of mycology negative conversion rate,TCM syndrome efficacy and VVC score improvement,with no statistical difference between the two groups(P>0.05).2.Vaginal micro:flora:?Nugent score:After treatment,both groups were able to significantly reduce the Nugent score and optimize the Nugent score.The efficacy of the experimental group was better than that of the control group(P<0.05).?Lactobacillus and quantity of Gardner/prevotella:After treatment,the quantity of lactobacillus increased in both groups,while the quantity of Gardner/prevotella decreased.The curative effect of the experimental group was better than that of the control group(P<0.05).?lactobacillus grade:after treatment,lactobacillus grade in both groups changed from"?b grade"of non-dominant bacteria to "?a grade+? grade"of dominant bacteria.The efficacy of the experimental group was better than fluconazole alone during follow-up(P<0.05).?PH,Community density and diversity:the two groups had no significant influence on PH,Community intensity and diversity than before treatment(P>0.05).3.Short-term recurrence rate:during follow-up,short-term recurrence rate(8.7%)in the experimental group was lower than that in the control group(17.39%),and the experimental group was superior to the control group in improving short-term recurrence rate.Conclusion1.The clinical efficacy of Shenbaixunyu decoction combined with fluconazole in the treatment of VVC is positive,which is better than fluconazole alone in reducing short-term recurrence rate.2.Shenbaixunyu decoction may reduce the Nugent score and optimize the Nugent score by promoting the increase of lactobacillus in VVC microflora and the reduction of Gardner/prevotella,so as to have an impact on the microflora of VVC microecology.3.Shenbaixunyu decoction combined with fluconazole in the treatment of VVC has the protective advantages of traditional Chinese medicine in maintaining the efficacy,regulating the number of bacteria and reducing the short-term recurrence rate,which can be used for clinical reference and further study. |
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