乳杆菌活菌制剂对细菌性阴道病的微生态调节作用研究

发布时间：2018-03-28 02:14

本文选题：乳杆菌活菌制剂　切入点：定君生　出处：《大连医科大学》2014年硕士论文

【摘要】：目的：细菌性阴道病(Bacterial Vaginosis, BV)是育龄妇女最常见的泌尿生殖道感染性疾病,其主要临床症状为白带增多,外阴骚痒,给患者的生活带来很大不便,因其易复发,抗生素治疗效果不佳。大量研究认为细菌性阴道病是由于阴道内乳酸菌减少而其他细菌大量繁殖导致的阴道内菌群失调。近年来采用乳杆菌活菌制剂(定君生)治疗细菌性阴道病取得了良好的疗效。但是目前乳杆菌活菌制剂对阴道微生态结构的调节作用尚不明确。本实验对300例细菌性阴道病患者随机使用抗生素(100例),定君生(100例)及抗生素联合定君生(100例),观察乳杆菌在阴道内定植情况及用药前后阴道内微生态结构的变化,为治疗细菌性阴道病提供实验依据。方法：(1)DNA样本提取：分别提取确诊的300例细菌性阴道病患者用药前和用药后的阴道微生物元基因组DNA。 (2)聚合酶链式反应(PCR)：以德氏乳杆菌特异性引物进行PCR,检测300例细菌性阴道病患者用药后乳杆菌在阴道内的定植情况。 (3)聚合酶链式反应-变性梯度凝胶电泳(PCR-DGGE):以细菌16S rDNA V3区通用引物进行PCR,扩增产物进行DGGE,对所得指纹图谱进行分析,以观察患者用药前后阴道内微生态结构的变化。结果:(1)DNA提取结果：300例细菌性阴道病患者均能提取出DNA,但由于个体差异性,提取的DNA浓度不同。 (2)德氏乳杆菌的定植情况：抗生素治疗组用药前后均没有乳杆菌定植;定君生治疗组用药后有乳杆菌定植,检出率为54%；抗生素联合定君生治疗组用药后有乳杆菌定植,检出率为77%,联合用药后乳杆菌定植率大于单独使用定君生治疗组。 (3)用药前后阴道微生态结构的改变：抗生素治疗组用药后微生物种类和数量显著减少,微生态结构有差异；定君生治疗组用药后微生物种类和数量有减少,微生态结构无显著差异,有乳杆菌定植；抗生素联合定君生治疗组,用药后虽较用药前微生物种类和数量有减少,但较前两组均有增加,微生态结构无显著差异,有乳杆菌定植。结论：抗生素对阴道微生态结构有显著影响；定君生对阴道微生态的影响明显小于抗生素。定君生的使用也有利于抗生素干预后阴道微生态平衡的重建。
[Abstract]:Objective: Bacterial Vaginosism (BV) is the most common infectious disease of genitourinary tract in women of childbearing age. Its main clinical symptoms are increased leucorrhea and itchy vulva. Antibiotic treatment is not good. A large number of studies believe that bacterial vaginosis is due to the reduction of lactic acid bacteria in the vagina and other bacteria due to mass reproduction of the vaginal flora imbalance. In recent years, the use of live Lactobacillus preparation (Ding Junsheng). The therapeutic effect on bacterial vaginosis was good, but the regulating effect of Lactobacillus vaginalis on vaginal microecology was not clear at present. In this study, 100 patients with bacterial vaginosis were randomly treated with antibiotics. To observe the colonization of Lactobacillus in vagina and the changes of microecological structure in vagina before and after treatment. To provide experimental basis for the treatment of bacterial vaginosis. Methods DNA samples were extracted from 300 patients with bacterial vaginosis. (2) Polymerase chain reaction (PCR): Lactobacillus de specific primers were used to detect the colonization of Lactobacillus in the vagina of 300 patients with bacterial vaginosis. Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGEA): using the universal primers of bacterial 16s rDNA V3 region, the amplified products were used for DGGE, and the fingerprints were analyzed to observe the changes of microecological structure in vagina before and after treatment. Results the results showed that all the 300 patients with bacterial vaginosis could extract DNA, but the concentration of DNA extracted was different because of the individual difference. (2) the colonization of Lactobacillus de: there was no Lactobacillus colonization before and after treatment in the antibiotic treatment group; the Lactobacillus colonization was detected in the Dingjunsheng treatment group with a positive rate of 54; and the Lactobacillus colonization was found in the antibiotic combined with Junsheng treatment group. The positive rate of lactobacillus was 77%, and the rate of Lactobacillus colonization was higher than that of Dingjunsheng alone. (3) the changes of vaginal microecological structure before and after treatment: the species and quantity of microorganism in antibiotic treatment group decreased significantly, the microecological structure was different, and the species and quantity of microorganism in Dingjunsheng treatment group decreased after treatment. There was no significant difference in microecological structure, but there was no significant difference in Lactobacillus colonization, but there was no significant difference in microecological structure between the two groups, although the species and quantity of microorganism were decreased after treatment with antibiotics combined with Dingjunsheng. Lactobacillus was colonized. Conclusion: antibiotics have a significant effect on the vaginal microecological structure, Dingjunsheng has less effect on vaginal microecology than antibiotics, and the use of Dingjunsheng is also beneficial to the reconstruction of vaginal microecological balance after antibiotic intervention.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.25

【参考文献】