联合乳酸杆菌活菌制剂的抗真菌治疗对比单一抗真菌治疗策略对外阴阴道假丝酵母菌病疗效的系统评价

发布时间：2018-10-18 19:48

【摘要】：目的：系统评价应用抗真菌药物联合乳酸杆菌活菌制剂治疗外阴阴道假丝酵母菌病(vulvovaginal candidiasis, WC)的疗效和安全性。方法：检索PubMed、Embase、the Cochrane Central Register of Trial、 CBMdisc、CNKI、VIP和万方等数据库,收集使用抗真菌药物联合乳酸杆菌活菌制剂治疗VVC的临床随机对照试验(randomized controlled trials, RCTs),检索时间截止至2014年2月。主要研究指标为：治愈率、复发率,次要研究指标为：症状缓解率、阴道pH值改善率、不良反应。所有数据处理应用ReviewManager5.2进行meta分析。结果：共纳入8篇RCT,包含1102例患有VVC的育龄期非孕女性(其中558例患者接受抗真菌联合乳酸杆菌活菌制剂治疗,544例患者接受抗真菌药物联合安慰剂或单一抗真菌药物治疗)。Meta分析结果显示：抗真菌药物联合乳酸杆菌活菌制剂明显提高治愈率(OR=3.40,95%CI:1.83～6.29,P=0.0001),降低复发率(OR=0.17,95%CI:0.09～0.33, P0.00001),提高症状缓解率(OR=3.80,95%CI:1.47～9.82, P=0.006),阴道pH值改善率(OR=1.42,95%CI:0.31～6.62, P=0.65)无显著差异,不良反应无统计学差异。结论：抗真菌药物联合乳酸杆菌活菌制剂相较单一抗真菌药物在治疗VVC的治愈率、症状缓解率、降低复发率等方面有更优的疗效,且安全可行,可考虑作为临床有效的辅助治疗策略。
[Abstract]:Objective: to evaluate the efficacy and safety of antifungal drugs combined with active Lactobacillus preparation in the treatment of vulvovaginal candidiasis (vulvovaginal candidiasis, WC). Methods: the databases of PubMed,Embase,the Cochrane Central Register of Trial, CBMdisc,CNKI,VIP and Wanfang were searched, and the searching time of (randomized controlled trials, RCTs), in clinical randomized controlled trial (randomized controlled trials, RCTs),) with antifungal drugs combined with active Lactobacillus preparation for treatment of VVC was collected until February 2014. The main indicators were: cure rate, recurrence rate, secondary study index: symptom relief rate, vaginal pH improvement rate, adverse reaction. All data processing is analyzed by meta using ReviewManager5.2. Results: a total of 1102 non-pregnant women with VVC were included in 8 RCT, articles (558 of them received antifungal therapy combined with live Lactobacilli preparation and 544 received antifungal drugs combined with placebo or single antifungal agents). The results of). Meta analysis showed that antifungal drugs combined with active Lactobacillus preparations significantly increased the cure rate (OR=3.40,95%CI:1.83~6.29,P=0.0001), decreased the recurrence rate (OR=0.17,95%CI:0.09~0.33, P0.00001), improved the remission rate of symptoms (OR=3.80,95%CI:1.47~9.82, P0. 006), and improved the pH value of vagina (OR=1.42,95%CI:0.31~6.62, P0. 65). There was no statistical difference in adverse reactions. Conclusion: the antifungal drugs combined with the active Lactobacillus preparations have better curative effect than the single antifungal drugs in the treatment of VVC in the aspects of cure rate, symptom relief rate and reduction of recurrence rate, and are safe and feasible. It can be considered as an effective adjuvant therapy strategy.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.31

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