乳杆菌对女性生殖道感染的干预治疗调查

发布时间：2018-07-09 18:52

本文选题：乳杆菌制剂 + 阴道微生态评价　；参考：《吉林大学》2013年硕士论文

【摘要】：目的：通过对我院妇科门诊就诊的阴道炎患者及健康体检者，进行阴道分泌物检测和阴道微生态评价，分析阴道微生态平衡的影响因素，调查阴道微生态失调的检出率、各种阴道炎症的构成比等，并根据阴道微生物检测及微生态评价结果，探讨微生态疗法在女性阴道炎症治疗中的临床价值，为预防阴道炎症的发生和降低阴道炎症的复发，提供更好的方法。方法：将2012年9月至2013年3月间，就诊于我院妇科门诊的阴道炎患者、健康体检者总计1560例，作为研究对象,以体检结合问卷调查的形式对每一位调查对象进行阴道分泌物检测和阴道微生态评价，统计出阴道微生态失调的检出情况，各种阴道炎症的构成情况；同时，对于患有阴道炎症的患者，依据自愿原则，在治疗上分别采取抗（真）菌药组及抗（真）菌药+乳杆菌制剂组，比较并分析两组的治疗效果（治愈率、复发率）；对于只存在微生态失调而无阴道感染的患者，同样依据自愿分为两组，即干预组和未干预组，比较两组的患病情况。结果： 1.1560例调查对象中，阴道微生态失调者1089例，失调检出率为69.81%。1089例阴道微生态失调患者中，892例患阴道炎症，197例无阴道炎症状，，感染罹患率为81.91%。其余471例妇女，阴道微生态正常。 2.892例阴道炎构成情况：单纯VVC335例，占37.56%；单纯BV267例，占29.93%；单纯TV189例，占21.19%；混合感染101例，占11.32%。 3.668例无阴道感染者阴道微生态评价结果：微生态正常471例，占70.51%；微生态失调197例，占29.49%。 4.两种不同方法治疗阴道炎效果比较：（7天、14天的治愈率，3个月的复发率） 1）单纯VVC：抗真菌药组170例，抗真菌药+乳杆菌制剂组165例：7天治愈率分别为87.65%和91.52%，P0.05，差异无统计学意义；14天治愈率分别为94.71%和99.39%，P0.05，差异有统计学意义；3个月复发率分别为13.53%和3.03%，P0.01，差异有统计学意义。 2）单纯BV：抗菌药组134例，抗菌药+乳杆菌制剂组133例：7天治愈率分别为90.30%和98.50%，P0.01，差异有统计学意义；14天治愈率分别为98.51%和100.00%，P0.05，差异无统计学意义；3个月复发率分别为8.96%和0.00%，P0.01，差异有统计学意义。 3）单纯TV：抗菌药组98例，抗菌药+乳杆菌制剂组91例：7天治愈率分别为92.86%和100.00%，P0.05，差异有统计学意义；14天治愈率分别为97.96%和100.00%，P0.05，差异无统计学意义；3个月复发率分别为10.20%和0.00%，P0.01，差异有统计学意义。 4）混合感染：抗(真)菌药组49例，抗(真)菌药+乳杆菌制剂组52例，7天治愈率分别为69.39%和88.46%；P0.05，差异有统计学意义；14天治愈率分别为93.88%和100.00%；P0.05，差异无统计学意义；3个月复发率分别为26.53%和3.85%；P0.01，差异有统计学意义。 5.微生态制剂对于阴道微环境的调节：对首次检查无阴道炎的197例阴道微生态失调者中，95例接受了预防性干预（乳杆菌组），102例未接受干预。干预组在干预后的3个月，行阴道分泌物检测，有16人患阴道炎，（分别为VVC9例、BV4例，TV3例，无混合感染），发病率为16.84%；未干预组，在同一时间行阴道分泌物，有35例患阴道炎症，（其中VVC16例，BV11例，TV7例，混合感染１例）发病率34.31%；P0.01，差异有统计学意义。结论: 1.阴道微生态失调是各种阴道炎的重要影响因素。 2.外阴阴道假丝酵母菌病和细菌性阴道病是最常见阴道炎。 3.部分正常妇女也存在阴道微生态失调。 4.乳杆菌制剂能够增加治疗各种阴道炎药物的疗效。 5.乳杆菌制剂用于调节阴道微环境，可以预防各种阴道炎的发生。
[Abstract]:Objective: through the examination of vagina secretion and the microecological evaluation of vagina, the influence factors of vaginal microecological balance were analyzed, the detection rate of vagina microecological imbalance and the composition ratio of various vaginitis were investigated, and the results were based on the vaginal microorganism detection and microecological evaluation. To explore the clinical value of microecological therapy in the treatment of female vaginitis, and to provide a better way to prevent the occurrence of vaginitis and to reduce the recurrence of vaginitis.
Methods: from September 2012 to March 2013, a total of 1560 cases of vaginitis in the gynecologic outpatient department of our hospital were treated with a total of 1560 cases. As a study object, the detection of vaginal secretions and the vaginal microecological evaluation were carried out in the form of physical examination and questionnaire investigation, and the detection of vaginal microecological disorders was found. At the same time, for the patients with vaginitis, according to the voluntary principle, the anti (true) bacteria medicine group and the anti (true) drug + lactobacillus preparation group were adopted respectively, and the treatment effect (cure rate, recurrence rate) of the two groups was compared and analyzed, and the patients with only microecological disorder but no vaginal infection were also based on the same basis. They were voluntarily divided into two groups, namely, intervention group and non intervention group. The prevalence of two groups was compared.
Result:
Among the 1.1560 cases, 1089 cases of vagina microecologic maladjustment were found in 69.81%.1089 cases, 892 cases were vaginitis, 197 had no vaginitis, the infection rate was the other 471 cases of 81.91%., and the vagina microecology was normal.
2.892 cases of vaginitis constitute: simple VVC335 cases, accounting for 37.56%; simple BV267 cases, accounting for 29.93%; simple TV189 cases, accounting for 21.19%; mixed infection 101 cases, accounting for 11.32%.
Results of vaginal microecological evaluation in 3.668 cases without vaginal infection: 471 cases of Microecology were normal, accounting for 70.51%, and 197 cases of microecological imbalance, accounting for 29.49%.
4. comparison of two different treatments for vaginitis: (7 days, 14 days cure rate, 3 months recurrence rate)
1) simple VVC: antifungal drug group 170 cases, antifungal drugs + lactobacillus preparation group 165 cases: 7 days cure rate was 87.65% and 91.52%, P0.05, the difference was not statistically significant; 14 days cure rate was 94.71% and 99.39%, P0.05, the difference was statistically significant; 3 months recurrence rate was 13.53% and 3.03%, P0.01, the difference was statistically significant.
2) simple BV: 134 cases of antibacterial drug group and 133 cases of antibacterial + lactobacillus preparation group: 7 days cure rate was 90.30% and 98.50%, P0.01, the difference was statistically significant; 14 days cure rate was 98.51% and 100%, P0.05, the difference was not statistically significant; 3 months recurrence rate was 8.96% and 0%, P0.01, the difference was statistically significant.
3) simple TV: 98 cases of antibacterial drug group and 91 cases of antibacterial + lactobacillus preparation group: 7 days cure rate was 92.86% and 100%, P0.05, the difference was statistically significant; 14 days cure rate was 97.96% and 100%, P0.05, the difference was not statistically significant; 3 months recurrence rate was 10.20% and 0%, P0.01, the difference was statistically significant.
4) mixed infection: 49 cases of anti (true) bacteria medicine group, 52 cases of anti (true) bacteria and Lactobacillus preparation group, 7 days cure rate was 69.39% and 88.46%, P0.05, the difference was statistically significant; 14 days cure rate was 93.88% and 100%, respectively, the difference was not statistically significant; 3 months relapse rate was 26.53% and 3.85%, respectively, P0.01, the difference was statistically significant.
5. the regulation of microecologic agents for vaginal microenvironment: of the 197 cases of vagina microecoecology for the first time without vaginitis, 95 cases received preventive intervention (Lactobacillus group) and 102 unaccepted intervention. In the intervention group, vaginal secretions were detected in 3 months, and 16 patients were infected with vaginitis (VVC9 cases, BV4 cases, TV3 cases, no mixture, respectively). Infection), the incidence rate was 16.84%; the vaginal secretions were performed at the same time and 35 cases of vaginitis were found at the same time. (among them VVC16, BV11, TV7, and mixed infection 1 cases), the incidence rate was 34.31%, and the difference was statistically significant.
Conclusion:
1. the imbalance of vaginal microecology is an important factor affecting vaginitis.
2. vulvovaginal candidiasis and bacterial vaginosis are the most common vaginitis.
The 3. part of normal women also has vaginal microecological imbalance.
4. lactobacillus preparation can increase the curative effect of various vaginitis drugs.
5. lactobacillus preparation can be used to regulate vaginal microenvironment and prevent the occurrence of various vaginitis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R173

【参考文献】