| 摘要: |
| 目的：观察比较中西结合治疗肝肾阴虚型萎缩性阴道炎临床疗效，探讨阴道微生态改善与预防复发的关系。方法：选取天津市南开医院妇科门诊的萎缩性阴道炎符合纳入标准的肝肾阴虚型患者 62 例，分为对照组（西药治疗）予阴道置入可宝净（氯喹那多一普罗雌烯阴道片）31 例；治疗组（中西结合治疗）予可宝净阴道上药 + 口服知柏地黄丸 + 地锦茶熏洗坐浴 31 例。以治疗前后中医症状积分、局部体征积分来评估临床疗效，监测治疗前后子宫内膜厚度变化。统计停药 1 个月后的复发率，其中以局部体征中的过氧化氢酶（H2O2)，白细胞酯酶（LE），酸碱值（pH）作为阴道微生态环境改善评价指标。结果：与对照组（53.67±31.00）相比，治疗组（77.28±19.27）治疗后中医症状积分与治疗前相比均有显著差异，经统计学分析结果具有统计学意义（P ＜ 0.05）；治疗组（74.80±33.09）比对对照组（62.17±35.17）治疗后局部体征积分与治疗前相比均有显著差异，经统计学分析结果具有统计学意义（P ＜ 0.05）；治疗组与对照组进行治疗后局部症状在停药 3 天后临床效果对比，治疗组（96.00）明显优于对照组（90.00）；治疗组（96.00）与对照组（80.00）进行治疗后中医证候在停药 3 天后临床效果对比，治疗组明显优于对照组；47 例患者阴道微生态环境得到改善（对照组 20 例，治疗组 27 例），阴道微生态改善率对照组 =66.67%（20/30）阴道微生态改善率治疗组 =87.10%（27/31），P=0.058。治疗组治疗后阴道微生态环境改善优于对照组，但无统计学意义。结论：中西结合疗法治疗萎缩性阴道炎，增强患者全身及阴道局部抵抗力，恢复阴道微生态平衡，复发率低，有显著的优越性。 |
| 关键词: 萎缩性阴道炎 中西医结合 肝肾阴虚 阴道微生态 |
| DOI：10.3969/j.issn.1007-6948.2019.06.018 |
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| 基金项目: |
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| Clinical Observation on Treatment of Pelvic Inflammation of Liver and Kidney Yin Deficiency Type by Integrated Traditional Chinese and Western Medicine |
| YANG Yang,CAO Bao-li,ZONG Yang |
| Tianjin Nankai Hospital, Tianjin (300100), China |
| Abstract: |
| Objective To observe and compare the clinical efficacy of integrated traditional Chinese and Western medicine in the treatment of atrophic vaginitis of yin deficiency of liver and kidney, and to explore the relationship between improvement of vaginal microecology and prevention of recurrence. Methods Totally 62 patients with atrophic vaginitis in gynecological clinic of Tianjin Nankai Hospital were divided into control group (treated with Western medicine) and treatment group (treated with integrated traditional Chinese and Western medicine) with Kebaojing vaginal medicine+Zhibai Dihuang Pill. Thirty-one sitz baths were fumigated with Dijin tea. The clinical efficacy was evaluated by TCM symptom score and local sign score before and after treatment, and the changes of endometrial thickness before and after treatment were monitored. The recurrence rate was counted 1 month after withdrawal. Catalase (H2O2 ), leucocyte esterase (LE) and acid?base value (pH) in local signs were used as the evaluation indicators for improving vaginal micro-ecological environment. Results Compared with the control group (53.67+31.00), the scores of TCM symptoms in the treatment group after treatment (77.28+19.27) were significantly different from those before treatment (P<0.05); the score of local signs in the treatment group (74.80+33.09) was significantly different from that in the control group after treatment (62.17+35.17), with statistical analysis (P<0.05); the clinical effect of local symptoms in treatment group and control group was better than that in control group (90.00) after 3 days of drug withdrawal; the clinical effect of TCM syndromes in treatment group (96.00) and control group (80.00) after 3 days of drug withdrawal was better than that in control group, the treatment group was significantly better than that in control group; the vaginal microgenesis in 47 patients was better than that in control group. The improvement rate of vaginal microecology was 66.67% (20/30) in the control group and 87.10% (27/31) in the treatment group (P=0.058). The improvement of vaginal micro-ecological environment in the treatment group was better than that in the control group, but there was no statistical significance. Conclusion Integrated traditional Chinese and Western medicine therapy could enhance the patients' body and vaginal local resistance. It could restore vaginal micro-ecological balance and reduce the relapse radio. |
| Key words: Atrophic virginities integrated traditional Chinese and Western medicine liver-kidney yin deficiency vaginal micro ecosystem |
