微生态调节剂联合光疗基于多维度护理干预在老年糖尿病外阴阴道炎中的临床疗效

Clinical Efficacy of Microecological Modulator Combined with Phototherapy in Elderly Diabetic Vulvovaginitis Based on Multi-Dimensional Nursing Intervention

摘要: 目的：通过观察微生态调节剂联合红光疗基于多维度护理干预治疗老年糖尿病外阴阴道炎临床疗效，并探讨其机制。方法：本研究选取2024年4月2025年4月入住延安市安塞区人民医院与安塞区妇幼保健院妇产科或内科的老年糖尿病合并外阴阴道炎患者作为研究对象。采用随机双盲对照试验(RCT)，分2组(n = 32/组)：观察组：微生态调节剂 + 光疗 + 多维度护理；对照组：传统药物治疗(甲硝唑/克霉唑) + 常规护理。收集治疗2周后症状评分(瘙痒、灼痛VAS评分)、复发率(治疗后1、3个月随访)数据。计数资料描述用频数与构成比((n) %)，两组外阴阴道炎患者复发率组间比较采用χ²检验；治疗2周后症状评分符合正态分布采用($\overline{X}\pm s$ )描述，两组患者组间比较采用t检验，非正态分布的计量资料使用中位数、四分位数M (P₂₅, P₇₅)表示，两组患者组间比较采用非参数检验；以P < 0.05为差异具有统计学意义。结果：本研究共纳入64例老年糖尿病外阴阴道炎女性患者，观察组患者在瘙痒VAS评分上显著低于对照组患者，观察组治疗方案治疗老年糖尿病外阴阴道炎患者2周后临床效果优于对照组，差异具有统计学意义(P < 0.05)，但是两组患者在疼痛VAS评分上无显著差异(P > 0.05)。微生态调节剂联合光疗基于多维度护理干预治疗方案在治疗1、3个月后复发率显著低于对照组，差异具有统计学意义(P < 0.05)。结论：微生态调节剂联合红光疗基于多维度护理干预联合疗法在症状缓解(瘙痒、分泌物异常)、复发率方面显著优于单一药物治疗，该联合方案通过“局部治疗 + 全身管理”的多靶点干预模式，为老年糖尿病外阴阴道炎提供了更安全、持久的治疗策略，体现综合治疗的全面获益。

Abstract: Objective: To observe the clinical efficacy of microecological regulator combined with red light therapy in the treatment of elderly diabetic vulvovaginitis based on multi-dimensional nursing intervention, and to explore its mechanism. Methods: Elderly patients with diabetes mellitus and vulvovaginitis who were admitted to the obstetrics and gynecology department or the internal medicine department of Ansai County People’s Hospital of Yan’an City from April 2024 to April 2025 were selected as the study objects. A randomized double-blind controlled trial (RCT) was conducted and divided into 2 groups (n = 32/group): Observation group: microecological regulator + phototherapy + multi-dimensional nursing; Control group: traditional drug therapy (metronidazole/clotrimazole) + conventional nursing. Symptom score (VAS score of pruritus and burning pain) and recurrence rate (follow-up 1 and 3 months after treatment) were collected after 2 weeks of treatment. Frequency and component ratio ((n) %) were used to describe the counting data. The inter-group comparison of the recurrence rate of vulvovaginitis patients between the two groups was conducted by χ² test. After 2 weeks of treatment, symptom scores consistent with normal distribution were described by ($\overline{X}\pm s$ ). Comparison between the two groups was performed by T-test; measurement data with non-normal distribution were represented by median and quartile M (P₂₅, P₇₅), and comparison between the two groups was performed by non-parametric test. P < 0.05 was considered to be statistically significant. Results: A total of 64 elderly female patients with diabetic vulvovaginitis were included in this study. The pruritus VAS score of the observation group was significantly lower than that of the control group. The clinical effect of the treatment scheme in the observation group was better than that of the control group after 2 weeks, with statistical significance (P < 0.05). However, there was no significant difference in pain VAS score between the two groups (P > 0.05). The recurrence rate of microecological regulator combined with phototherapy based on multi-dimensional nursing intervention regimen was significantly lower than that of control group after 1 and 3 months of treatment, the difference was statistically significant (P < 0.05). Conclusion: The combination therapy of microecological regulator and red light therapy based on multi-dimensional nursing intervention is significantly better than single drug therapy in symptom relief (pruritus, abnormal secretion) and recurrence rate. This combination program provides a safer and durable treatment strategy for elderly diabetic vulvovaginitis through the multi-target intervention mode of “local treatment + systemic management” and embodies the comprehensive benefit of comprehensive treatment.