克林霉素磷酸酯阴道凝胶和甲硝唑阴道制剂治疗阳虚质细菌性阴道病的疗效观察及机制研究

Observation and Mechanism Study of Clindamycin Phosphate Ester Vaginal Gel and Metronidazole Vaginal Preparation in Treating Yang Deficiency Bacterial Vaginosis

摘要: 目的：探讨用克林霉素磷酸酯阴道凝和甲硝唑阴道制剂治疗阳虚质细菌性阴道病的临床效果及机制。方法：选取2021年10月~2022年10月贵州省贵阳市妇幼保健院门诊按体质辨识判定为阳虚质接受治疗的50例细菌性阴道病患者，按照随机数字表法分为观察组、对照组，分别为25例。于治疗前后行中医证候积分、中西医临床疗效，对比两组患者在治疗前后的阴道微生态改善情况、临床疗效、不良反应发生情况及复发情况方面的差异。结果：定期随访后，观察组病人的药物有效率明显提高(100% vs 80%)，且两组间的差别有统计意义(X² = 11.654, P < 0.05)；在阴道洁净度和pH ≤ 4.5、Nugent评分等阴道改善情况的患者中，观察组阴道微生态明显改善，且差异有统计学意义；观察组复发情况降低，且差异有统计学意义(P < 0.05)。结论：克林霉素磷酸酯阴道凝胶是治疗阳虚质BV的优选药物，能有效改善患者的临床症状和阴道微生态环境，减少复发率，安全性较高。

Abstract: Objective: To explore the clinical effect and mechanism of Clindamycin phosphate ester vaginal gel and Metronidazole vaginal preparation in the treatment of yang deficiency bacterial vaginosis. Methods: From October 2021 to October 2022, 50 patients with bacterial vaginosis were selected from the outpatient department of Guiyang Maternal and Child Health Care Hospital in Guizhou Province, who were identified as yang deficiency according to their physique, and were divided into an observation group and a control group according to the random number table, with 25 cases in each group. Compare the improvement of vaginal microbiota, clinical efficacy, incidence of adverse reactions, and recurrence between the two groups of patients before and after treatment by inte-grating traditional Chinese medicine syndrome scores and clinical efficacy of traditional Chinese and Western medicine. Result: After regular follow-up, the drug efficacy rate of the observation group patients was significantly improved (100% vs 80%), and the difference between the two groups was statistically significant (X² = 11.654, P < 0.05); Among patients with improved vaginal cleanliness, pH ≤ 4.5, and Nugent score, the observation group showed significant improvement in vaginal microbiota, and the difference was statistically significant; The recurrence rate in the ob-servation group decreased, and the difference was statistically significant (P < 0.05). Conclusion: Clindamycin phosphate ester vaginal gel is the best drug for the treatment of BV with yang defi-ciency, which can effectively improve the clinical symptoms and vaginal microenvironment of pa-tients, reduce the recurrence rate, and has high safety.