首页|完带汤防治脾虚湿盛型外阴阴道假丝酵母菌病的临床疗效及对DNA损伤的影响

完带汤防治脾虚湿盛型外阴阴道假丝酵母菌病的临床疗效及对DNA损伤的影响

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目的 探讨完带汤治疗脾虚湿盛型外阴阴道假丝酵母菌病(Vulvovaginal candidiasis,VVC)的临床疗效及对DNA损伤的影响.方法 将符合纳入标准的 70 例脾虚湿盛VVC患者随机分为完带汤组和氟康唑组各 35 例,治疗期间 2 组各脱落 5 例.氟康唑组采用 150 mg氟康唑口服一次;完带汤组采用完带汤口服 14 d.治疗后比较 2 组患者中医证候积分变化情况;评估 2组患者临床治愈(Test of cure,TOC)率及临床缓解(Clinical improvement,CI)率;比色法检测阴道灌洗液中 8-羟基脱氧鸟苷(8-hydroxydeoxyguanosine,8-OHDG)水平变化以评估DNA 损伤情况;治疗后 3 月评估患者访视临床完全缓解(Follow up,FU)、真菌学转阴及复发率.结果 治疗后,2 组患者中医证候积分均呈现不同程度改善(P<0.05,P<0.01);完带汤组优于氟康唑组(P<0.05,P<0.01);完带汤组TOC、CI、真菌学转阴率与氟康唑组未见明显差异(P>0.05);但完带汤组FU及复发率均显著优于氟康唑组(P<0.05,P<0.01).治疗后,氟康唑组阴道灌洗液中 8-OHDG表达显著增加(P<0.001),完带汤组未见明显变化,显著低于氟康唑组(P<0.001).结论 完带汤总体临床疗效与氟康唑相当,但在改善中医证候、防止复发方面优于氟康唑,同时具有不加剧阴道细胞DNA损伤的优势.
Clinical Efficacy of Wandai Decoction in Preventing and Treating VVC with Spleen Deficiency-Dampness Abundance Syn-drome and Its Impact on DNA Damage
OBJECTIVE To explore the clinical efficacy of Wandai Decoction in the treatment of vulvovaginal candidiasis(VVC)with spleen deficiency-dampness abundance and its effect on DNA damage.METHODS 70 VVC patients with spleen deficiency-dampness abundance who met the inclusion criteria were randomly divided into Wandai Decoction and fluconazole groups,35 cases each.The fluconazole group took 150 mg fluconazole orally once;the Wandai Decoction group took Wandai Decoction orally for 14 d.After treatment,changes in TCM syndrome scores of the two groups of patients were compared;the clinical cure(test of cure,TOC)rate and clinical improvement(CI)rate of the two groups of patients were evaluated;8-hydroxydeoxyguanosine(8-OHDG)in the vaginal lavage fluid was detected by colorimetry to assess DNA damage;clinical complete remission(follow up,FU),mycological negative conversion and recurrence rate were evaluated 3 months after treatment.RESULTS After treatment,the TCM syndrome scores of the two groups of patients were improved to varying degrees(P<0.05,P<0.01);the Wandai Decoction group was superior to the fluconazole group(P<0.05,P<0.01);there was no significant difference in TOC,CI,mycology negative conversion between the Wandai Decoction group and the fluconazole group(P>0.05);however,the FU and recurrence rate of the Wandai Decoction group were significantly better than those of the fluconazole group(P<0.05,P<0.01).After treatment,the expression of 8-OHDG in the vaginal lavage fluid of the fluconazole group increased significantly(P<0.001),while there was no significant change in the Wandai Decoction group,which was significantly lower than that of the fluconazole group(P<0.001).CONCLUSION The overall clinical efficacy of Wandai Decoction is equivalent to that of fluconazole,but it is better than fluconazole in improving TCM syndromes and pre-venting recurrence,with the advantage of not aggravating DNA damage in vaginal cells.

Wandai Decoctionvulvovaginal candidiasisDNA damageclinical efficacy

韩月、沈甦、傅捷、任青玲

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南京中医药大学附属医院,江苏 南京 210029

南京中医药大学连云港附属医院,江苏 连云港 222004

完带汤 外阴阴道假丝酵母菌病 DNA损伤 临床疗效

江苏省中医妇产生殖临床医学创新中心项目针灸与时间生物学四川省重点实验室开放基金

ZX2021022021001

2024

南京中医药大学学报
南京中医药大学

南京中医药大学学报

CSTPCD北大核心
影响因子:1.658
ISSN:1672-0482
年,卷(期):2024.40(2)
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