首页|女童外阴阴道炎中医证型及阴道局部微生态特点研究

女童外阴阴道炎中医证型及阴道局部微生态特点研究

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目的:总结女童外阴阴道炎临床特点及中医证型规律，研究不同证型女童阴道微生态特点，为中医证型研究提供客观参考依据。方法:制定青春期前女童外阴阴道炎中医证型辨证量表，收集临床资料，辨证分型;采集阴道分泌物，利用16s rRNA高通量测序方法进行阴道微生态检测，研究不同中医证型阴道微生态特点。结果:收集到合格调查问卷共428份。所有患儿均有异常阴道分泌物，炎症性前庭黏膜充血是主要体征。外阴痒痛不适者70。3％，外阴皮肤潮红者33。9％，尿频尿急者11。4％，有异味者18。9％。45。8％患儿(196例)合并有其他泌尿生殖系统疾病。中医证型以湿热下注证最为常见，占比77。1％，其次为脾虚湿困证，占比18。0％。16S rRNA测序结果提示:变形菌门(Proteobacteria)、梭杆菌门(Fusobacteriota)在A组(湿热下注证组)占有优势;而厚壁菌门(Firmicutes)、拟杆菌门(Bacteroidota)、放线菌门(Actinobacteriota)在A组、B组(脾虚湿困证组)中差别不明显。两组患儿阴道菌群在Alpha多样性Ace指数、Chao1指数中的差异具有统计学意义(均P＜0。05)，A组菌群丰富度高于B组。结论:女童外阴阴道炎所有患儿均有异常阴道分泌物，炎症性前庭黏膜充血是主要体征，部分患儿还合并有其他泌尿生殖系统疾病;中医证型以湿热下注证最为常见，不同中医证型间阴道微生态存在差异。
Study on Traditional Chinese Medicine Syndrome Types of Vulvovaginitis and Local Microecological Characteristics of Vagina in Prepubertal Girls
Objective:To summarize the clinical characteristics of vulvovaginitis in prepubertal girls and its traditional Chinese Medicine(TCM)syndrome types.To study the microecological characteristics of vaginas between different TCM syndromes in pre-pubertal girls,and to provide an objective reference for the study of TCM syndrome.Methods:A TCM syndrome differentiation scale for prepubertal girls with vulvovaginitis was established,and clinical data were collected to differentiate the pattern;vaginal secretions were collected,and vaginal microecological testing was conducted using 16s rRNA high-throughput sequencing to study the vaginal microecological characteristics of different TCM syndrome types.Results:A total of 428 qualified questionnaires were collected.All girls had abnormal vaginal discharge,with inflammatory vestibular mucosal congestion as the major sign.Patients with vulvovaginal itching and discomfort accounted for 70.3％,patients with flushing of the vulvar skin accounted for 33.9％,patients with urinary frequency and urgency accounted for 11.4％,and patients with odor accounted for 18.9％.Patients with combination of other genito-urinary diseases accounted for 45.8％(196 cases).The most common TCM syndrome was damp heat pouring down,accounting for 77.1％of cases,followed by spleen deficiency and dampness trapping,accounting for 18.0％.Results of 16S rRNA sequencing showed that Proteobacteria and Fusobacteriota were predominant in group A(damp heat pouring down group).However,there was no significant difference between Firmicutes,Bacteroidota,and Actinobacteriota in group A and those in group B(spleen deficiency and dampness trapping group).There were statistically significant differences in the Alpha diversity,Ace index and Chao1 index between the two groups(both P＜0.05),indicating that the community richness of the vaginal microbiota in group A was higher than that in group B.Conclusions:All the prepubertal girls with vulvovaginitis had abnormal vaginal discharge,with inflammatory vestibular mucosal congestion as the major body sign and some patients had other genitourinary disorders in combination.Damp heat pouring down was the most common TCM symptom,and there were differences in vaginal microecology among different TCM syndromes.

prepubertal girlsvulvovaginitistraditional Chinese medicine syndromemicrobiomicsabnormal vaginal dischargeinflammatory vestibular mucosal congestiondamp heat pouring downspleen deficiency and dampness trapping

舒静、刘雁峰、柳静、潘宇琛、张淼、杨阳

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北京中医药大学东直门医院,北京 100700

国家儿童医学中心,首都医科大学附属北京儿童医院中医科,北京 100045

青春期前女童 外阴阴道炎 中医证型 微生物组学 异常阴道分泌物 炎症性前庭黏膜充血 湿热下注 脾虚湿困

国家重点研发计划项目

2017YFC1703205

2024

10.16295/j.cnki.0257-358x.2024.04.006

山东中医杂志
山东中医药学会 山东中医药大学

山东中医杂志

CSTPCD
影响因子：0.431
ISSN：0257-358X
年,卷(期)：2024.43(4)
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