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目的:探讨复发性外阴、阴道假丝酵母菌病(RVVC)和妊娠期复发性VVC的合理有效治疗方案。方法:选择140例RVVC确诊患者,随机分3组:A组、口服易启康;B组、口服易启康+克霉唑栓阴道上药;C组、在B组基础上再进行维持治疗。3组均进行6个疗程治疗,治疗完成后第4、8、12、24周进行疗效评定。选择75例妊娠期复发性VVC确诊患者,随机分3组,采用凯妮汀500mg阴道上药。A组3 d 1次,连续2次;B组3d 1次,连续2次为1疗程,共2个疗程;C组为6 d 1次,连续使用15次,于治疗后7、14、28 d进行疗效评定。结果:3组RVVC治疗4周后差异无统计学意义(P>0.05),治疗8周后A组对于B、C组治愈率差异有统计学意义(P<0.05),24周后A组对于B、C组复发率差异有统计学意义(P<0.05)。妊娠期复发性VVC,3组用药7 d、14 d和28 d后治愈率差异有统计学意义(P<0.05),治疗后14 d和28 d复发率差异有统计学意义(P<0.05)。结论:联合用药周期治疗是治疗RVVC最有效可行的方案;凯妮汀栓治疗妊娠期复发性VVC安全有效,使用方便,维持治疗疗效更高。
Objective: To investigate the reasonable and effective treatment of recurrent vulvovaginal candidiasis (RVVC) and recurrent VVC during pregnancy. Methods: One hundred and forty patients diagnosed with RVVC were randomly divided into three groups: group A, Yiqikang oral; group B, oral Yiqikang + clotrimazole suppository; Group C, maintenance treatment on the basis of group B . Three groups were treated with 6 courses of treatment, and the curative effect was evaluated on the 4th, 8th, 12th and 24th week after the completion of the treatment. Select 75 cases of recurrent VVC during pregnancy diagnosed patients were randomly divided into three groups, the use of corticosteroid 500mg vaginal drug. A group of 3 d 1 times, 2 consecutive times; B group 3d 1 times, 2 consecutive 1 course of treatment, a total of 2 courses; C group of 6 d 1 times, continuous use 15 times after treatment 7,14,28 d for efficacy evaluation. Results: After 4 weeks of RVVC treatment, the difference was not statistically significant (P> 0.05). After 8 weeks of treatment, the cure rate of group A was significantly different from that of group B and C (P <0.05). After 24 weeks, The recurrence rates in groups B and C were significantly different (P <0.05). The recurrence rate of VVC in pregnancy was significantly lower than that of the control group (P <0.05). The recurrence rate of VVC in the third trimester was significantly lower than that of the third trimester after 7 d, 14 d and 28 d (P <0.05) . CONCLUSION: The combined treatment cycle is the most effective and feasible treatment for RVVC. Cortin suppository is safe and effective in the treatment of recurrent VVC during pregnancy, and it is easy to use and maintain the therapeutic efficacy.