哈氏止带Ⅱ号方治疗湿热下注型BV临床研究

Study on the clinical efficacy and mechanism of Hashi Zhidai Formulation Ⅱ in treating damp-heat Bacterial Vaginosis

关键词:  细菌性阴道病  湿热下注型  哈氏止带Ⅱ号方  乳杆菌  阴道局部免疫

Key words:  bacterial vaginosis  damp-heat bet type  Hashi Zhidai Formulation Ⅱ  vaginal lactobacilli  vaginal local immunity

摘要:

[目的] 探讨哈氏止带Ⅱ号方治疗湿热下注型细菌性阴道病（BV）的临床疗效、阴道内乳杆菌数量变化及阴道局部免疫情况。[方法] 选取2020年1—12月就诊于天津中医药大学第一附属医院妇科门诊的湿热下注型BV患者48例，采用随机对照的研究方法将患者分成治疗组和对照组。对照组予替硝唑栓治疗，治疗组在对照组的基础上内服哈氏止带Ⅱ号方，均治疗1个疗程。分别对比两组在临床疗效、治疗前后阴道内乳杆菌数量与阴道内白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）浓度的差异。对治疗后Nugent评分＜7分的患者分别于治疗结束后第1、2、3个月后进行随访观察。[结果] 治疗组临床疗效优于对照组，差异具有统计学意义（P＜0.05）。治疗组治疗后在降低阴道内IL-1β、IL-6、TNF-α浓度、增加阴道内乳杆菌数量方面优于对照组，差异均具有统计学意义（P＜0.05）。治疗结束后第1、2、3个月，两组Nugent评分均较治疗前下降，差异均具有统计学意义（P＜0.05），且治疗组下降趋势较大；治疗组在治疗后第1、2、3月Nugent评分均低于对照组，差异均具有统计学意义（P≤0.05）。治疗后第1个月，治疗组增加阴道内乳杆菌数量优于对照组，差异具有统计学意义（P＜0.05）。[结论] 哈氏止带Ⅱ号方可以治疗湿热下注型BV，增加阴道内乳杆菌数量、降低阴道内IL-1β、IL-6、TNF-α浓度和预防复发。

Abstract:

[Objective] To explore the clinical efficacy of Hashi Zhidai Formulation Ⅱ in the treatment of bacterial vaginosis(BV), the change in the number of lactobacilli in the vagina, and the local immunity of the vagina.[Methods] The 48 patients with damp invasion of lower energizer BV who met the inclusion and exclusion criteria were selected from the gynecological clinic of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to December 2020. The patients were divided into treatment group (24 cases) and control group(24 cases) through a randomized controlled research method. The control group was treated with tinidazole suppository, and the treatment group was taken orally on the basis of the control group Hashi Zhidai Formulation Ⅱ, and both were treated for 1 course of treatment. Observe the Nugent score, the number of lactobacilli in the vagina before and after treatment, and the concentration of IL-1β, IL-6 and TNF-α in the vagina before and after treatment. Patients with Nugent score less than 7 after treatment were followed up for observation at 1, 2, and 3 months after treatment.[Results] The clinical efficacy of the treatment group was better than that of the control group, and the difference was statistically significant (P < 0.05). The treatment group can increase the number of vaginal lactobacillii in the vagina after treatment and was better than the control group, the difference was statistically significant(P < 0.05). After treatment, the treatment group was better than the control group in reducing the concentration of IL-1β, IL-6 and TNF-α in the vagina, and the difference was statistically significant(P < 0.05). Follow-up for the first 1, 2, and 3 months after the treatment, the Nugent scores of the two groups after treatment decreased compared with that before treatment, and the difference was statistically significant(P < 0.05), and the treatment group had a greater downward trend. The treatment group's Nugent scores of the first, second, and third months were lower than those of the control group after treatment, and the differences were statistically significant (P < 0.05). In the first month after treatment, the treatment group increased the number of vaginal lactobacilli better than the control group, and the difference was statistically significant (P < 0.05). In the first month after treatment, the treatment group increased the number of vaginal lactobacilli better than the control group, and the difference was statistically significant (P < 0.05).[Conclusion] Hashi Zhidai Formulation Ⅱcan treat damp-heat betting type BV, increase the number of vaginal lactobacilli in the vagina, reduce the concentration of IL-1β, IL-6, and TNF-α in the vagina and prevent recurrence.