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目的探讨外阴阴道假丝酵母菌病(VVC)的相关因素及治疗效果。方法对752例VVC及复发性VVC(RVVC)的相关因素进行探讨。将738例VVC患者(4例女童只能口服伊曲康唑和外阴清洗;10例孕妇只上药,但丈夫需服药,故不参与分组)随机分为2组。A组365例夫妻双方口服伊曲康唑0.2g/d,连服3d;患者睡前阴道使用克霉唑阴道片(凯妮汀),每3d上药1次,共3次;当天用稀释的活力碘为患者进行阴道擦洗。B组373例夫妻双方口服伊曲康唑0.2g/d,连服2d;阴道擦洗及上药同A组。有手足癣者,需服伊曲康唑0.2g/d共7d。月经净后3～5d复查,若无症状,白带常规检查阴性者只需阴道上药3次,3次月经后均如此;若为RVVC患者,则治疗需达6个月。结果 738例患者中,治愈715例(96.9%),其中A组治愈90.7%(353/365),B组治愈97.1%(362/373),2组治愈率比较差异无统计学意义(P>0.05)。RVVC患者中丈夫患手足癣、本人患手足癣及患糖尿病的构成比明显高于VVC患者,显示这3个因素影响VVC的复发。结论治疗VVC必须全身治疗加阴道上药,并且配偶同时治疗,消除诱因,持续正规的治疗才能避免复发。
Objective To investigate the related factors and therapeutic effects of vulvovaginal candidiasis (VVC). Methods 752 cases of VVC and recurrent VVC (RVVC) related factors were discussed. 738 cases of VVC patients (4 girls only oral itraconazole and vulva cleaning; 10 pregnant women only on the drug, but her husband need medication, it does not participate in grouping) were randomly divided into two groups. A group of 365 patients with both husband and wife oral itraconazole 0.2g / d, and even served for 3d; patients with vaginal use of clotrimazole vaginal tablets before bedtime (cortisol), once every three days on the drug, a total of 3 times; the same day with a dilution Vital iodine for patients with vaginal scrub. Group B 373 couples oral itraconazole 0.2g / d, and even served 2d; vaginal scrub and the same drug with the A group. There are hand, foot and ringworm who need to wear itraconazole 0.2g / d a total of 7d. Menstrual net 3 ~ 5d review, if no symptoms, vaginal routine examination negative only vaginal medication 3 times, 3 times after menstruation are so; if RVVC patients, the treatment up to 6 months. Results Among 738 patients, 715 cases (96.9%) were cured, of which 90.7% (353/365) were cured in group A, 97.1% (362/373) cured in group B, and there was no significant difference in cure rate between the two groups (P> 0.05). Husband suffering from RVVC patients hand, foot and ringworm, I suffer from hand, foot and ringworm and diabetes mellitus were significantly higher than the composition of VVC patients, showing that these three factors affect the recurrence of VVC. Conclusion The treatment of VVC must be systemic plus vaginal drug, and spouses at the same time treatment to eliminate the incentive to continue regular treatment in order to avoid recurrence.