雌激素软膏联合克林霉素磷酸酯阴道凝胶对阴道炎患者阴道菌群与性生活质量的影响

The impact of estrogen ointment with clindamycin phosphate vaginal gel on vaginal flora and sexual quality of life in patients with vaginitis

摘要:

目的 探究雌激素软膏联合克林霉素磷酸酯阴道凝胶对阴道炎患者阴道菌群与性生活质量的影响。方法 选取2022年6月—2023年6月中国人民解放军西部战区空军医院收治的100例阴道炎患者作为研究对象，按信封抽签法随机分为单一组和联合组，各50例。对照组给予克林霉素磷酸酯阴道凝胶治疗，联合组给予雌激素软膏联合克林霉素磷酸酯阴道凝胶治疗，比较两组治疗前后的阴道菌群、阴道微生态情况、性生活质量、炎症因子及不良反应。结果 联合组治疗前后乳杆菌、支原体、类杆菌、白色念珠菌、肠杆菌菌落数量差值均高于单一组（P <0.05）。联合组治疗后pH≤4.5、菌群密集度（Ⅱ、Ⅲ）、菌群多样性（Ⅱ、Ⅲ）、乳酸杆菌占优率均高于单一组（P <0.05）。两组治疗前、治疗后1个月、治疗后2个月的FSFI评分，采用重复测量设计的方差分析，结果 ①不同时间点FSFI评分比较，差异有统计学意义（P <0.05）；②联合组与单一组FSFI评分比较，差异有统计学意义（P <0.05），联合组FSFI评分较高，相对性生活质量较好；③两组FSFI评分变化趋势比较，差异有统计学意义（P <0.05）。联合组治疗前后CRP、IL-17、IL-8差值均高于单一组（P <0.05）。治疗后，联合组的不良反应发生率（8.0%）与单一组（6.0%）比较，差异无统计学意义（P > 0.05）。结论 雌激素软膏联合克林霉素磷酸酯阴道凝胶对阴道炎患者阴道菌群与性生活质量的影响较为显著。

Abstract:

Objective To investigate the effects of combined treatment with estrogen ointment and clindamycin phosphate vaginal gel on the vaginal flora and sexual quality of life in patients with vaginitis.Methods From June 2022 to June 2023, 100 vaginitis patients were enrolled from the Air Force Hospital of the Western Theater Command of the People's Liberation Army of China. They were randomly divided into two groups: a monotherapy group (n =50) treated with clindamycin phosphate vaginal gel alone, and a combination therapy group (n =50) treated with both estrogen ointment and clindamycin phosphate vaginal gel. The study compared the changes in vaginal flora, microecology, sexual quality of life, inflammatory markers, and adverse reactions between the two groups before and after treatment.Results The differences in the counts of lactobacilli, mycoplasma, corynebacteria, Candida albicans, and enterobacteria were greater in the combined treatment group than in the single treatment group before and after treatment (P <0.05). After treatment, the combined group exhibited higher values for pH≤4.5, bacterial density (Ⅱ-Ⅲ), microbial diversity (Ⅱ-Ⅲ), and the predominance of lactobacilli compared to the single treatment group (P <0.05). The FSFI scores of both groups before treatment, and one and two months after treatment were analyzed using repeated measures ANOVA. The results showed that: (1) there were significant differences in FSFI scores across different time points (P <0.05); (2) there were significant differences in FSFI scores between the combined and single treatment groups (P <0.05), with the combined group having higher FSFI scores and relatively better sexual quality of life; (3) there was a significant difference in the trend of changes in FSFI scores between the two groups (P <0.05). The differences in CRP, IL-17, and IL-8 levels before and after treatment were greater in the combined treatment group than in the single treatment group (P <0.05). After treatment, the incidence of adverse effects was 8.0% in the combined group compared to 6.0% in the single treatment group, a difference that was not statistically significant (P >0.05).Conclusion The combination of estrogen ointment and clindamycin phosphate vaginal gel significantly impacts the vaginal flora and sexual quality of life in patients with vaginitis, offering a promising treatment approach.