摘要
目的:研究复发性外阴阴道假丝酵母菌病(Recurrent Vulvovaginal Candidiasis,RVVC)脾虚湿阻证的阴道微生态特点。方法:收集RVVC患者35例(脾虚湿阻证30例,湿热证5例),外阴阴道假丝酵母菌病(Vulvovaginal Candidiasis,VVC)患者39例(脾虚湿阻证30例,湿热证9例),正常组37例,通过比较证候分布及积分来探讨RVVC患者证候特点,以高通量测序(Illumina MiSeq Seguencing)作为研究手段,通过比较阴道微生态异同来阐析RVVC脾虚湿阻证阴道微生态与RVVC发病之间的关系。结果:RVVC组与VVC组间证型分布差异无统计学意义。两组脾虚湿阻证积分、过氧化氢(H_(2)O_(2))阳性率比较差异有统计学意义(P<0.05)。RVVC组湿热证患者阴道pH值与脾虚湿阻证患者阴道pH值比较差异有统计学意义(P<0.0001);RVVC组(35~45岁)较组内(20~34岁)阴道pH值升高(P=0.0004);VVC组(20~34岁)较组内(35~45岁)阴道pH值升高(P=0.0008);RVVC组的阴道菌落多样性下降;RVVC组、VVC组脾虚湿阻证患者的阴道菌落丰度均显著下降。结论:RVVC脾虚湿阻证与湿热证患者的阴道微生态功能均存在一定的失调,但RVVC湿热证患者表现更为显著,其阴道pH值较脾虚湿阻证患者显著升高;RVVC组脾虚湿阻证积分较VVC组脾虚湿阻证积分高,说明VVC反复发作,久则深入,或本自脾虚湿易潜伏,治宜扶正祛邪。RVVC脾虚湿阻证患者的阴道菌落多样性下降,乳酸杆菌占比升高,治疗RVVC需重视重建阴道菌落丰度,促进优势菌群功能的恢复。
Objective:To study the vaginal microecological characteristics of recurrent vulvovaginal candida disease(RVVC)with spleen deficiency and dampness obstruction.Methods:35 RVVC patients(30 cases of spleen deficiency dampness syndrome,5 cases of damp-heat syndrome),39 cases of VVC patients(30 cases of spleen deficiency dampness syndrome,9 cases of damp-heat syndrome),37 cases in the control group were collected.The syndrome characteristics of RVVC patients were explored by comparing the distribution and integral of syndromes;and the relationship between vaginal microecology and the onset of RVVC were analyzed by comparing the similarities and differences of vaginal microecology.Results:There was no statistical difference in the distribution of syndrome types between the RVVC group and the VVC group.The scores of spleen deficiency and dampness and the positive rate of H_(2)O_(2) were statistically different between the two groups(P<0.05).In the RVVC group,there was a statistically significant difference in vaginal pH between patients with damp-heat syndrome and those with spleen deficiency and dampness obstruction syndrome(P<0.0001).The vaginal pH value of the 35~45 year-old patients in the RVVC group was higher than the 20~34 year-old patients(P=0.0004).The vaginal pH value of the 20~34 year-old patients in the VVC group was higher than the 35~45 year-old patients in the group(P=0.0008).The species diversity index of vaginal colonies in the RVVC group decreased significantly,which was lower than that in the VVC group and the normal group.The abundance of vaginal colonies in the patients with spleen deficiency and dampness obstruction syndrome in the VVC group and RVVC group decreased significantly.Conclusion:There are certain disorders in the vaginal microecological function of patients with RVVC spleen deficiency and dampness resistance syndrome or damp-heat syndrome,However,the performance of RVVC patients with damp-heat syndrome is more pronounced,because the vaginal pH value of patients with damp-heat syndrome is
出处
《中医临床研究》
2021年第29期32-37,共6页
Clinical Journal Of Chinese Medicine
基金
广东省罗颂平名中医工作室项目,粤中医办函[2019]5号
院长基金(YZ2020MS05),RVVC脾虚湿阻证与湿热证病证结合的阴道微生态研究
广东省中医药局课题(完带汤调节阴道菌落丰度治疗脾虚湿阻型RVVC的临床研究)。
关键词
复发性外阴阴道假丝酵母菌病
阴道微生态
脾虚湿阻证
湿热证
中医证型
Recurrent vulvovaginal candidiasis
Vaginal microecology
Spleen deficiency and dampness syndrome
Damp-heat Syndrome
TCM syndrome type
