氟康唑联合乳杆菌对RVVC的疗效及免疫因子水平的影响_石文印.pdf

of Diabetes,2020,11(1):1-124 莫帅帅,孙立娟.超重/肥胖 2 型糖尿病患者腹部脂肪分布与胰岛素抵抗的相关性J.中国实验诊断学,2020,24(1):57-595 Fadini GP,Zatti G,Baldi I,et al.Use and effectiveness of dapagli-flozin in routine clinical practice.An Italian multicenter retrospectivestudyJ.Diabetes Obesity&Metabolism,2018,20(7):1781-17866 梁斌,李兰,魏东.聚乙二醇洛塞那肽联合二甲双胍对 2 型糖尿病患者的临 床疗效 J.川北医 学院学报,2021,36(2):246-2497 Jourdan T,Godlewski G,Kunos G.Endocannabinoid regulation of-cell functions:implications for glycemic control and diabetesJ.Diabetes,Obesity and Metabolism,2016,18(6):549-5578 陈颖,夏明锋,李小英.体脂分布与糖尿病风险J.中国糖尿病杂志,2017,9(4):218-2209 Davies MJ,Da DAlessio,Fradkin J,et al.Management of hypergly-cemia in type 2 diabetes,2018.A consensus report by the AmericanDiabetes Association(ADA)and the European Association for theStudy of Diabetes(EASD)J.Diabetes Care,2018,41(12):2669-270110朱延华,翁建平.胰高血糖素样肽-1 受体激动剂类药物的临床应用 J.中国实用内科杂志,2014,10:942-94611Anderson JE.Combining glucagon-like peptide 1 receptor agonistsand sodium-glucose cotransporter 2 inhibitors to target multiple organdefects in type 2diabetes J.Diabetes Spectrum,2020,33(2):165-17412温彩霞,杨晓燕,徐卫娟,等.利拉鲁肽联合达格列净对超重或肥胖 2 型糖尿病患者肾功能、氧化应激以及内脏脂肪含量的影响J.现代 生物医 学 进 展,2021,21(12):2271-2274,229713菅小红,徐建宾,申晶.达格列净对中心肥胖型新诊断 T2MD 患者 胰岛细胞功能和脂代谢紊乱的影响 J.国际检验医学杂志,2019,40(10):63-6614Chen X,L X,Yang G,et al.Polyethylene glycol loxenatide injec-tions added to metformin effectively improve glycemic control and ex-hibit favorable safety in type 2diabetic patients J.J Diabetes,2017,9(2):158-16715姚璐,武云涛,田国祥,等.聚乙二醇洛塞那肽注射液联合二甲双胍对 2 型糖尿病患者的疗效J.中国循证心血管医学杂志,2017,9(5):577-57916Millar P,Pathak N,Parthsarathy V,et al.Metabolic and neuropro-tective effects of dapagliflozin and liraglutide in diabetic miceJ.JEndocrinol,2017,234(3):255-26717李芝,李堃宜,钟志鹏,等.聚乙二醇洛塞那肽联合达格列净治疗肥胖 2 型糖尿病患者的疗效及安全性研究J.中国医院药学杂志,2021,41(9):936-93918陈菡,李奉其,原苑,等.达格列净联合利拉鲁肽治疗 2 型糖尿病患者疗效及对肝肾功能影响 J.创伤与急危重病医学,2021,9(3):237-24019Bailey CJ,Gross JL,Hennicken D,et al.Dapagliflozin add-on tometformin in type 2diabetes inadequately controlled with metformin:arandomized,double-blind,placebo-controlled 102-week trialJ.BMC Med,2013,20(11):4320Gao F,Lv X,Mo Z,et al.Efficacy and safety of polyethylene glycolloxenatide as add-on to metformin in patients with type 2diabetes:amulticentre,randomized,double-blind,placebo-controlled,phase3b trialJ.Diabetes Obes Metab,2020,22(12):2375-238321Shuai Y,Yang G,Zhang Q,et al.Efficacy and safety of polyethyleneglycol loxenatide monotherapy in type 2diabetes patients:a multicen-tre,randomized,double-blind,placebo-controlled phase 3a clini-cal trialJ.Diabetes Obes Metab,2021,23(1):116-12422Chen X,Lv X,Yang G,et al.Polyethylene glycol loxenatide injec-tions added to metformin effectively improve glycemic control and ex-hibit favorable safety in type 2diabetic patients J.J Diabetes,2017,9(2):158-167(收稿日期:2022-03-28)(修回日期:2022-04-15)基金项目:江苏省镇江市科技社会发展项目(SH2021042);江苏省镇江市重点研发计划项目(SH2018045)作者单位:212000镇江,江苏大学附属第四医院通信作者:李卫,硕士生导师,电子信箱:Xmliwei50885 氟康唑联合乳杆菌对 RVVC 的疗效及免疫因子水平的影响石文印陈伟鸿张亚娇李卫摘要目的探究口服氟康唑联合乳杆菌阴道用药在复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidiasis,RVVC)患者中的疗效及对炎性指标水平的影响。方法选取门诊确诊为 RVVC 的患者 120 例,并采用随机数字表法分为观察组和对照组,每组 60 例,对照组口服氟康唑,观察组在此基础上予阴道置乳酸杆菌胶囊,观察两组临床症状消失时间、疗效、不良反811论著J Med Res,February 2023,Vol.52 No.2应和复发率,比较两组治疗前后外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)评分、生存质量评分、炎症指标(白细胞介素(interleukin,IL)-4、IL-10、肿瘤坏死因子(tumer necrosis factor,TNF)-、IL-2、干扰素(interferon,IFN)-、CD4+、CD8+水平。结果观察组总有效率明显高于对照组(P 0.05);观察组白带异常恢复的时间、总体不良反应发生率、复发率均较对照组明显减少(P 0.05)。与治疗前比较,两组患者治疗后复查 VVC 评分均降低(P 0.05),且观察组均较对照组低(P 0.05)。两组治疗后生存质量评分与治疗前比较均升高(P 0.05),且观察组的评分高于对照组(P 0.05)。两组患者治疗后 IL-4、IL-10、CD8+水平均低于治疗前(P 0.05),且观察组患者中以上指标水平低于对照组(P 0.05);TNF-、IL-2、IFN-、CD4+、CD4/CD8 的水平检测在治疗后高于治疗前(P 0.05),且观察组水平高于对照组(P 0.05)。结论氟康唑联合乳杆菌阴道用药治疗 RVVC 临床疗效较好,安全性能高,可有效改善免疫细胞和相关细胞因子水平。关键词氟康唑乳杆菌复发性外阴阴道假丝酵母病炎性细胞因子疗效中图分类号R711.31文献标识码ADOI 10.11969/j.issn.1673-548X.2023.02.024Efficacy of Fluconazole Combined with Lactobacillus in Treatment of RVVC and Its Influence on Inflammation Indexes.SHI Wenyin,CHEN Weihong,ZHANG Yajiao,et al.Department of Obstetrics and Gynecology,Fourth Affiliated Hospital of Jiangsu University,Jiangsu212000,ChinaAbstractObjectiveTo explore the efficacy of oral Fluconazole combined with Lactobacillus vaginal medication in patients with re-current vulvovaginal candidiasis(RVVC)and its influence on the levels of inflammation indicators.MethodsA total of 120 patientswith RVVC were randomly divided into observation group and control group,60 cases in each group.The patients of control group weregiven Fluconazole orally,the patients of observation group were given Lactobacillus capsules vaginally on the basis of the control group.The disappearance time of clinical symptoms,clinical efficacy,adverse reactions and recurrenct rate of the two groups were observed.TheVVC scores,quality of life scores,the levels of inflammation indicators interleukin-4(IL-4),interleukin-10(IL-10),tumornecrosis factor-(TNF-),interleukin-2(IL-2),interferon-(IFN-),CD4+,CD8+were compared before and aftertreatment between the two gr