冯智慧 张晓甦 冯莉苏 李佩

【摘 要】 复发性外阴阴道假丝酵母菌病（Recurrent vulvovaginal candidiasis，RVVC）是临床常见女性疾病之一，具有反复瘙痒不适、难以根除的问题，严重困扰女性生活、工作。目前西医多用抗真菌药物治疗RVVC，但多次使用后耐药性增加，疗效也随之下降，中医药应用时无明显耐药性，且用药后复发率低，患者依从性较高，对控制本病的发生发展具有较好的作用。文章归纳总结了张晓甦教授临床治疗RVVC的经验，张教授基于多年经验，提出RVVC致病尤以湿热为著，并提出以中药清化湿热为治疗原则，予口服及外洗药联合对症治疗，临床见效显著。

【关键词】 复发性外阴阴道假丝酵母菌病;清化湿热;张晓甦;中医药;名医经验

【中图分类号】R249.2/.7 【文献标志码】 A 【文章编号】1007-8517（2021）14-0095-04

Abstract：Recurrent vulvovaginal candidiasis （RVVC） is one of the most common diseases in clinical women， with the problem such as repeated itching discomfort、difficult to eradicate， so RVVC can troubled women's life and work seriously. At present， Western medicine multi-use antifilmic drugs to treat RVVC， but after repeated use of increased resistance， the efficacy also decreased. The application of Chinese medicine without obvious drug resistance， with low recurrence rate， and patient compliance is high， so Chinese medicine has a better effect to control the occurrence and development of the disease. This paper summarizes the experience of Professor Zhang Xiaosu's clinical treatment of RVVC，Professoe Zhang thinks that RVVC disease-giving is mainly due to wet and heat， and puts forward the principle of treating Chinese medicine with purification of wet heat， and treats the disease with a combination of oral and external wash medicine， with remarkable clinical effect.

Keywords：Recurrent Vulvovaginal Candidiasis;Clearing Wet and Heat; Zhang Xiaosu;Traditional Chinese Medicine; Treatment Experience

复发性外阴阴道假丝酵母菌病（Recurrent vulvovaginal candidiasis，RVVC）是指一年內发作至少4次、有临床症状并经真菌学证实的VVC，多表现有明显外阴潮红、瘙痒、肿胀，或见白色凝乳状及豆腐渣样带下[1]。多数研究[2-3]发现其主要致病菌是白色念珠菌，临床上常由于抗真菌药物的反复使用、不正确的阴道冲洗、口服避孕药、妊娠状态、糖尿病等破坏阴道生态平衡，造成致病菌的反复感染。西医方面治疗本病的手段包括口服及局部外用抗真菌药物、使用干扰素、激光治疗等方式，但临床见效局限，且耐药性逐渐增加，不利于该病的长期管理及防治。

张晓甦教授是南京市名中医，长期从事中医妇科临床与科研工作，结合自己多年经验，认为本病是脾虚、湿热、肝郁、血瘀等多因素互相协同作用的结果。……