王国宁 李扬 王丹丹 魏延菊

*基金项目：潍坊市科技计划发展项目（2022YX020）

【摘要】 目的：探讨清热止带方坐浴联合乳杆菌活菌胶囊治疗湿热下注型绝经后萎缩性阴道炎的临床效果及对性激素的影响。方法：选择2019年4月—2022年11月潍坊市中医院收治的130例湿热下注型绝经后萎缩性阴道炎患者，随机分为对照组（n=65）和观察组（n=65）。对照组给予乳杆菌活菌胶囊，观察组在乳杆菌活菌胶囊的基础上给予清热止带方坐浴，两组患者均治疗4周。比较两组临床疗效、性激素[促卵泡激素（follicle-stimulating hormone，FSH）、雌二醇（estradiol，E2）]、免疫功能指标[免疫球蛋白M（immunoglobulin M，IgM）、免疫球蛋白G（immunoglobulin G，IgG）、免疫球蛋白A（immunoglobulin A，IgA）]、阴道分泌物中炎症因子[白细胞介素-8（interleukin-8，IL-8）、白细胞介素-4（interleukin-4，IL-4）及C反应蛋白（C reactive protein，CRP）]及不良反应。结果：观察组总有效率（95.38%）高于对照组（84.62%）（P<0.05）。治疗后两组FSH均降低，E2均升高，观察组FSH低于对照组，而E2高于对照组（P<0.05）。治疗后，两组IgM、IgG、IgA水平均升高，且观察组IgM、IgG、IgA水平均高于对照组（P<0.05）。治疗后，两组阴道分泌物中IL-8、IL-4、CRP水平均降低，且观察组IL-8、IL-4、CRP水平均低于对照组（P<0.05）。观察组不良反应发生率（6.15%）低于对照组（18.46%）（P<0.05）。结论：清热止带方坐浴联合乳杆菌活菌胶囊治疗湿热下注型绝经后萎缩性阴道炎的效果确切，能够改善性激素和提高免疫功能，抑制阴道炎症反应，安全性较好。

【关键词】 清热止带方 乳杆菌活菌胶囊 绝经后萎缩性阴道炎 性激素

Clinical Effect of Sitz Bath with Qingre Zhidai Prescription Combined with Live Lactobacillus Capsules in the Treatment of Postmenopausal Atrophic Vaginitis with Pattern of Dampness-heat Diffusing Downward and Its Influence on Sex Hormone/WANG Guoning， LI Yang， WANG Dandan， WEI Yanju. //Medical Innovation of China， 2024， 21（15）： 0-033

[Abstract] Objective： To investigate the clinical effect of sitz bath with Qingre Zhidai Prescription combined with Live Lactobacillus Capsules in the treatment of postmenopausal atrophic vaginitis with pattern of dampness-heat diffusing downward and its influence on sex hormone. Method： A total of 130 patients with postmenopausal atrophic vaginitis with pattern of dampness-heat diffusing downward treated in Weifang Hospital of Traditional Chinese Medicine from April 2019 to November 2022 were selected and randomly divided into control group （n=65） and observation group （n=65）. The control group was given Live Lactobacillus Capsules， and the observation group was given Qingre Zhidai Prescription sitz bath on the basis of Live Lactobacillus Capsules. Both groups were treated for 4 weeks. The clinical efficacy， sex hormone [follicle-stimulating hormone （FSH）， estradiol （E2）]， immune function indexes [immunoglobulin M （IgM）， immunoglobulin G （IgG）， immunoglobulin A （IgA）]， inflammatory factors [interleuin-8 （IL-8）， interleukin-4 （IL-4） and C reactive protein （CRP）] in vaginal discharge and adverse reactions were compared between the two groups. Result： The total effective rate of observation group （95.38%） was higher than that of control group （84.62%） （P<0.05）. After treatment， FSH were decreased and E2 were increased in both groups， FSH in observation group was lower than that in control group， while E2 was higher than that in control group （P<0.05）. After treatment， the levels of IgM， IgG and IgA in both groups were increased， and the levels of IgM， IgG and IgA in observation group were higher than those in control group （P<0.05）. After treatment， the levels of IL-8，

IL-4 and CRP in vaginal discharge of both groups were decreased， and the levels of IL-8， IL-4 and CRP in observation group were lower than those in control group （P<0.05）. The incidence of adverse reactions in observation group （6.15%） was lower than that in control group （18.46%） （P<0.05）. Conclusion： The effect of sitz bath with Qingre Zhidai Prescription combined with Live Lactobacillus Capsules in the treatment of postmenopausal atrophic vaginitis with pattern of dampness-heat diffusing downward is exact， which can improve sex hormones and immune function， inhibit vaginal inflammatory reaction， and have good safety.

[Key words] Qingre Zhidai Prescription Live Lactobacillus Capsules Postmenopausal atrophic vaginitis Sex hormone

First-author's address： Department of Gynecology， Weifang Hospital of Traditional Chinese Medicine， Weifang 261074， China

doi：10.3969/j.issn.1674-4985.2024.15.007

萎缩性阴道炎又被称为老年性阴道炎，是绝经后和围绝经期妇女中比较常见的疾病，是由于雌激素水平降低、阴道局部环境改变及抵抗力降低等因素引起的一种阴道炎症[1-2]。据报道，萎缩性阴道炎在妇女中的发病率可达30%[3]。萎缩性阴道炎可以表现为外阴灼热感、瘙痒，阴道分泌物增多，同时伴有尿急、尿频等膀胱刺激征表现，部分患者可伴有血性白带、性交疼痛等症状，且该病容易反复发作，根治十分困难，严重影响患者的身心健康[4-5]。目前西医主要是采用改善阴道局部微生态环境、抗感染及补充雌激素等措施治疗萎缩性阴道炎，但是西医长期使用的疗效欠佳，患者的病情容易反复发作[6-7]。……