念珠菌病（外阴阴道）
Candidiasis (vulvovaginal).
作者信息
Spence Des
机构信息
General Practice, Glasgow University, Glasgow, Scotland.
出版信息
BMJ Clin Evid. 2010 Jan 5;2010:0815.
INTRODUCTION
Vulvovaginal candidiasis is estimated to be the second most common cause of vaginitis after bacterial vaginosis. Candida albicans accounts for 85% to 90% of cases.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments for acute vulvovaginal candidiasis in non-pregnant symptomatic women? What are the effects of alternative or complementary treatments for acute vulvovaginal candidiasis in non-pregnant symptomatic women? What are the effects of treating a male sexual partner to resolve symptoms and prevent recurrence in non-pregnant women with symptomatic acute vulvovaginal candidiasis? What are the effects of alternative or complementary treatments for symptomatic recurrent vulvovaginal candidiasis in non-pregnant women? What are the effects of treating a male sexual partner in non-pregnant women with symptomatic recurrent vulvovaginal candidiasis? What are the effects of treating asymptomatic non-pregnant women with a positive swab for candidiasis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 61 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: alternative or complementary treatments; douching; drug treatments; garlic; intravaginal preparations (boric acid, nystatin, imidazoles, tea tree oil); oral fluconazole; oral itraconazole; treating a male sexual partner; and yoghurt containing Lactobacillus acidophilus (oral or vaginal).
引言
据估计，外阴阴道念珠菌病是仅次于细菌性阴道病的第二大常见阴道炎病因。白色念珠菌占病例的85%至90%。
方法与结果
我们进行了一项系统评价，旨在回答以下临床问题：药物治疗对非妊娠有症状女性急性外阴阴道念珠菌病有何效果？替代或补充治疗对非妊娠有症状女性急性外阴阴道念珠菌病有何效果？治疗男性性伴侣对非妊娠有症状急性外阴阴道念珠菌病女性缓解症状及预防复发有何效果？替代或补充治疗对非妊娠有症状复发性外阴阴道念珠菌病女性有何效果？治疗男性性伴侣对非妊娠有症状复发性外阴阴道念珠菌病女性有何效果？治疗念珠菌病拭子检查阳性的无症状非妊娠女性有何效果？我们检索了：截至2009年3月的Medline、Embase、Cochrane图书馆及其他重要数据库（临床证据综述会定期更新；请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品和医疗产品监管局（MHRA）等相关组织的危害警示。
结果
我们发现61项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施的证据质量进行了GRADE评估。
结论
在本系统评价中，我们提供了以下干预措施的有效性和安全性相关信息：替代或补充治疗；阴道灌洗；药物治疗；大蒜；阴道制剂（硼酸、制霉菌素、咪唑类、茶树油）；口服氟康唑；口服伊曲康唑；治疗男性性伴侣；以及含嗜酸乳杆菌的酸奶（口服或阴道用）。
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