Alfa Institute of Biomedical Sciences, 9 Neapoleos Street, Marousi, Athens, Greece..
J Womens Health (Larchmt). 2011 Aug;20(8):1245-55. doi: 10.1089/jwh.2010.2708. Epub 2011 Jul 20.
Recurrent vulvovaginal candidiasis (VVC) remains a challenge to manage in clinical practice. Recent epidemiologic studies indicate that non-albicans Candida spp. are more resistant to conventional antifungal treatment with azoles and are considered as causative pathogens of vulvovaginal candidiasis.
We searched PubMed and Scopus for studies that reported clinical evidence on the intravaginal use of boric acid for vulvovaginal candidiasis.
We identified 14 studies (2 randomized clinical trials [RCTs], 9 case series, and 4 case reports) as eligible for inclusion in this review. Boric acid was compared with nystatin, terconazole, flucytosine, itraconazole, clotrimazole, ketoconazole, fluconazole, buconazole, and miconazole; as monotherapy, boric acid was studied in 7 studies. The mycologic cure rates varied from 40% to 100% in patients treated with boric acid; 4 of the 9 included case series reported statistically significant outcomes regarding cure (both mycologic and clinical) rates. None of the included studies reported statistically significant differences in recurrence rates. Regarding the adverse effects caused by boric acid use, vaginal burning sensation (<10% of cases), water discharge during treatment, and vaginal erythema were identified in 7 studies.
Our findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains.
复发性外阴阴道念珠菌病（VVC）仍然是临床实践中难以处理的问题。最近的流行病学研究表明，非白念珠菌属念珠菌对唑类常规抗真菌治疗更具耐药性，被认为是外阴阴道念珠菌病的致病病原体。
我们在 PubMed 和 Scopus 上搜索了报道硼酸阴道内使用治疗外阴阴道念珠菌病的临床证据的研究。
我们确定了 14 项符合纳入本综述标准的研究（2 项随机临床试验[RCT]，9 项病例系列研究和 4 项病例报告）。硼酸与制霉菌素、酮康唑、氟胞嘧啶、伊曲康唑、克霉唑、酮康唑、氟康唑、布康唑和咪康唑进行了比较；作为单一疗法，硼酸在 7 项研究中进行了研究。接受硼酸治疗的患者的真菌学治愈率从 40%到 100%不等；9 项纳入的病例系列研究中有 4 项报告了关于治愈率（真菌学和临床）的统计学显著结果。纳入的研究均未报告复发率存在统计学差异。关于硼酸使用引起的不良反应，7 项研究中发现阴道烧灼感（<10%的病例）、治疗期间水样分泌物和阴道红斑。
我们的研究结果表明，当由于涉及非白念珠菌属念珠菌或唑类耐药株导致常规治疗失败时，硼酸是一种安全、替代、经济的选择，适用于复发性和慢性阴道炎症状的女性。
