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[激素与益生菌疗法在围绝经期和绝经后合并外阴阴道萎缩的慢性复发性细菌性膀胱炎女性综合治疗中的应用经验]

[Experience of application of hormonal and probiotic therapy in the complex treatment of women in peri- and postmenopausal with chronic recurrent bacterial cystitis in the background of vulvovaginal atrophy].

作者信息

Kuzmenko A V, Kuzmenko V V, Gyaurgiev T A

机构信息

Voronezh State Medical University n.a. N.N. Burdenko, Voronezh, Russia.

出版信息

Urologiia. 2019 Jul(3):66-71.

Abstract

INTRODUCTION

Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used.

MATERIALS AND METHODS

The study included 60 women aged with the diagnosis: "Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage". The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment.

RESULTS

At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05).

CONCLUSION

Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.

摘要

引言

下尿路感染(LUTI)是女性中最常见的疾病之一。围绝经期和绝经后期发病时,下尿路感染的风险会增加。55岁女性中有30%会出现外阴阴道萎缩,70岁女性中有75%会出现。目前,局部激素治疗是其主要治疗方法。然而,也会使用不同的综合治疗方案。

材料与方法

该研究纳入了60名诊断为“绝经后萎缩性阴道炎。慢性复发性细菌性膀胱炎急性期”的女性。患者被分为两组,每组30人。第1组采用病因性抗生素治疗,并联合局部使用单剂制剂或雌三醇,为期3个月。第2组患者接受抗生素联合Triozhinal治疗,为期3个月。在治疗的第1天和第7天以及治疗开始后3个月监测疗效。

结果

两组患者入院时均有外阴阴道萎缩和慢性膀胱炎加重的症状。含有干酪乳杆菌鼠李糖亚种多德勒林冻干培养物的Triozhinal综合治疗有助于pH值正常化、恢复阴道生物群落,从而减轻阴道干燥和灼烧感、性交困难等不适症状的严重程度。因此,尽管大多数女性的症状有所减轻,但第2组中此类患者的比例更高,达到96.7%,而第1组为83.3%。持续服用该药物3个月。这使得在阴道营养恢复之前能够维持阴道正常微生物群落,与第1组结果相比,菌尿症和白细胞尿症的发生率降低了20%,并显著减少了感染复发次数(p<0.05)。

结论

Triozhinal可改善绝经前后外阴阴道萎缩女性复发性尿路感染的治疗效果,可推荐用于联合治疗。

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