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克霉唑阴道膨胀栓与阴道片治疗轻中度外阴阴道假丝酵母菌病的多中心、随机、开放、阳性平行对照临床研究

[A multicenter, randomized, open and positive parallel controlled clinical study of clotrimazole vaginal expansion suppository and vaginal tablet in the treatment of mild and moderate vulvovaginal candidiasis].

作者信息

Zhang L, Liao Q P, Wang C H, Zhang D, An R F, Zheng J H, Wang Y, Zhang Q Q, Chen R

机构信息

Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2020 Oct 25;55(10):697-702. doi: 10.3760/cma.j.cn112141-20200403-00293.

Abstract

Using clotrimazole vaginal tablet as a positive control, to evaluate the results of clotrimazole vaginal expansion suppository in the treatment of mild and moderate vulvovaginal candidiasis in terms of efficacy, patient satisfaction, side effects, and recurrence rate. This study was jointly conducted by 5 hospitals from August 2017 to October 2018, patients with mild and moderate vulvovaginal candidiasis confirmed by fungal culture and symptoms scores were selected. They were randomized to experimental group and control group as 1∶1 ratio. In the experimental group (=105), the subjects applied clotrimazole vaginal expansion suppository (150 mg) daily at night for 7 days. In the control group (=106), the subjects used a single dose of clotrimazole vaginal tablet (500 mg). Follow-ups were performed at (8±3) and (30±5) days after the discontinuation of the drugs, respectively. The difference in clinical symptoms and signs scores was used to evaluate the improvement of clinical symptoms, and the patient's satisfaction and side effects were recorded. At the first follow-up, the experimental group and control group were followed up by fungal culture on the cure rate [66.7% (70/105) versus 63.2% (67/106), >0.05] and total effective rate [98.1% (103/105) versus 99.1% (105/106), >0.05], the differences were not statistically significant. At the second follow-up, the recurrence rates of the experimental group and the control group were 5.7% (4/70) and 14.9% (10/67), respectively, with no significant difference (>0.05). In the evaluation of patient satisfaction, the leakage of the drug in the experimental group was significantly better than that in the control group (<0.01). The side effects mainly included vaginal stimulation, itching and burning sensation, and there was no statistical difference between the two groups (1.070, =0.586). In the treatment of mild and moderate vulvovaginal candidiasis, clotrimazole vaginal expansion suppository is no less effective than clotrimazole vaginal tablet, and there is no significant difference in the recurrence rate between the two. In terms of patient satisfaction, clotrimazole vaginal expansion suppository is superior to clotrimazole vaginal tablet.

摘要

以克霉唑阴道片作为阳性对照,从疗效、患者满意度、副作用及复发率等方面评价克霉唑阴道膨胀栓治疗轻中度外阴阴道假丝酵母菌病的效果。本研究于2017年8月至2018年10月由5家医院联合开展,选取真菌培养及症状评分确诊的轻中度外阴阴道假丝酵母菌病患者。按1∶1比例随机分为试验组和对照组。试验组(=105)患者每晚应用克霉唑阴道膨胀栓(150mg),连用7天。对照组(=106)患者单次使用克霉唑阴道片(500mg)。分别在停药后(8±3)天和(30±5)天进行随访。采用临床症状和体征评分的差值评估临床症状改善情况,记录患者满意度及副作用。首次随访时,试验组和对照组真菌培养治愈率[66.7%(70/105)比63.2%(67/106),>0.05]和总有效率[98.1%(103/105)比99.1%(105/106),>0.05]差异均无统计学意义。第二次随访时,试验组和对照组复发率分别为5.7%(4/70)和14.9%(10/67),差异无统计学意义(>0.05)。在患者满意度评价中,试验组药物渗漏情况明显优于对照组(<0.01)。副作用主要包括阴道刺激、瘙痒和烧灼感,两组间差异无统计学意义(1.070,=0.586)。治疗轻中度外阴阴道假丝酵母菌病时,克霉唑阴道膨胀栓疗效不低于克霉唑阴道片,两者复发率差异无统计学意义。在患者满意度方面,克霉唑阴道膨胀栓优于克霉唑阴道片。

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