Han Yue, Shen Su, Fu Jie, Ren Qingling
（ 210029） Department of Gynecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2025 Jan 20;56(1):68-73. doi: 10.12182/20250160110.
To explore the mechanism by which Wandai Decoction prevents and treats vulvovaginal candidiasis (VVC) of the spleen deficiency and excessive dampness type and restores the vaginal flora structure, and to identify the potential metabolic pathways involved using metagenomics and metabolomics.
Twenty VVC patients who met the inclusion criteria were randomly assigned to a Wandai Decoction group and a fluconazole group ( = 10 in each group). Subjects in the fluconazole group were given a single oral dose of 150 mg fluconazole, while those in the Wandai Decoction group took the Wandai Decoction orally for 14 days. The vulvovaginal signs and symptoms (VSS) scores of both patient groups were evaluated before and after treatment. Vaginal secretions were collected before and after treatment. The Illumina sequencing and the liquid chromatography with tandem mass spectrometry (LC-MS/MS) platform were used to conduct metagenomic and metabolomics analyses of the vaginal secretions, respectively.
The VSS score results showed that the VSS scores of both groups decreased after treatment compared with those before treatment ( < 0.01), and there was no statistically significant difference in the VSS scores between the two groups after treatment. Metagenomics results showed that, after treatment, the vaginal microbial communities in the Wandai Decoction group were of CST Ⅱ and Ⅴ types (predominated by and ), while those in the fluconazole group were and 431. KEGG functional enrichment analysis results showed that, in terms of the cell cycle and meiosis functions of , statistically significant differences between the Wandai Decoction and fluconazole groups were observed ( < 0.05). Metabolomic analysis identified 120 differential metabolites between the two groups after treatment. The results of KEGG metabolic pathway enrichment analysis of differential metabolites showed that the Wandai Decoction might be significantly superior to fluconazole in improving local vaginal metabolic pathways of α-linolenic acid, glycerophospholipid metabolism, pentose and glucuronic acid interconversion, and arachidonic acid.
The Wandai Decoction can improve the vaginal flora of VVC patients. It may be superior to fluconazole in the signaling pathways of the cell cycle and meiosis. The improvement of the vaginal flora by the Wandai Decoction may be associated with its effect on metabolic pathways of glycerophospholipid metabolism, pentose and glucuronic acid interconversion, and others in the vagina.
探讨完带汤防治脾虚湿盛型外阴阴道假丝酵母菌病（VVC）及恢复阴道菌群结构的作用机制，并运用宏基因组学和代谢组学方法鉴定其中潜在的代谢途径。
将20例符合纳入标准的VVC患者随机分为完带汤组和氟康唑组（每组10例）。氟康唑组患者单次口服150 mg氟康唑，完带汤组患者口服完带汤14天。评估两组患者治疗前后的外阴阴道体征和症状（VSS）评分。收集两组患者治疗前后的阴道分泌物。分别采用Illumina测序和液相色谱-串联质谱（LC-MS/MS）平台对阴道分泌物进行宏基因组学和代谢组学分析。
VSS评分结果显示，两组患者治疗后的VSS评分均低于治疗前（P<0.01），且治疗后两组患者的VSS评分差异无统计学意义。宏基因组学结果显示，治疗后，完带汤组阴道微生物群落为CSTⅡ型和Ⅴ型（以和为主），而氟康唑组为和431。KEGG功能富集分析结果显示，在的细胞周期和减数分裂功能方面，完带汤组与氟康唑组存在统计学差异（P<0.05）。代谢组学分析鉴定出两组治疗后有120种差异代谢物。差异代谢物的KEGG代谢途径富集分析结果显示，完带汤在改善阴道局部α-亚麻酸、甘油磷脂代谢、戊糖与葡糖醛酸相互转化以及花生四烯酸代谢途径方面可能显著优于氟康唑。
完带汤可改善VVC患者的阴道菌群。在细胞周期和减数分裂信号通路方面可能优于氟康唑。完带汤对阴道菌群的改善可能与其对阴道甘油磷脂代谢、戊糖与葡糖醛酸相互转化等代谢途径的影响有关。
