目的 观察盐酸特比萘芬联合氟康唑治疗反复发作的念珠菌性阴道炎(recurrent vulvovaginal candidasis, RVVC)的疗效和安全性。方法 228例RVVC患者随机分为氟康唑组(氟康唑150 mg, 口服, 1次/3 d, 共3次)和联合用药组(在氟康唑组的基础上加用盐酸特比萘芬阴道泡腾片, 每晚1片放入阴道, 50 mg/片, 连续应用2周)。观察治疗结束后两组治愈率、临床症状、体征改变、不良反应情况。结果 氟康唑组治愈率为81.6%, 联合用药组治愈率为92.1%, 联合用药组高于氟康唑组, 差异有统计学意义(χ²=5.53, P=0.02)。两组治疗后外阴灼痛、外阴瘙痒、阴道分泌物、阴道充血等各项临床症状体征均较治疗前有明显好转。联合用药组阴道分泌物、阴道充血等临床体征较氟康唑组明显减轻, 差异有统计学意义(P<0.05)。两组不良反应发生率(氟康唑组13.2%, 联合用药组14.9%)比较, 差异无统计学意义。结论 盐酸特比萘芬阴道泡腾片联合氟康唑较单独采用氟康唑治疗RVVC有更高的治愈率, 且未增加不良反应。

Objective To study the efficacy and safety of ternbinafine vaginal effervescent tablets combined with fluconazole in the treatment of recurrent vulvovaginal candidiasis (RVVC). Methods Totally 228 patients with RVVC were randomly divided into the control group and the study group with 114 cases in each. The control group was treated with fluconazole 150 mg orally for a total of 3 times per 3 days. The study group was given the same drug as the control group and additionally treated with ternbinafine vaginal effervescent tablets 50 mg every day (the treatment course was 14 days). The clinical effect, effective rate and the incidence of adverse reactions in the two groups were compared. Results The total cure rate in the study group was 92.1%, higher than that in the control group ( 81.6% ), and the difference was statistically significant (χ²=5.53, P=0.02 ). The clinical symptoms in the two groups were significantly improved after the treatment (P<0.05). The clinical symptom of vaginal secretion and vaginal congestion improved significantly in the study group (P<0.05). The adverse reactions in the two groups(control group 13.2%, study group 14.9%)had no significant difference. Conclusions The ternbinafine vaginal effervescent tablets can raise the cure rate of RVVC. No obvious adverse effects were observed about ternbinafine vaginal effervescent tablets.