本文選題：乳桿菌活菌制劑　切入點：定君生　出處：《大連醫(yī)科大學》2014年碩士論文

【摘要】：目的：細菌性陰道病(Bacterial Vaginosis, BV)是育齡婦女最常見的泌尿生殖道感染性疾病,其主要臨床癥狀為白帶增多,外陰騷癢,給患者的生活帶來很大不便,因其易復發(fā),抗生素治療效果不佳。大量研究認為細菌性陰道病是由于陰道內乳酸菌減少而其他細菌大量繁殖導致的陰道內菌群失調。近年來采用乳桿菌活菌制劑(定君生)治療細菌性陰道病取得了良好的療效。但是目前乳桿菌活菌制劑對陰道微生態(tài)結構的調節(jié)作用尚不明確。本實驗對300例細菌性陰道病患者隨機使用抗生素(100例),定君生(100例)及抗生素聯(lián)合定君生(100例),觀察乳桿菌在陰道內定植情況及用藥前后陰道內微生態(tài)結構的變化,為治療細菌性陰道病提供實驗依據(jù)。 方法：(1)DNA樣本提�。悍謩e提取確診的300例細菌性陰道病患者用藥前和用藥后的陰道微生物元基因組DNA。 (2)聚合酶鏈式反應(PCR)：以德氏乳桿菌特異性引物進行PCR,檢測300例細菌性陰道病患者用藥后乳桿菌在陰道內的定植情況。 (3)聚合酶鏈式反應-變性梯度凝膠電泳(PCR-DGGE):以細菌16S rDNA V3區(qū)通用引物進行PCR,擴增產(chǎn)物進行DGGE,對所得指紋圖譜進行分析,以觀察患者用藥前后陰道內微生態(tài)結構的變化。 結果:(1)DNA提取結果：300例細菌性陰道病患者均能提取出DNA,但由于個體差異性,提取的DNA濃度不同。 (2)德氏乳桿菌的定植情況：抗生素治療組用藥前后均沒有乳桿菌定植;定君生治療組用藥后有乳桿菌定植,檢出率為54%；抗生素聯(lián)合定君生治療組用藥后有乳桿菌定植,檢出率為77%,聯(lián)合用藥后乳桿菌定植率大于單獨使用定君生治療組。 (3)用藥前后陰道微生態(tài)結構的改變：抗生素治療組用藥后微生物種類和數(shù)量顯著減少,微生態(tài)結構有差異；定君生治療組用藥后微生物種類和數(shù)量有減少,微生態(tài)結構無顯著差異,有乳桿菌定植；抗生素聯(lián)合定君生治療組,用藥后雖較用藥前微生物種類和數(shù)量有減少,但較前兩組均有增加,微生態(tài)結構無顯著差異,有乳桿菌定植。 結論：抗生素對陰道微生態(tài)結構有顯著影響；定君生對陰道微生態(tài)的影響明顯小于抗生素。定君生的使用也有利于抗生素干預后陰道微生態(tài)平衡的重建。
[Abstract]:Objective: Bacterial Vaginosism (BV) is the most common infectious disease of genitourinary tract in women of childbearing age. Its main clinical symptoms are increased leucorrhea and itchy vulva. Antibiotic treatment is not good. A large number of studies believe that bacterial vaginosis is due to the reduction of lactic acid bacteria in the vagina and other bacteria due to mass reproduction of the vaginal flora imbalance. In recent years, the use of live Lactobacillus preparation (Ding Junsheng). The therapeutic effect on bacterial vaginosis was good, but the regulating effect of Lactobacillus vaginalis on vaginal microecology was not clear at present. In this study, 100 patients with bacterial vaginosis were randomly treated with antibiotics. To observe the colonization of Lactobacillus in vagina and the changes of microecological structure in vagina before and after treatment. To provide experimental basis for the treatment of bacterial vaginosis. Methods DNA samples were extracted from 300 patients with bacterial vaginosis. (2) Polymerase chain reaction (PCR): Lactobacillus de specific primers were used to detect the colonization of Lactobacillus in the vagina of 300 patients with bacterial vaginosis. Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGEA): using the universal primers of bacterial 16s rDNA V3 region, the amplified products were used for DGGE, and the fingerprints were analyzed to observe the changes of microecological structure in vagina before and after treatment. Results the results showed that all the 300 patients with bacterial vaginosis could extract DNA, but the concentration of DNA extracted was different because of the individual difference. (2) the colonization of Lactobacillus de: there was no Lactobacillus colonization before and after treatment in the antibiotic treatment group; the Lactobacillus colonization was detected in the Dingjunsheng treatment group with a positive rate of 54; and the Lactobacillus colonization was found in the antibiotic combined with Junsheng treatment group. The positive rate of lactobacillus was 77%, and the rate of Lactobacillus colonization was higher than that of Dingjunsheng alone. (3) the changes of vaginal microecological structure before and after treatment: the species and quantity of microorganism in antibiotic treatment group decreased significantly, the microecological structure was different, and the species and quantity of microorganism in Dingjunsheng treatment group decreased after treatment. There was no significant difference in microecological structure, but there was no significant difference in Lactobacillus colonization, but there was no significant difference in microecological structure between the two groups, although the species and quantity of microorganism were decreased after treatment with antibiotics combined with Dingjunsheng. Lactobacillus was colonized. Conclusion: antibiotics have a significant effect on the vaginal microecological structure, Dingjunsheng has less effect on vaginal microecology than antibiotics, and the use of Dingjunsheng is also beneficial to the reconstruction of vaginal microecological balance after antibiotic intervention.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.25

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