【摘要】： 目的: 通過對外陰陰道念珠菌病(vulvovaginal candidiasis,VVC)及復(fù)發(fā)性外陰陰道念珠菌病(relapsing vulvocaginal candidiasis,RVVC)患者病原菌進(jìn)行分離培養(yǎng)、菌種鑒定和17味單味中藥煎劑體外藥物敏感性試驗(yàn),從病原學(xué)角度分析探討VVC、RVVC的病因,并為中藥煎劑外治念珠菌性陰道炎的有效稀釋濃度提供參考。 方法: 收集具有典型臨床癥狀的VVC及RVVV患者的陰道分泌物標(biāo)本,用沙氏培養(yǎng)基分離純化菌株,然后應(yīng)用科瑪嘉顯色培養(yǎng)基及酵母菌鑒定試劑條對分離的81株病原菌進(jìn)行菌種鑒定。同時(shí)采用微量稀釋法對黃連、黃芩、黃柏、大黃、虎杖、丹皮、五倍子、知母、百部、蛇床子、苦參、蒼耳子、梔子、射干、白術(shù)、烏梅、龍膽草17種單味中藥煎劑進(jìn)行最小抑菌濃度(minimal inhibitory concentration,MIC)測定。對17種中藥煎劑藥敏試驗(yàn)參照美國國家實(shí)驗(yàn)室標(biāo)準(zhǔn)委員會(huì)(nationalcommittee clinical laboratory standards,NCCLS)M-27 A方案。 結(jié)果: ①VVC及RVVC 2組共分離出4種81株酵母菌,分別是:白念珠菌(69株,占85.19%)、光滑念珠菌(6株,占7.41%)、熱帶念珠菌(4株,占4.94%)和近平滑念珠菌(2株,占2.47%)。 ②VVC與RVVC組使用抗生素及其它類洗液沖洗陰道率分別為17.14%(6/35)、45.65%(21/46)。 ③VVC組35株酵母中白念珠菌33株,占94.29%,非白念珠菌2株,占5.71%:RVVC組46株酵母中白念珠菌36株,占78.26%,非白念珠菌10株,占21.74%.RVVC組非白念珠菌所占比率明顯高于VVC組,兩組之間的差異有統(tǒng)計(jì)學(xué)意義(X~2=4.04,P＜0.05)。 ④標(biāo)準(zhǔn)株中,黃芩、黃連、黃柏、虎杖分別對白念珠茵、熱帶念珠菌、近平滑念珠MIC值依次為:62.5mg/mL、250mg/mL、250mg/mL;3.91mg/mL、7.81mg/mL、15.6mg/mL。臨床株中,黃芩、黃連、黃柏、虎杖分別對白念珠菌、熱帶念珠菌、近平滑念珠、光滑念珠菌MIC值依次為:250mg/mL、500mg/mL、500mg/mL、500mg/mL;3.91mg/mL、3.91mg/mL、7.81mg/mL、3.91mg/mL;125mg/mL、125mg/mL、500mg/mL、125mg/mL;250mg/mL、500mg/mL、500mg/mL、500mg/mL。其余13味中藥煎劑各孔均見菌落生長,模糊不清。 結(jié)論: ①VVC、RVVC感染仍以白念珠菌為主,非白念珠菌在RVVC中所占比率較初發(fā)者增多,以光滑念珠菌為主。VVC與RVVC中,非白念珠菌與念珠菌所占比率有統(tǒng)計(jì)學(xué)意義。 ②RVVC組有頻繁使用抗生素類及其它洗液沖洗史者所占比率顯著高于初發(fā)組。 ③17味中藥中對念珠菌有明顯抑制作用的有黃芩、黃連、黃柏、虎杖,余無明顯抗念珠菌的作用。 ④非白念珠菌對黃芩、黃連、黃柏、虎杖4味單味中藥煎劑的MIC值普遍較白念珠菌偏高,但非白念珠菌的MIC值不盡相同,之間存在差異。
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圖片說明：白念珠菌鏡下所見〔革蘭氏染色:100)
[Abstract]:Aim: to isolate and culture the pathogenic bacteria of patients with vulvovaginal candidiasis (vulvovaginal candidiasis,VVC) and recurrent vulvovaginal candidiasis (relapsing vulvocaginal candidiasis,RVVC), to identify the bacteria and to test the drug sensitivity of 17 single traditional Chinese medicine decoction in vitro, to analyze the etiology of VVC,RVVC from the etiological point of view, and to provide reference for the effective dilution concentration of traditional Chinese medicine decoction in the treatment of candida vaginosis. Methods: the vaginal secretions of VVC and RVVV patients with typical clinical symptoms were collected and purified by Sha's medium, and then 81 strains of pathogenic bacteria were identified by Camaga color medium and yeast identification reagent strip. At the same time, the minimal inhibitory concentration (minimal inhibitory concentration,MIC) of 17 kinds of single traditional Chinese medicine decoction of Coptis chinensis, Scutellaria baicalensis, Phellodendron chinense, Rhubarb, Polygonum cuspidatum, Radix Paeoniae Alba, Galla chinensis, Anemarrhena asphodeloides, Fructus Cinnamomum, Sophora flavescens, Xanthium sibiricum, Gardenia jasminoides Elm. The drug sensitivity test of 17 kinds of traditional Chinese medicine decoction was conducted according to (nationalcommittee clinical laboratory standards,NCCLS) M 鈮，

本文編號(hào)：2510999