定君生调整自然分娩后阴道菌群失调的临床探讨

目的了解自然分娩后阴道菌群的改变及其危害，探讨定君生用于恢复自然分娩后阴道菌群失调的效果。方法分别对57例正常体检妇女、50例晚期妊娠妇女和45例自然分娩产后妇女进行阴道pH检测，同时取阴道分泌物进行细菌培养。另外，选择产后42d来我院复查的产妇72例，随机分为两组，定君生组42例，连续应用定君生10d，对照组30例，对其中已存在阴道感染的患者应用达克宁栓或复方甲硝唑栓进行治疗，疗程均为10d，对比分析两组的阴道炎发生情况。结果产后阴道乳酸杆菌检出率明显低于孕前期和妊娠期（P〈0．01），产后阴道pH高于孕前期，两者之间差异有非常显著性（P〈0．01）。产后阴道厌氧菌的比例下降，非正常菌和条件致病菌增多。产后42d细菌和念珠菌性阴道病的发生率为15．3％，产后3个月定君生组细菌和念珠菌性阴道病的发生率均明显低于对照组（P〈0．05）。结论自然分娩可导致阴道菌群失调，使产后妇女易患细菌和念珠菌性阴道病，应用定君生可恢复阴道内乳酸杆菌的优势地位，对于防治产后细菌和念珠菌性阴道病具有重要作用。

Clinical study on the adjustment of vaginal dysbacteriosis after spontaneous labor with living preparation of lactobacillus

Objective To study the change of the vaginal bacterial flora after spontaneous labor, and its harm to lying-in women, and discuss the effect of living preparation of lactobacillus on regulating vaginal dysbacteriosis after vaginal delivery. Methods Vaginal pH degree was explored respectively in 57 cases of normal healthy women,50 cases of late pregnancy women and 45 cases of vaginal labor women. At the same time, bacterial culture of vaginal secretion from these women were performed. Besides ,72 cases of lying-in women who had adopted spontaneous labor and accepted general callback after 42 days after delivery were allocated into two groups randomly：living preparation of lactobacillus group（42 cases） and control group（ 30 cases）. 42 cases were treated by living preparation of Lactobacillus for 10 days continuously. Lying-in women in the control group who had suffered from vaginal infection were treated by compound metronidazole suppository or miconazole for 10 days continuously. The prevalence of vaginitis in two groups were compared and analyzed. Results Detectable rate of vaginal lactohacillus in lying-in women was lower significantly than that in pregnant women and normal healthy women （ P 〈 0.01 ）. Vaginal pH in lying-in women was higher than that in normal healthy women. There was significant difference between two groups（ P 〈 0.01 ）. Anaerobe proportion came down, while abnormal bacilli and conditioned pathogen increased in vagina of lying-in women. The incedence rate of bacterial vagiosis（BV） and vulvovaginal candidiasis （VVC） in women who had adopted spontaneous labor was 15.3% after 42 da0ys after delivery ,while three months the incedence rate of BV and VVC of living preparation of lactobacillus group was both lower than that of control group （ P 〈 0.05 ）. Conclusions Normallabor can lead to vaginal dysbacteriosis and make lying-in women to be sensitive to BV and VVC. The application of living preparation of lactobacilus can restore the predominant status of lactobaci