阴道用乳杆菌活菌胶囊在宫颈癌前病变LEEP术后应用价值的临床研究

目的 研究阴道用乳杆菌活菌胶囊在宫颈癌前病变LEEP术后应用的临床价值。方法 采用前瞻性对照研究方法，将符合纳入标准的168例研究对象，按照试验组和对照组1:2的比例随机分配，试验组56例，对照组112例。两组对象的平均年龄、孕次和产次相比，差异均无统计学意义（Ps>0.05）。两组对象在LEEP术后第1、2、3月在非经期用阴道内重组人干扰素α-2b阴道泡腾胶囊（80万IU每晚一粒，阴道用药，连用10天）；试验组在术后第4、5、6月在非经期用阴道用乳杆菌活菌胶囊（0.25 g每晚一粒，阴道用药，连用10 天），对照组在术后第4、5、6月不用任何药物，LEEP术后第7月两组研究对象在月经干净后3~7 d内复查。研究高危型人乳头瘤病毒（HR-HPV）、细菌性阴道病、阴道微生态指标的阳性率在两组之间的差异。结果 在LEEP术后第7月，试验组和对照组的HR-HPV阳性率（19.64%和37.50%），细菌性阴道病（BV）阳性率（0.00%和12.50%），微生态四项指标（pH值>4.5、唾液酸苷酶、过氧化氢和白细胞酯酶）全部异常阳性率（0.00%和9.82%）相比较，差异均具有统计学意义（Ps<0.05）。结论 在宫颈癌前病变LEEP术后，可以应用阴道用乳杆菌活菌胶囊改善阴道微环境，减少细菌性阴道病的发生，促进阴道内微生态平衡，以降低HR-HPV的持续阳性率。

The value of postoperative application of vaginal lactobacilli capsules in LEEP patients with precancerous lesion of cervix

Objective To explore the clinical value of postoperative use of vaginal lactobacilli capsules in LEEP patients with precancerous lesion of cervix．Methods Using a prospective controlled study method，168 subjects who met the inclusion criteria were randomly assigned in the ratio of 1:2 in the observation group（n=56）or control group（n=112）．There were no significant differences between the two groups in average age，pregnancy and delivery times（Ps>0.05）．Both groups were treated with recombinant human interferon α-2b intra-vaginal effervescent capsules at the 1st，2nd and 3rd months after LEEP operation（800，000 IU qd at night，10 days）．The observation group was additionally treated with vaginal lactobacilli capsules at the 4th，5th and 6th months after the operation（0.25 g qd at night，10 days）．The two groups were reviewed at the 7th month after LEEP within 3-7 days after menstrual cycle ended to analyze the differences in the positive rates of HR-HPV，BV and vaginal microecological indexes between the two groups．Results The differences in the positive rate of HR-HPV（19.64% vs 37.50%），the positive rate of BV（0.00% vs 12.50%）and the abnormal co-incidence of the four indicators（pH>4.5，neuraminidase，hydrogen peroxide and leukocyte esterase）of vaginal microecology（0.00% vs 9.82%）between the two groups were statistically significant（Ps<0.05）．Conclusion After LEEP for cervical precancerous lesions，lactobacilli capsules can be used to improve the vaginal microenvironment，promote the microecological balance in the vagina and reduce the persistent infection rate of HR-HPV．