Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study
Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study
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DOI：
10.1007/s10096-012-1671-1
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发表时间：
2012-11-01
影响因子：
4.5
通讯作者：
Sesikeran, B.
中科院分区：
文献类型：
--
作者：
Hemalatha, R.;Mastromarino, P.;Sesikeran, B.
本研究的目的是评估乳酸杆菌对阴道健康和促炎细胞因子的有效性。这项双盲研究纳入了 67 名细菌性阴道病 (BV) 患者、50 名中等菌群患者和 42 名正常阴道菌群患者。受试者随机接受益生菌乳杆菌阴道片（短乳杆菌 CD2、唾液乳杆菌 Salicinius 亚种、植物乳杆菌）或阴道 pH 片（活性比较剂）。收集宫颈阴道灌洗液，通过ELISA测定IL-1β、TNFα和IL-6的浓度。还在治疗前后对双臂的中性鞘磷脂酶活性进行了定量。益生菌阴道片具有良好的耐受性，并且没有副作用的报道。研究表明治愈率接近80%；即，32% 的女性可以恢复正常阴道菌群，47% 的 Nugent 评分有所改善，而 20% 的受试者在第一次随访（治疗 8 天后）中没有清除 BV。含有 pH 降低化合物的 pH 片剂分别诱导 BV 消退和正常阴道菌群恢复，分别为 74% 和 26%。研究发现，在健康受试者中，乳酸菌片剂比 pH 片剂更能预防 BV。用乳酸杆菌治疗后观察到IL-1β和IL-6阴道细胞因子显着减少，而活性比较剂对局部促炎细胞因子没有任何影响。两组中阴道中性鞘磷脂酶活性均未改变。含有乳酸杆菌的阴道片可以治愈 BV 并减轻阴道炎症反应。
The purpose of this study was to evaluate the effectiveness of lactobacilli on vaginal health and proinflammatory cytokines. Sixty-seven patients with bacterial vaginosis (BV), 50 with intermediate flora and 42 with normal vaginal flora were enrolled in this double-blind study. The subjects were randomized to receive probiotic lactobacilli vaginal tablets (L. brevis CD2, L. salivarius subsp. salicinius, L. plantarum) or the vaginal pH tablet (active comparator). Cervico-vaginal lavage was collected to measure the concentrations of IL-1 beta, TNF alpha and IL-6 by ELISA. Neutral sphingomyelinase activity was also quantified in both arms before and after treatment. The probiotic vaginal tablet was well tolerated and no side effects were reported. The study demonstrated a cure rate of nearly 80 %; i.e., 32 % of the women could restore normal vaginal flora and 47 % had improved Nugent score, whereas 20 % of the subjects did not clear BV in the first follow-up (after 8 days treatment). The pH tablet containing pH lowering compounds induced resolution of BV and restoration of normal vaginal flora in 74 % and 26 %, respectively. The lactobacilli tablet was found to be better than the pH tablet in preventing BV in healthy subjects. A significant reduction in IL-1 beta and IL-6 vaginal cytokines was observed after treatment with lactobacilli, while the active comparator did not have any effect on local proinflammatory cytokines. Vaginal neutral sphingomyelinase activity was not modified in either group. Vaginal tablets containing lactobacilli can cure BV and reduce vaginal inflammatory response.