The use of Lactobacillus rhamnosus in the therapy of bacterial vaginosis. Evaluation of clinical efficacy in a population of 40 women treated for 24 months
The use of Lactobacillus rhamnosus in the therapy of bacterial vaginosis. Evaluation of clinical efficacy in a population of 40 women treated for 24 months
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DOI：
10.1007/s00404-009-1287-6
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发表时间：
2010-06
影响因子：
2.6
通讯作者：
A. Rossi;T. Rossi;M. Bertini;G. Caccia
中科院分区：
文献类型：
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作者：
A. Rossi;T. Rossi;M. Bertini;G. Caccia
研究背景细菌性阴道病(BV)是世界范围内最常见的成年女性阴道疾病。许多临床研究表明，无论是在最初的抗菌治疗后，还是在单独使用时，通过乳酸杆菌重新定植阴道黏膜来重建生理生态系统，都可能是治疗BV的有效方法。阴道pH值为4.5被认为是生理的，它的测量被认为是一个客观参数，对阴道微生物群的变化非常敏感，并与临床相关的BV相关。目的本研究的目的是评估长期(24个月)使用鼠李糖乳杆菌(NORMOGIN®)阴道内治疗对40例符合Amsel标准的BV患者的阴道pH值和临床症状的疗效。分别有24/40和32/40的女性在治疗12个月和24个月后恢复到4.5值以下。PH值在治疗12个月时显著下降(P<；0.001)，在治疗24个月时进一步下降(P<；0.02vs.12个月)。阴道生理pH的逐渐恢复与症状积分的降低有关。结论本研究支持使用pH值测量对BV妇女进行敏感、客观和简单的治疗随访，并表明长期服用含鼠李糖乳杆菌的阴道片是恢复阴道生理pH和控制BV症状的有效和安全的治疗方法。
BackgroundBacterial vaginosis (BV) is the most prevalent vaginal disorder in adult women worldwide. A number of clinical studies indicate that re-establishment of the physiological ecosystem by re-colonization of vaginal mucosa by lactobacilli may be an effective therapy for BV both after initial antimicrobial therapy or when given alone. A vaginal pH <4.5 is considered physiological and its measurement has been reported as an objective parameter, very sensitive to alterations of vaginal microflora and correlated with clinically relevant BV.ObjectiveThe aims of this work were to assess the effectiveness of a long-term (24 months) intravaginal treatment withLactobacillus rhamnosus(NORMOGIN®) on the vaginal pH and on the clinical symptoms in a group of 40 women affected by BV diagnosed by the Amsel criteria.MethodA prospective open clinical trial was performed in 40 consecutive cases evaluated for B.V. by the Amsel criteria.ResultsVaginal pH was above the physiological value of 4.5 in 36 out of 40 patients at the first visit. It returned under 4.5 value in 24/40 and 32/40 women after 12 and 24 months of treatment, respectively. pH values were significantly decreased at 12 month treatment (P< 0.001) and further reduction in pH values was found at 24 months of treatment (P< 0.02 vs. 12 months). The gradual return to a vaginal physiological pH was associated with a reduction of the intensity of symptoms as shown by the decrease in the symptoms score.ConclusionsThe present study supports the use of pH measurement for sensitive, objective, and simple therapy follow-up in women with BV and shows that long-term administration of vaginal tablets containingLactobacillus rhamnosusrepresents an effective and safe treatment for restoring the physiological vaginal pH and controlling BV symptoms.