Combination of candida vulvovaginitis and bacterial vaginosis: optimization of diagnostics and treatment for the women of genesial age

Abstract

The objective: increase of efficiency of diagnostics and treatment of combination of candida vulvovaginitis and bacterial vaginosis for the women of genesial age on the basis of study of new aspects of pathogeny and improvement of algorithm of prognostic and treatment-and-prophylactic measures.Materials and methods. Researches carried stage-by-stage character. The I stage is development of the special questionnaire for a selection, account and bringing of master data. In it taken into account: age, social information, anthropometric descriptions, anamnesis of gynaecological diseases, somatic pathology. II stage is the conducted selection 150 women with the identical clinical displays of candida vulvovaginitis and bacterial vaginosis, which before did not treat oneself and produced characteristic complaints about appearance of pathological excretions from sexual ways, itch of vulva, burning at urination. At gynaecological examination: hyperemia, edema of vulva, mucous membranes of vagina and cervix of uterus, «curd» or watery excretions. III stage is an estimation of the got material and setting of treatment. On every woman «Map of clinical-laboratory researches», in which brought in information of anamnesis, results of inspection from history of illness and ambulatory card, was led, to the fame about a presence and completion of inflammatory diseases of organs of small pelvis, results of bacteriological, microbiological, taking about tactic of conduct and result of treatment.For comparison of efficiency of treatment 150 patients with identical clinical displays and presence of Candida albicans, non-albicans and «key» cages part on 3 groups. Estimation of efficiency of the algorithm improved by us was conducted on three criteria: general state and feel of patients, clinical information (information of anamnesis and gynaecological review), laboratory and backterioscopy information. All methods of research answered ethics standards, developed in accordance with Helsinki declaration of the World medical association «Ethics principles of leadthrough of scientific medical researches with participation of man».Results. For early diagnostics of combination of vulvovaginal candidiasis and bacterial vaginosis the use of a twostage method of individual prognostication is needed on the basis of model of mathematical structural boolean algebra with the obligatory estimation of the most informing indexes: expression of molecules of adhesion of vascular walls (VCAM-1) and intercellular molecules of adhesion (ICAM-1); concentration of anti-inflammatory cytokines (4, 6 and 8).Conclusion. With the purpose of increase of efficiency of treatment of combination of vulvovaginal candidiasis and bacterial vaginosis the additional use is needed 1–2 hours prior to the combined therapy of local correction 0,01% solution of preparation of miramictine. Efficiency of the use for women at combination of vulvovaginal candidiasis and bacterial vaginosis of the combined anti-inflammatory therapy (miconazole and metronidazole) is 92,0%; in combination with probiotic – 98,0% and with immunocorrector of local action – 100,0%.