目的：观察苦参百部黄柏汤联合抗生素治疗细菌性阴道炎的临床疗效。方法：按随机数字表法将 206 例细菌性阴道炎患者随机分为抗生素组与联合组各103 例。抗生素组采取抗生素治疗，联合组加用苦参百 部黄柏汤治疗。2 组均治疗1 个月。比较2 组治疗前后中医证候积分、阴道菌群类型分布、炎症因子水平，并 比较2 组临床疗效及不良反应。结果：治疗1 个月后，联合组总有效率99.03%，高于抗生素组92.23%（P＜ 0.05）。治疗后，2 组各项中医证候积分均降低（P＜0.05），且联合组低于抗生素组（P＜0.05）。治疗后，2 组 乳杆菌分布增加（P＜0.05），类杆菌、肠杆菌、白色念珠菌、支原体分布减少（P＜0.05），且联合组乳杆菌分 布多于抗生素组（P＜0.05），类杆菌、肠杆菌、白色念珠菌、支原体分布均少于抗生素组（P＜0.05）。治疗 后，2 组血清C-反应蛋白（CRP）、肿瘤坏死因子-α （TNF-α）、白细胞介素-6 （IL-6） 水平均降低（P＜ 0.05），且联合组低于抗生素组（P＜0.05）。联合组不良反应发生率低于抗生素组（P＜0.05）。2 组复发率比 较，差异无统计学意义（P＞0.05）。结论：采用苦参百部黄柏汤联合抗生素治疗细菌性阴道炎患者可提高临床 疗效，有效减轻症状，优化阴道菌群分布，控制炎症反应，降低药物不良反应发生率。
Abstract： Objective： To observe the clinical effect of external wash with Kushen Baibu Huangbai Decoction combined with antibiotics for bacterial vaginitis. Methods：A total of 206 cases of patients with bacterial vaginitis were divided into the control group and the treatment group according to the random number table method，with 103 cases in each group. The control group was treated with antibiotics，and the treatment group was treated with Kushen Baibu Huangbai Decoction combined with antibiotics. Both two groups were treated for one months. Traditional Chinese medicine (TCM) syndrome scores， the distribution of vaginal flora types， the levels of inflammatory factors were compared before and after treatment between the two groups. Clinical effects and the incidence of adverse reactions were compared between the two groups. Results：After one month treatment，the total effective rate was 99.03% in the treatment group， higher than that of 92.23% in the control group (P＜0.05). After treatment， the TCM syndrome scores in the two groups were decreased when compared with those before treatment (P＜ 0.05)，and the scores in the treatment group were lower than those in the control group (P＜0.05). After treatment，the distribution of Lactobacilli in the two groups was increased (P＜0.05)，and the distribution of Bacteroides， Enterobacter， Candida albicans， and Mycoplasma was decreased (P＜0.05)； the distribution of Lactobacilli in the treatment group was more than that in the control group (P＜0.05)，and the distribution of Bacteroides，Enterobacter，Candida albicans，and Mycoplasma in the treatment group was less than that in the control group (P＜0.05). After treatment，the levels of C-reactive protein (CRP)，tumor necrosis factor- α (TNF- α) and interleukin 6 (IL- 6) in serum in the two groups were decreased when compared with those before treatment (P＜0.05)，and the levels in the treatment group were lower than those in the control group (P＜0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group (P＜0.05). There was no significant difference being found in the comparison of the recurrence rates between the two groups(P＞0.05). Conclusion：Kushen Baibu Huangbai Decoction combined with antibiotics for patients with bacterial vaginitis can enhance clinical effects， effectively alleviate symptoms，optimize the distribution of vaginal flora，control inflammatory reactions，and reduce the incidence of adverse drug reactions.