To observe the clinical effect of live vaginal Lactobacillus capsule for vaginal use combined with nifuratel nystatin vaginal soft capsule on patients with recurrent vulvovaginal candidiasis (RVVC) and its influence on vaginal microecological environment of patients.

The RVVC patients were divided into the control group and the treatment group according to the cohort method. The patients in the control group were treated with one grain of vaginal embolization before going to bed with nifuratel nystatin vaginal soft capsule. The patients in the treatment group were treated with 0.25 g of vaginal live Lactobacillus capsule in the morning combined with one grain of vaginal embolization before going to bed with nifuratel nystatin vaginal soft capsule. The initial treatment time of the two groups lasted for 7 days. Initial treatment lasted for 7 days in both groups. Pathogenic bacteria culture was performed after 7 days of drug withdrawal. The negative patients were cured, and the cured patients were treated with nifuratel nysfungin vaginal suppository for consolidation treatment once a week for 6 months. The clinical therapeutic effect in the two groups was recorded. The changes in vaginal microecology and human β-defensin (HβD)-3, interleukin (IL)-1β and IL-8 in vaginal secretions were compared between the two groups before treatment and after 7 days of treatment, and the safety evaluation was carried out.

A total of 268 patients were enrolled in this study, including 136 in the treatment group and 132 in the control group. The mycological cure rates of initial treatment in the treatment group and the control group were 84.56% (115 cases/136 cases) and 73.48% (97 cases/132 cases), respectively; the mycological cure rates of consolidation treatment were 82.61% (95 cases/115 cases) and 70.10% (68 cases/97 cases), respectively; the differences were statistically significant (all P<0.05). The proportions of vaginal cleanliness grade Ⅲ-Ⅳ in treatment group and control group after 7 days of treatment were 24.26% and 36.36%; the proportions of vaginal flora density grade Ⅱ-Ⅲ were 79.41% and 68.18%; the proportions of vaginal flora diversity grade Ⅱ-Ⅲ were 77.94% and 65.91%; the proportions of dominant bacteria of Lactobacillus were 82.35% and 68.18%; the levels of HβD-3 in vaginal secretions were (129.65±11.51) and (135.87±10.46) pg·mL^-1; IL-1β levels were (65.48±9.27) and (72.46±10.38) pg·mL^-1; IL-8 levels were (159.36±12.50) and (176.30±13.19) pg·mL^-1 , and the differences were statistically significant (all P<0.05). The total incidence rates of adverse drug reactions in the treatment group and control group were 23.53% (32 cases/136 cases) and 18.38% (25 cases/132 cases), respectively (P>0.05).

Compared with nifuratel nysfungin vaginal soft capsule therapy, the combination of vaginal live Lactobacillus capsule can improve the vaginal microecology of RVVC patients, and the cure rate of vaginal fungal infection is higher, with better safety.