To study the clinical effect of Longdan Xiegan Decoction (龙胆泻肝汤) in the treatment of bacterial vaginitis based on the mechanism of vaginal flora changes.

Ninety-six patients with bacterial vaginitis treated in the hospital from June 2023 to June 2024 were selected as the research objects. According to the principle of randomization and control, they were divided into observation group and control group, with 48 cases in each group. The patients in the control group were treated with metronidazole combined with Keyangshu Lotion (克痒舒洗液), and the observation group was treated with Longdan Xiegan Decoction on the basis of the control group, 4 weeks as a course of treatment. The efficacy, traditional Chinese medicine syndrome scores (main symptoms of vaginal burning sensation, abnormal leucorrhea, vulva pruritus), vaginal microenvironment status (vaginal pH value, vaginal cleanliness), vaginal flora distribution and adverse reactions were compared between the two groups.

The total effective rate of the observation group was 95.83% (46/48), which was significantly higher than 81.25% (39/48) of the control group, the difference was statistically significant (P<0.05) . After treatment, the scores of vaginal burning, leucorrhea abnormality and vulva pruritus in the two groups were significantly decreased (P<0.05), and the scores of the above symptoms in the observation group were lower than those in the control group (P<0.05) . After treatment, the vaginal pH values of the two groups decreased (P<0.05), and the normal rate of vaginal cleanliness increased (P<0.05). The vaginal pH value of the observation group was lower than that of the control group, and the normal rate of vaginal cleanliness was higher than that of the control group (P<0.05) . After treatment, the distribution of Lactobacillus in the vaginal dominant flora of the two groups increased (P<0.05), and the distribution of Bacteroides, Enterobacter and Candida albicans decreased (P<0.05) . The distribution of Lactobacillus in the observation group was more than that in the control group (P<0.05), while the distribution of Bacteroides, Enterobacter and Candida albicans was less than that in the control group (P<0.05) . There were no serious adverse reactions in both groups.

The effect of Longdan Xiegan Decoction in the treatment of bacterial vaginitis is satisfactory. It can significantly improve the vaginal microenvironment and vaginal flora distribution of the patients, so as to alleviate various syndromes of the body and improve the curative effect. It is a safe and effective medication regimen.