阴道炎可口服活菌制剂吗？

患者，女，24岁，处方诊断：阴道炎。处方用药：
双歧杆菌四联活菌片1g,tid,po
双唑泰泡腾片，1粒，qd,外用

口服双歧杆菌主要用于肠道菌群失调，口服不能吸收就不可能到达病患处，所以口服不可行。另外阴道炎有外用塞的制剂微生态制剂。

可以此篇文献作为支持使用活菌制剂口服用于阴道炎的证据吗？
BMC Womens Health. 2015 Dec 3;15:115. doi: 10.1186/s12905-015-0246-6.
Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial.

Abstract
BACKGROUND:
This multicentre, randomised, double-blind, placebo-controlled trial was performed to determine whether the use of oral probiotic preparation (prOVag®) containing three Lactobacillus strains together with standard metronidazole treatment and also targeted antibiotic treatment (following the failure of metronidazole therapy) could reduce the recurrence rates of bacterial vaginosis (BV) and aerobic vaginitis (AV).

METHODS:
Patients at private gynaecological clinics in Poland with histories of recurrent BV/AV and current symptoms were randomly allocated to receive metronidazole and probiotic or placebo, and assessed monthly on visits II and III-V. The total number of study visits was 5-6 (I, II, II bis - if applicable, III, IV, V). One probiotic or placebo capsule was administered with metronidazole/targeted antibiotic twice daily for 10 days; during follow up, patients took one capsule daily for 10 days perimenstrually. Clinical examination and vaginal swabbing were performed at each visit. Primary outcomes were clinical or microbiological BV/AV recurrence and probiotic safety. Secondary outcomes were vaginal pH, Nugent score, and Lactobacillus counts in the vaginal microbiota. Safety analysis was performed in 578 (probiotic, n = 285; placebo, n = 293) 18-50-year-old women who were randomised.

RESULTS:
BV/AV was confirmed microbiologically in 241 (probiotic, n&#8201;=&#8201;118; placebo, n&#8201;=&#8201;123) participants, who continued the trial. Data from 154 (probiotic, n&#8201;=&#8201;73; placebo, n&#8201;=&#8201;81) participants who completed the study were analysed to determine the efficacy of prOVag. Additional analyses included 37 (probiotic, n&#8201;=&#8201;22; placebo, n&#8201;=&#8201;15) participants who received targeted antibiotics and probiotics or placebo. prOVag lengthened the time to clinical relapse of BV/AV symptoms up to 51 % (p&#8201;<&#8201;0.05) compared with placebo; AV relapse was delayed by up to 76 % (p&#8201;<&#8201;0.05). Probiotic use also reduced and maintained low vaginal pH and Nugent score, and increased vaginal Lactobacillus counts following standard treatment.

CONCLUSION:
This study demonstrated that oral probiotics lengthened remission in patients with recurrent BV/AV and improved clinical and microbiological parameters.

口服的给药方式不确切，但是治疗方案可以理解，但是有阴道用乳杆菌胶囊。

前两天看过一篇报道说活菌制剂对阴道炎有一定的作用

有一定作用吧！

dailihuan 发表于 2016-5-13  10:13
有一定作用吧！

这个应该没有作用。活菌制剂只能用于治疗肠道菌群失调，不可能影响到阴道的。

湖底人 发表于 2016-5-23  11:09
这个应该没有作用。活菌制剂只能用于治疗肠道菌群失调，不可能影响到阴道的。

在论文上有人发表过

开错了吧，本想开的是阴道用胶囊

如果有合适的病例，可积累下经验&#128515;