摘要:Objective In order to reduce the incidence of adverse reactions in the treatment of candidal balanitis, and to seek a better treatment plan, to investigate the clinical efficacy of three different treatments for candidal balanitis. Methods Selected 183 cases of candidal balanitis patients who had been treated in the 161 Hospital of PLA, Hubei, Wuhan from March 2015 to April 2017. According to the random number table, all the patients were randomly divided into three groups, an average of 61 patients per group. In group A, patients were treated with Chinese medicine liquid washing outside wrapping glans, 2 times / day, 5min/ time; In group B, patients were treated with Sophora flavescens gel, 2 times / day; In group C, patients were treated with Clotrimazole Cream, 2 times / day, oral 200mg Itraconazole Capsules, 1 times / day. All treatments continued a week for a course of treatment, and determined the clinical effect of patients in each group and examined fungal cultivation and microscopic of patients in each group. Results The results showed that the patients of group A with the total effective rate was 96.72%, significantly higher than that in group B and group C which were 83.61% and 85.25% (P< 0.05). The negative rate in group A was 91.80%, the negative rate in group B was 72.13%, the negative rate in group C was 93.44%, the negative rate of group A and C were significantly higher than that in group B (P< 0.05), but there has no significant difference between group A and C patients (P> 0.05). Three patients in group A had balanitis, two patients in group B had balanitis, and two patients in group C had balanitis, and 35 patients in group C had diarrhea, anorexia, epigastric discomfort, nausea, vomiting and other gastrointestinal reactions. Adverse symptoms in all patients were disappeared after drug withdrawal. The adverse reactions of patients in group C were significantly higher than those in group A and group B patients (P<0.05). Conclusion External washing with Chinese medicine liquid has a higher negative conversion rate than the other two candida methods in the treatment of monilia wrapping balanitis patients, and also improve the clinical symptoms of patients, has lower incidence of adverse reactions.%目的 为了降低临床上治疗念珠菌性包皮龟头炎的不良反应发生率,寻求更优治疗方案,探讨3种不同治疗方法治疗念珠菌性包皮龟头炎的临床疗效.方法 选取湖北武汉解放军第一六一医院于2015年3月-2017年4月期间收治的183例念珠菌性包皮龟头炎患者,按照随机数字表法将所有患者随机分为甲、乙、丙3组,平均每组患者61例.其中甲组患者均采用中药液外洗包皮龟头进行治疗,2次/d,5 min/次;乙组患者均采用苦参凝胶进行治疗,2次/d;丙组患者均采用克霉唑乳膏进行治疗,2次/d,同时口服200 mg的伊曲康唑胶囊,1次/d.所有患者均以1周为1个治疗疗程,判定各组患者的治疗效果并对各组患者的龟头分泌物进行真菌培养和镜检.结果 甲组患者的总有效率为96.72%,均显著高于乙组患者和丙组患者的83.61%和85.25%(均P<0.05).甲组患者转阴率为91.80%,乙组患者的转阴率为72.13%,丙组患者的转阴率为93.44%,甲组和丙组患者的念珠菌转阴率均显著高于乙组患者(均P<0.05),但是甲组和丙组患者之间无明显差异(P>0.05).甲组患者有3例患者出现龟头肿痛,乙组患者中有2例患者出现龟头肿痛,丙组患者中有2例患者出现龟头肿痛,且有35例患者出现腹泻、食欲减退、胃脘不适、恶心呕吐等胃肠道反应.停药后所有患者的不良症状均自行消失.其中丙组患者的不良反应发生率显著高于甲组和乙组患者(均P<0.05).结论 在治疗念珠菌性包皮龟头炎患者时采用中药液外洗比其他2种治疗方法具有更高的念珠菌转阴率,并且在改善患者临床症状方面也更具有优势,不良反应发生率更低.