Efficacy of a topical drug combination intervention for recurrent mycosis fungoides

  I. Objective To investigate the clinical efficacy and methods of outpatient treatment of recurrent mycotic vaginitis. METHODS: One hundred and eighty patients with recurrent mycotic vaginitis who came to our hospital from January 2010 to October 2013 were selected and randomly divided into two groups, 84 cases in the control group (drug treatment alone) and 96 cases in the observation group (drug treatment plus nursing intervention), with the recurrence rate after 1 year of follow-up. RESULTS: The effective rate in the observation group (94.79%) was significantly higher than that in the control group (72.62%), with a significant difference (P<0.01); the recurrence rate after 1 year follow-up was significantly lower in the observation group (8.79%) than that in the control group (47.54%), with a significant difference (P<0.01). CONCLUSION: The drug combined with nursing intervention was significantly effective and could effectively prevent recurrence.  Clinically, mycosis fungoides is characterized by quick cure and easy recurrence, mainly manifested by intense vaginal itching, accompanied by burning sensation in the vulva, slight redness and swelling, excessive leucorrhea with a bean-like consistency, which affects the quality of life of patients. Since 2010, 180 cases of recurrent mycosis vaginalis have been treated in our hospital. The treatment methods and results are reported below.  The treatment is divided into intensive treatment and consolidation treatment.  1. Intensive treatment: Fluconazole 150mg, 1 time/d, 5-7d for 1 course of treatment. At night, take a sitz bath with 20%-40% baking soda for 15min; apply miconazole nitrate suppository 200mg (1 piece) at bedtime, 1 time/night, and place it deep in the vagina for 7d as a course of treatment. For those with vulvar pruritus, miconazole nitrate cream was given for external application. Review before menstruation after 3 courses of oral and topical treatment.  2.Consolidation treatment After intensive treatment to achieve negative fungal science, consolidation treatment was carried out for six months. The consolidation medication was mainly topical and consisted of miconazole nitrate suppositories 200mg (1) at bedtime, once/night, placed deep in the vagina, for 7d as a course of treatment, for a total of 6 months. All the above treatments were started after menstruation. During intensive treatment, spouse should take the medicine together, fluconazole 150mg, 1 time/d for 5d. III. Nursing interventions Mainly explain to patients what they need to pay attention to in daily life, lifestyle and hygiene habits, including psychological care, health education, therapeutic care and regular follow-up (during intensive treatment period, every 7-10d of medicine should be followed up for clinical symptoms, signs and mycological examination. (During the consolidation treatment period, monthly premenstrual follow-up and vaginal secretion smear examination).  1.5 Judgment standard of efficacy Cure: clinical symptoms and signs completely disappeared after treatment, and fungal microscopic examination of vaginal secretion was negative for three consecutive premenstrual follow-up examinations. Effective: clinical symptoms and signs improved significantly after treatment, and fungal microscopic examination of vaginal secretion was negative for three consecutive premenstrual retests. Effective: Clinical symptoms and signs were reduced after treatment, and fungal microscopic examination of vaginal secretion was positive for 1 or 2 times in 3 consecutive premenstrual examinations. Ineffective: Clinical symptoms and signs did not improve after treatment, and the fungal microscopic examination of vaginal secretion was positive for 3 consecutive premenstrual examinations.  IV. Conclusion 0% of non-pregnant women and 30% of pregnant women have Candida parasites in the vagina, which usually do not develop, but often do when the resistance is low. In this study, the total effective rate of 96 cases in the observation group was 94.79% and the recurrence rate after cure was 8.79% after nursing intervention and proper hygiene promotion; in the control group, the total effective rate was 72.62% and the recurrence rate after cure was 47.54%. Therefore, along with active treatment, good nursing intervention is essential to eliminate the pathogenic conditions that may cause mycosis fungoides. In daily life, one should practice good hygiene, pay attention to personal hygiene, change underwear regularly, use antibiotics and hormonal drugs reasonably, and actively treat underlying and predisposing conditions. Mycotic vaginitis can be transmitted sexually. For recurrent cases, couples should be treated together and measures should be taken to avoid sexual transmission in order to eradicate it completely.