Abstract: Abstract: Objective Tracking of the vaginal microflora recovery and the expression of immune factors from untreated and treated patients with bacterial vaginosis (BV) by using different administration regimens and studying the relationship of treatment results and regimen selections. Methods 25 healthy females were selected as a control group and 100 BV patients were randomly divided into 4 groups (n=25/group). Group A: Intravaginal administration of metronidazole (× 7 d), Group B: Continuous intravaginal administration of metronidazole (×7 d) and then live Lactobacillus Capsule (×7 d) , Group C: Intravaginal administration of nifuratel (× 7 d), Group D: Continuous intravaginal administration of nifuratel (× 7 d) and then live Lactobacillus Capsule (×7 d). The microecological assessment system and EILSA were used to compare the clinical efficacy, vaginal microflora recovery and the changes in IL-8, TLR2 and TNF-α of the vaginal lavage fluid in healthy women or patients with bacterial vaginosis before and after treatments by four treatment strategies. Results ① The vaginal microflora imbalance, flora disturbance, pH value increased were presented in BV group compared with the control group.② Compared to the median of IL- 8, TLR2 and TNF- α in vaginal lavage fluids of control group, there was no significant difference in IL-8 level but both TLR2 and TNF-α were significantly increased (P＜0.05) in BV group. The immune factors had no significantly difference in all BV groups.③The therapeutic effect in each BV groups was compared after stopping treatment for 7 days. The cure rate and the vaginal microflora recovery rate were significant higher in group B and D than group A and C (P＜0.05). ④ After treatment there was no significant change in IL- 8 level but there was an obviously decrease in TLR2 and TNF-α (P＜0.05). The decreased levels are more significant in groups B and D than groups A and C (P＜0.05). Conclusion By combining with the microecological assessment system to evaluate the therapeutic effect of BV, our research suggests that the sequence schemes of nifuratel plus live Lactobacillus Capsule is more effective in therapy effect, restoring normal vaginal micro-ecological environment and vaginal local immunity than metronidazole used alone.

Key words:  vaginosis, bacterial, lactobacillus, metronidazole, nifuratel, interleukin- 8, toll- like receptor 2, tumor necrosis factor-alpha