OBJECTIVE  To explore the clinical efficacy of Wandai Decoction in the treatment of vulvovaginal candidiasis (VVC) with spleen deficiency-dampness abundance and its effect on DNA damage.

  METHODS  70 VVC patients with spleen deficiency-dampness abundance who met the inclusion criteria were randomly divided into Wandai Decoction and fluconazole groups, 35 cases each. The fluconazole group took 150 mg fluconazole orally once; the Wandai Decoction group took Wandai Decoction orally for 14 d. After treatment, changes in TCM syndrome scores of the two groups of patients were compared; the clinical cure (test of cure, TOC) rate and clinical improvement (CI) rate of the two groups of patients were evaluated; 8-hydroxydeoxyguanosine (8-OHDG) in the vaginal lavage fluid was detected by colorimetry to assess DNA damage; clinical complete remission (follow up, FU), mycological negative conversion and recurrence rate were evaluated 3 months after treatment.

  RESULTS  After treatment, the TCM syndrome scores of the two groups of patients were improved to varying degrees (P < 0.05, P < 0.01); the Wandai Decoction group was superior to the fluconazole group (P < 0.05, P < 0.01); there was no significant difference in TOC, CI, mycology negative conversion between the Wandai Decoction group and the fluconazole group (P>0.05); however, the FU and recurrence rate of the Wandai Decoction group were significantly better than those of the fluconazole group (P < 0.05, P < 0.01). After treatment, the expression of 8-OHDG in the vaginal lavage fluid of the fluconazole group increased significantly (P < 0.001), while there was no significant change in the Wandai Decoction group, which was significantly lower than that of the fluconazole group (P < 0.001).

  CONCLUSION  The overall clinical efficacy of Wandai Decoction is equivalent to that of fluconazole, but it is better than fluconazole in improving TCM syndromes and preventing recurrence, with the advantage of not aggravating DNA damage in vaginal cells.