中药清热扶正法干预宫颈癌前病变高危型HPV感染的临床研究  

Study of Intervention by Traditional Chinese Medicine for Cervical Precancerous Lesion Infected by High-risk HPV

作　　者：张培影[1] 王旭波 徐侠 杨静 杨海燕 

机构地区：[1]南京中医药大学第一临床医学院 [2]徐州市中医院,江苏徐州221003

出　　处：《辽宁中医杂志》2010年第7期1191-1194,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：江苏省中医药局科研课题(HZ07099)

摘　　要：目的:探讨中药清热扶正法干预宫颈癌前病变高危型HPV(16/18型)感染的临床价值。方法:运用荧光定量PCR法检测128例患者宫颈组织HPV16/18型的表达和载量水平;检测HPV感染者免疫功能状况;将128例HPV16/18型感染者病理分级为CINⅠ、Ⅱ、Ⅲ级并随机分为治疗组与对照组;应用中药清热解毒扶正法干预HPV感染者,观察用药前后两组与各级别间免疫功能状况和HPV16/18型的载量变化情况。结果:128例患者的治疗组64例:治疗前IgG、IgA、IgM平均值分别为:6.82g/L、0.71g/L、0.65g/L;用药后分别为:16.63g/L、4.26g/L、3.56g/L。对照组:治疗前IgG、IgA、IgM平均值分别为:7.28g/L、0.87g/L、0.71g/L;用安慰剂后分别为:11.34g/L、1.23g/L、0.96g/L。治疗组HPV载量变化:治疗前平均值1.73×106,治疗后平均值1.16×105;对照组64例:治疗前平均值1.69×106,治疗后平均值1.47×106。治疗组各级别间治疗前后比较差异有显著性(P<0.01),治疗组与对照组各级别间治疗后比较差异有显著性(P<0.01)。结论:荧光定量PCR检测法检测高危型HPV载量变化具有客观、敏感、特异的特点;中药清热解毒扶正法干预宫颈HPV感染具有清热解毒、增强免疫、抗病毒和降低HPV载量的作用,二者协同使用对HPV感染和宫颈癌前病变的早期筛查与干预、阻断和治疗具有较高的临床使用价值和推广前景。Objective：To explore the clinical value of traditional chinese medicine of clear away heat and reinforce body resistance prescription for cervical precancerous lesion infected by high-risk HPV.Methods：Adopting real time PCR to express and quantify HPV（16/18 type） in 128 cases of patients.Detecting the immunity of the patient.Group the patients into CINI、II、III,and into trail group and control group.Giving the patients the Clearaway Heat and Reinforce Body Resistance Prescription and observe the immunity and viral load of HPV（16/18） between the two groups.Results：In 64 cases of the trail group,before the treatment the average of IgG、IgA、IgM was as follow：6.82g/L、0.71g/L、0.65g/L.After being treated by TCM,the average was as follow：16.63g/L、4.26 g/L、3.56 g/L.In the control group before the treatment the average of IgG、IgA、IgM was as follow 7.28g/L、0.87g/L、0.71g/L.After being treated by placebo,the average was as follow 11.34g/L、1.23 g/L、0.96 g/L.In the trail group,the viral load of HPV changed from 1.73×10^6 to 1.06×10^6 after the treatment.In the control group,the viral load of HPV changed from 1.69×10^6 to 1.47×10^6.There was a significant difference in three levels in trail group（P〈0.01）,and there was a significant difference between the trail group and contral group（P〈0.01）.Conclusion：Real time PCR was objective,accurate,specific to detect the viral load of HPV.The intervention of clear away heat and reinforce body resistance prescription can clearing away heat and toxic material,enhanc immune function,and reduce the viral load of HPV.It showed a high clinical value in improving cervical precancerous lesion early screening by real time PCR and intervention by traditional Chinese medicine to use them synergistically.

关 键 词：宫颈癌前病变 人乳头瘤病毒(HPV) HPV载量 免疫功能 清热扶正 干预 

分 类 号：R737.33[医药卫生—肿瘤]