高级别宫颈上皮内瘤变中医证型分布及其与高危型HPV负荷量关系的研究  

Distribution of Chinese Medicine Syndrome Types in Patients with High-grade Cervical Intraepithelial Neoplasia and Relationship with High Risk HPV Load

作　　者：吴冬梅[1] 郑怡真[1] 刘倩[1] 余江[1] 徐萍[1] 汪敏华[1] 

机构地区：[1]福建中医药大学院附属第二人民医院妇产科,福州350003

出　　处：《光明中医》2012年第3期489-491,共3页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：陈可冀中西医结合发展基金(CKJ2009010)

摘　　要：目的探讨高级别宫颈上皮内瘤变(CIN)中医证型分布及其与高危型HPV负荷量的关系。方法对149例高级别CIN患者进行中医辨证分型,检测高危型HPV负荷量,探究证型与高危型HPV负荷量的相关性。结果本病主要证型依次为湿热蕴毒型、外染毒邪型、肝经湿热型。不同证型组间的年龄分布差异无统计学意义(P=0.292)。不同证型组间的高危型HPV负荷量差异有统计学意义(χ2=7.5432,P=0.023),肝经湿热型、湿热蕴毒型与外染毒邪型比较差异有统计学意义(P<0.05),湿热蕴毒型与肝经湿热型差异无统计学意义(P>0.05)。结论高级别CIN中医证型以湿热蕴毒型为多,湿热蕴毒型、肝经湿热型CIN出现持续性CIN及进展为宫颈癌的风险更大。Objective To explore the Chinese medicine syndrome type distribution in high-grade cervical intraepithelial neoplasia（CIN）and its relationship with high risk HPV load capacity.Methods Chinese medicine syndrome types of 59 patients with CINⅡ-Ⅲ were sorted,the viral load of high risk HPV was detected,and its relationship with syndrome type distribution was analyzed.Results Chinese medicine syndrome of 59 women with high-grade CIN were differentiated into three types,15 patients（25.4%） of out-evil infection type,31（52.5%） of damp-hot poison-aggregation type,13（22.0%）of liver-meridian damp-hot type.Among three types,the largest proportion was damp-hot poison-aggregation type,followed out-evil infection type and liver-meridian damp-hot type.Fisher’s exact probability shows that no significant differences were found in comparing the age distribution between patients with different syndromes types（P=0.292）.Kruskal-Wallis test was apply to compare different syndromes,there was significant difference in the viral load of high risk HPV（χ2=7.5432,P=0.023）.In further analysis,Nemenyi test was used to compare the three different syndromes in viral load.Compared with out-evil infection type,high risk HPV viral load was significant higher in patients with damp-hot poison-aggregation type and liver-meridian damp-hot type（P0.05）.However,there was no difference between damp-hot poison-aggregation type with liver-meridian damp-hot type（P0.05）.Conclusion Damp-hot poison-aggregation type account for most of Chinese medicine syndrome type in patients with high-grade CIN.The risk of CIN persistence and progressing to cervical cancer was higher in the patients with damp-hot poison-aggregation type and liver-meridian damp-hot type.

关 键 词：宫颈上皮内瘤变 高危型HPV 中医证型 

分 类 号：R737.33[医药卫生—肿瘤] R273[医药卫生—临床医学]