健脾解毒方治疗对HR-HPV持续性感染患者外周血CD_(4)^(+)、CD_(8)^(+)及HR-HPV DNA表达水平的影响  

Effect of Jianpi Jiedu recipe on expression levels of peripheral blood CD_(4)^(+),CD_(8)^(+) and HR-HPV DNA in patients with HR-HPV persistent infection

作　　者：张永会[1] 胡红娟[1] 彭强丽[1] 钱艳萍 柯欣 ZHANG Yong-hui;HU Hong-juan;PENG Qiang-li;QIAN Yan-ping;KE Xin(Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming,Yunnan 650021,China)

机构地区：[1]云南省中医医院妇科,云南昆明650021

出　　处：《中华医院感染学杂志》2021年第10期1470-1475,共6页Chinese Journal of Nosocomiology

基　　金：云南省卫生科技计划基金资助项目(2017NS141)。

摘　　要：目的探究健脾解毒方对高危型人乳头瘤病毒(HR-HPV)持续性感染患者外周血T淋巴细胞亚群(CD_(4)^(+)、CD_(8)^(+))及HR-HPV脱氧核糖核酸(DNA)表达水平的影响.方法选取2019年1月-2020年4月云南省中医医院诊治的330例HR-HPV持续性感染患者为研究对象,其中对照组165例接受常规治疗,研究组165例在对照组基础上联合健脾解毒方治疗,经倾向性得分模型配对最终获得160对基线资料统计学无意义患者,其中因随访资料不全研究组剔除1例,对照组剔除8例,最终研究组159例和对照组152例均完成3个月经周期的治疗.记录两组不同亚型HR-HPV转阴率,分析两组治疗前后HR-HPV DNA负荷量、中医证候积分、外周血CD_(4)^(+)、CD_(8)^(+)表达水平及阴道分泌物白细胞介素(IL)-4、IL-12水平差异.结果两组HR-HPV亚型分布均以16型、58型、52型、53型、18型居多,且组内各亚型HR-HPV转阴率以16型、18型转阴率最低,但研究组HR-HPV转阴率高于对照组(P<0.05).治疗后,两组HR-HPV DNA负荷量、中医证候积分、外周血CD_(8)^(+)表达水平及阴道分泌物IL-4水平均较治疗前降低(P<0.05),且研究组治疗后上述指标均低于对照组(P<0.05);外周血CD_(4)^(+)表达水平、CD_(4)^(+)/CD_(8)^(+)比值及阴道分泌物IL-12水平均较治疗前升高(P<0.05),且研究组治疗后高于对照组(P<0.05).结论健脾解毒方能调节HR-HPV感染者局部及全身免疫功能,纠正中医证候,对提升HR-HPV转阴率有利.OBJECTIVE To explore the effect of Jianpi Jiedu recipe on expression levels of peripheral blood T lymphocyte subsets(CD_(4)^(+),CD_(8)^(+))and HR-HPV deoxyribonucleic acid(DNA)in the patients with high-risk human papillomavirus(HR-HPV)persistent infection.METHODS A total of 330 patients with HR-HPV persistent infection who were treated in the Yunnan Provincial Hospital of Traditional Chinese Medicine from Jan 2019 to Apr 2020 were recruited as the study subjects,165 of whom were assigned as the control group and received conventional therapy,and 165 were set as the study group and received additional Jianpi Jiedu recipe on basis of the treatment of the control group.Totally 160 pairs of patients whose baseline data were not significant were acquired through propensity score matching model,1 case in the study group and 8 cases in the control group were excluded due to insufficient follow-up data,and 159 cases in the study group and 152 cases in the control group finally completed a 3 menstrual cycles of therapy.The negative conversion rates of HR-HPV subtypes were recorded;the HR-HPV DNA load,TCM syndromes scores,expression levels of peripheral blood CD_(4)^(+)and CD_(8)^(+)and levels of vaginal secretion interleukin-4(IL-4)and interleukin-12(IL-12)were observed and compared between the two groups of patients before and after the treatment.RESULTS Among the HR-HPV subtypes that were detected in the two groups of patients,HPV16,HPV58,HPV53 and HPV18 were dominant;the negative conversion rates of HPV16 and HPV18 were the lowest among all the HR-HPV subtypes,however,the negative conversion rate of HR-HPV of the study group was significantly higher than that of the control group(P<0.05).The HR-HPV DNA load,TCM syndromes scores,peripheral blood CD_(8)^(+)level and vaginal secretion IL-4 level of the two groups of patients were significantly lower after the treatment than before the treatment(P<0.05),and the above indexes of the study group were significantly lower than those of the control group after the treatment(P<0

关 键 词：人乳头瘤病毒 健脾解毒方 免疫功能 阴道分泌物 转阴 DNA 

分 类 号：R373[医药卫生—病原生物学]