清热利湿法防治宫颈上皮内瘤变伴高危型人乳头瘤病毒感染患者阴道微生态和P16、Ki67、KAI1蛋白表达  

Prevention and treatment of vaginal microecology and protein expression of P16,Ki67 and KAI1 in patients with cervical intraepithelial neoplasia complicated with high-risk human papilloma virus infection by heat-clearing and dampening method

作　　者：马铁玉 王海杰 MA Tieyu;WANG Haijie(Gynaecology and Obstetrics,Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,Hebei,China)

机构地区：[1]承德市中医院妇产科,河北承德067000

出　　处：《中国性科学》2021年第10期130-133,共4页Chinese Journal of Human Sexuality

基　　金：河北省医学科学研究重点课题计划(20171076);承德市科学技术研究与发展计划(201801A017)。

摘　　要：目的探讨清热利湿法防治宫颈上皮内瘤变伴高危型人乳头瘤病毒(HPV)感染患者阴道微生态和P16、Ki67、KAI1蛋白表达。方法选取2018年1月至12月承德市中医院诊治的94例宫颈上皮内瘤变伴高危型HPV感染患者作为研究对象,进行前瞻性研究。根据随机数字表法将其分为中医联合组(n=47)和常规治疗组(n=47)。对照组采用保妇康栓进行治疗,中医联合组在对照组治疗基础上采用清热利湿法进行外洗治疗。治疗结束后比较两组治疗前后中医症状积分、疗效情况、阴道微生态情况和P16、Ki67、KAI1蛋白阳性率变化情况。结果治疗后两组中医证候积分均下降,且中医联合组低于常规治疗组,差异具有统计学意义(P<0.05);治疗后中医联合组疗效分级情况优于常规治疗组,差异具有统计学意义(P<0.05);治疗后中医联合组阴道微生态正常率高于常规治疗组,Nugent评分和阴道分泌物pH低于常规治疗组,差异具有统计学意义(P<0.05);治疗后两组P16、Ki67蛋白阳性率均下降,且中医联合组低于常规治疗组,差异具有统计学意义(P<0.05);治疗后两组KAI1蛋白阳性率均升高,且中医联合组高于常规治疗组,差异具有统计学意义(P<0.05)。结论清热利湿法防治宫颈上皮内瘤变伴高危型HPV感染患者疗效较好,可调节患者阴道分泌物pH并改善阴道微生态,降低P16、Ki67蛋白表达,增加KAI1蛋白表达从而抑制宫颈癌变。Objective To explore the heat-clearing and dampening method in the prevention and treatment of cervical intraepithelial neoplasia with high-risk human papilloma virus(HPV)infection in vaginal microbiota and the protein expression of P16,Ki67 and KAI1.Methods 94 patients with cervical intraepithelial neoplasia accom-panied by high-risk HPV infection in Chengde Hospital of Traditional Chinese Medicine from January to December 2018 were selected as the subjects for a prospective study.According to the random number table method,they were divided into TCM combined group(n=47)and conventional treatment group(n=47).The control group was trea-ted with Baofukang suppository,while the TCM combined group was treated with Baofukang suppository and heat clearing and dampening method.After treatment,TCM symptom score,curative effect,vaginal microecology and positive rate of P16,Ki67 and KAI1 proteins were compared between the two groups before and after treatment.Results After treatment,the TCM syndrome scores of both groups decreased,and the TCM combined group was lower than the conventional treatment group(P<0.05).The efficacy grade of TCM combined group was better than conventional treatment group(P<0.05).The normal rate of vaginal microecology in TCM combined group was higher than that in conventional treatment group,and Nugent score and vaginal secretion pH were lower than that in conventional treatment group(P<0.05).The positive rates of P16 and Ki67 protein in both groups were de-creased,and those in TCM combined group were lower than those in conventional treatment group(P<0.05).The positive rate of KAI1 protein was increased in both groups,and the combination group was higher than the conven-tional treatment group(P<0.05).Conclusions The heat-clearing and dampening method is effective in preven-ting and treating cervical intraepithelial neoplasia with high-risk HPV infection.It can adjust the vaginal pH and im-prove the vaginal microecology,reduce the expression of P16 and Ki67 protein,and increase the expression of

关 键 词：宫颈上皮内瘤变 人乳头瘤病毒感染 清热利湿法 阴道微生态 P16蛋白 KI67蛋白 KAI1蛋白 

分 类 号：R275[医药卫生—中医皮科]