不同药物对高危型HPV持续感染及宫颈癌前病变合并高危型HPV感染的临床疗效对比研究  

Different drugs in the treatment of high-risk human papillomavirus persistent infection and cervical precancerous lesions complicated with high-risk human papilloma virus infection

作　　者：唐宇星 王敏[1] 张诗敏 王佩[2] 丁伟 曾志[1] 周莹莹[1] TANG Yu-xing;WANG Min;ZHANG Shi-min;WANG Pei;DING Wei;ZENG Zhi;ZHOU Ying-ying(Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of Obstetrics and Gynecology,Xingtai People′s Hospital,Xingtai 054000,China)

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004 [2]邢台市人民医院妇产科,河北邢台054000

出　　处：《实用药物与临床》2022年第5期385-391,共7页Practical Pharmacy and Clinical Remedies

基　　金：盛京自由研究者基金(201705);中国医科大学校级研究课题(S526,SF034)。

摘　　要：目的对比不同药物对高危型人乳头瘤病毒(Human papilloma vrius,HPV)持续感染及宫颈癌前病变合并高危型HPV感染的临床疗效。方法收集2018年9月至2020年1月符合入组标准的120例受试患者,按照患者意愿分配为4组。Nr-CWS组(30例)给予外用红色诺卡氏菌细胞壁骨架(Nr-CWS)阴道上药,隔日给药1次,连续给药10次;保妇康栓组(30例)给予阴道用保妇康栓3个月;干扰素组(30例)给予阴道用重组人干扰素α-2b栓3个月;空白对照组(30例)不给予处置,仅按时随访。所有的受试者均于停药后的1、4、8、12个月行HPV和TCT检测,必要时行阴道镜检查及组织病理学检查,比较各组的HPV转阴率、TCT改变、阴道镜及组织病理学改变。结果停药后1个月,Nr-CWS组的转阴率及总有效率高于保妇康栓组及空白对照组,差异具有统计学意义(P<0.05),转阴率高于干扰素组(P<0.05),但总有效率相比差异无统计学意义(P>0.05)。停药后4个月,Nr-CWS组的转阴率高于干扰素组、空白对照组(P<0.05);Nr-CWS组的总有效率高于空白对照组(P<0.05)。停药后8、12个月,Nr-CWS组的转阴率及总有效率高于空白对照组(P<0.05)。保妇康栓组和干扰素组的总有效率均高于空白对照组(P<0.05)。四组停药后的TCT、阴道镜和低级别鳞状上皮内病变(Low-grade squamous intraepithelial lesion,LSIL)转归情况比较,差异均无统计学意义(P>0.05)。结论外用Nr-CWS、保妇康栓和重组人干扰素α-2b栓在治疗高危型HPV感染上均有显著疗效,外用Nr-CWS在一定程度上优于传统的保妇康栓和重组人干扰素α-2b栓。Objective To compare the clinical effects of different drugs on high-risk HPV persistent infection and cervical precancerous lesions with high-risk HPV infection.Methods Totally 120 patients with high-risk HPV persistent infection and cervical precancerous lesions complicated with high-risk HPV infection treated from September 2018 to January 2020 were randomly divided into 4 groups.Nr-CWS group(n=30)was given Nr-CWS by vagina once every other day for 10 times in a row.Baofukang suppository group(n=30)was treated with Baofukang suppository;interferon group(n=30)was treated with recombinant human interferonα-2b suppository for 3 months;the blank control group(n=30)was not given any drugs or special treatment,only regular follow-up.All patients received HPV and TCT detection at 1 month,4 months,8 months and 12 months after treatment,and colposcopy and histopathology examination were performed when necessary.The negative conversion rate of HPV,TCT changes,colposcopy and histopathological changes were compared in each group.Results One month after drug withdrawal,the negative conversion rate and total effective rate of the Nr-CWS group were higher than those of the Baofukang suppository group and the blank control group(P<0.05);the negative conversion rate of Nr-CWS group was higher than that of interferon group(P<0.05),but there was no significant difference in the total effective rate between the two groups(P>0.05).Four months after drug withdrawal,the Nr-CWS group had a higher rate of negative conversion than interferon group and the blank control group(P<0.05);the total effective rate of Nr-CWS group was higher than that of the blank control group(P<0.05).At 8 months and 12 months after drug withdrawal,the negative conversion rate and total effective rate of Nr-CWS group were higher than those of the blank control group(P<0.05).The total effective rate of Baofukang suppository group and interferon group was higher than that of the blank control group(P<0.05).There was no significant difference in the outcome of

关 键 词：外用红色诺卡氏菌细胞壁骨架 高危型人乳头瘤病毒感染 宫颈癌前病变 

分 类 号：R737.33[医药卫生—肿瘤]