化湿解毒汤联合辛复宁治疗宫颈上皮内瘤变合并高危HPV感染疗效观察  

Effect of Huashijiedu Decoction combined with Xinfuning in the treatment of cervical intraepithelial neoplasia combined with high-risk HPV infection

作　　者：吴志兵 陆瑞 李文清 董其虎 潘金津 WU Zhi-bing;LU Rui;LI Wen-qing;DONG Qi-hu;PAN Jin-jin(Department of Obsterics and Gynecology,Shuyang Hospital Affiliated to Yangzhou University School of Medicine,Suqian 223600,China)

机构地区：[1]扬州大学医学院附属沭阳医院妇产科,江苏宿迁223600

出　　处：《哈尔滨医科大学学报》2022年第2期151-155,共5页Journal of Harbin Medical University

基　　金：江苏省自然科学基金面上项目(BK20181235);2020年度市级指导性科技计划项目(Z2020066)。

摘　　要：目的 探讨化湿解毒汤联合辛复宁治疗宫颈上皮内瘤变(cervical intraepithelial neoplasia, CIN)合并高危人乳头瘤病毒(human papillomavirus, HPV)感染疗效及对阴道局部炎症因子水平的影响。方法 选择2018年6月~2020年9月本院收治的82例CIN合并高危HPV感染患者为研究对象,以随机数字表法分为对照组(n=41)和研究组(n=41)。2组均行宫颈环形电切刀术(loop electrosurgical excision procedure, LEEP),对照组术后采用辛复宁治疗,研究组在对照组的基础上联合化湿解毒汤治疗,2组均治疗3个月,2组经期期间均停用药物治疗。比较2组临床疗效及治疗期间不良反应发生情况,观察2组治疗前后湿热下注证中医症候评分、阴道局部炎症因子水平、生存素(Survivin)和增殖细胞核抗原(Ki67)等凋亡抑制基因表达情况。结果 2组疗效等级分布差异显著(P<0.05),且研究组总有效率高于对照组(92.68%vs. 73.17%,P<0.05)。治疗前,2组湿热下注证中医症候评分、血清白细胞介素-4(interleukin-4,IL-4)、白细胞介素-12(interleukin-12,IL-12)、γ-干扰素(interferon-γ,IFN-γ)水平、Ki67、Survivin阳性表达率比较无统计学差异(P>0.05);治疗后,2组湿热下注证中医症候评分、血清IL-4水平、Ki67、Survivin阳性表达率均降低(P<0.05),且研究组更低(P<0.05);治疗后,2组血清IL-12、IFN-γ水平均升高(P<0.05),且研究组更高(P<0.05)。2组治疗期间不良反应发生率相近(P>0.05)。结论 化湿解毒汤联合辛复宁可改善湿热下注证CIN合并高危HPV感染的临床症状,疗效显著,改善阴道局部炎症因子水平,降低Ki67、Survivin阳性表达率,且安全可靠。Objective To investigate the therapeutic effect of Huashijiedu Decoction combined with Xinfuning in the treatment of cervical intraepithelial neoplasia(CIN) combined with high-risk human papillomavirus(HPV) infection and its effect on the level of local inflammatory factors in the vagina. Methods A total of 82 patients with CIN combined with high-risk HPV infection who were admitted to the hospital from June 2018 to September 2020 were selected. They were divided into control group(n=41) and study group(n=41) by a random number table.Both groups were treated with loop electrosurgical excision procedure(LEEP), then the control group was treated with Xinfuning after operation, and the study group was treated with Huashijiedu Decoction on the basis of the control group. Both groups were treated for 3 months. The drug therapy was discontinued during menstruation in both groups. The clinical efficacy and the occurrence of adverse reactions during the treatment of the two groups were compared, and the traditional Chinese medicine syndrome scores of damp-heat betting syndrome, the level of local inflammatory factors in the vagina, the expression of survivin(Survivin) and proliferating cell nuclear antigen(Ki67) and other apoptosis-inhibiting genes before and after treatment in the two groups were observed. Results There was a significant difference in the distribution of curative effects between the two groups(P<0.05), and the total effective rate of the study group was higher than that of the control group(92.68% vs. 73.17%, P<0.05). Before treatment, there was no statistical difference in the expression rate of the scores of damp-heat betting, serum interleukin-4(IL-4), interleukin-12(IL-12), interferon-γ(IFN-γ) levels, Ki67 and Survivin positive area in the two groups(P>0.05). After treatment, the Chinese Medicine symptom score, serum IL-4 level, Ki67 and Survivin positive expression rate of the two groups of damp-heat lowering syndrome decreased(P<0.05), and was even lower in the study group(P<0.05). After treatme

关 键 词：化湿解毒汤 辛复宁 宫颈上皮内瘤变 高危人乳头瘤病毒 临床疗效 阴道局部炎症因子水平 

分 类 号：R737.33[医药卫生—肿瘤]