解毒祛瘀汤治疗宫颈上皮内瘤变合并高危型人乳头瘤病毒感染的临床效果  

Clinical effect of Jiedu Quyu Decoction on treatment of cervical intraepithelial neoplasia patients complicated with high-risk human papilloma virus infection

作　　者：林瓒贞 罗强 叶晓菲 吴沁格 钟燕英 LIN Zan-zhen;LUO Qiang;YE Xiao-fei;WU Qin-ge;ZHONG Yan-ying(Ding’an County People’s Hospital,Anding,Hainan 571200,China)

机构地区：[1]定安县人民医院妇产科,海南安定571200 [2]定安县人民医院中医科,海南安定571200

出　　处：《中华医院感染学杂志》2022年第21期3307-3311,共5页Chinese Journal of Nosocomiology

基　　金：海南省科研基金资助项目(2020H0210)。

摘　　要：目的探究解毒祛瘀汤治疗宫颈上皮内瘤变(CIN)合并高危型人乳头瘤病毒(HR-HPV)感染的临床效果。方法将2019年9月-2020年12月定安县人民医院收治的298例CIN合并HR-HPV感染患者按随机数表法分为研究组149例与对照组149例。两组均行宫颈环形电切刀治疗,术后对照组采用重组人干扰素α-2b治疗,研究组在此基础上加用解毒祛瘀汤治疗。观察两组疗效、围术期指标及HR-HPV转归情况,并比较两组白细胞介素(IL)-12、IL-10、IL-4、IL-2、γ-干扰素(IFN-γ)水平及k-ras、人髓细胞增生原癌(c-myc)mRNA水平和人端粒酶RNA(hTERC)基因表达。结果研究组总有效率高于对照组(P<0.05);研究组术后出血量、排液量、出血时间、排液时间均低于对照组(P<0.05);研究组HR-HPV转阴率高于对照组(P<0.05);两组治疗后HR-HPV病毒载量下降(P<0.05),且研究组下降程度比对照组高(P<0.05);两组治疗后IL-12、IL-2、IFN-γ上升,IL-10、IL-4下降(P<0.05),且研究组各指标上升/下降程度比对照组高(P<0.05);两组治疗后k-ras、c-myc mRNA表达水平和hTERC基因表达率下降(P<0.05),且研究组各指标下降程度比对照组高(P<0.05)。结论对CIN合并HR-HPV感染患者采用解毒祛瘀汤治疗可以提高疗效,降低癌基因k-ras、c-myc及hTERC基因表达,改善患者预后。OBJECTIVE To explore the clinical effect of Jiedu Quyu Decoction on treatment of cervical intraepithelial neoplasia(CIN)patients complicated with high-risk human papilloma virus(HR-HPV)infection.METHODS A total of 298 CIN patients complicated with HR-HPV who were treated in Ding’an County People’s Hospital from Sep 2019 to Dec 2020 were enrolled in the study and randomly divided into the study group with 149 cases and the control group with 149 case.Both groups were treated with cervical circular electric knife.After the surgery,the control group was treated with recombinant human interferonα-2b,and the study group was given additional Jiedu Quyu Decoction on basis of the treatment of the control group.The curative effect,perioperative indexes and outcomes of HR-HPV were observed.The levels of interleukin(IL)-12,IL-10,IL-4,IL-2,interferon-γ(IFN-γ)and the expression levels of k-ras,myelocytomatosis oncogene(c-myc)mRNA and human telomerase RNA component(hTERC)gene were compared between the two groups of patients.RESULTS The total effective rate of the study group was higher than that of the control group(P<0.05).The postoperative blood loss volume,drainage volume,hemorrhage time and drainage time were lower in the study group than in the control group(P<0.05).The negative conversion rate of HR-HPV of the study group was higher than that of the control group(P<0.05).The HR-HPV load of the two group was reduced after the treatment(P<0.05),which was reduced more remarkably in the study group than in the control group(P<0.05).The levels of IL-12,IL-2 and IFN-γof the two groups were elevated after the treatment,while the levels of IL-10 and IL-4 were reduced(P<0.05),the levels of above indexes of the study group were elevated/reduced more significantly than those of the control group(P<0.05).The expression levels of k-ras and c-myc mRNA and expression level of hTERC gene of the two groups were reduced after the treatment(P<0.05),and the indexes of the study group were reduced more significantly than those of the

关 键 词：宫颈上皮内瘤变 人乳头瘤病毒 感染 解毒祛瘀汤 人髓细胞增生原癌基因 人端粒酶RNA 疗效 

分 类 号：R737.33[医药卫生—肿瘤]