针灸治疗宫颈高危型HPV感染临床疗效观察及对宫颈局部免疫微环境影响的研究  

Clinical effect of acupuncture and moxibustion on cervical high-risk HPV infection and its influence on cervical local immune microenvironment

作　　者：赵琳[1] 宋殿荣[1] 王雅楠[1] 郭洁[1] 吴思依 陈然然 ZHAO Lin;SONG Dian-rong;WANG Ya-nan(The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)

机构地区：[1]天津中医药大学第二附属医院,天津300250

出　　处：《中国处方药》2023年第8期138-142,共5页Journal of China Prescription Drug

基　　金：天津中医药大学第二附属医院2020年度青苗计划(QMJH202016)。

摘　　要：目的 探究针灸治疗高危型宫颈人乳头瘤病毒(HR-HPV)感染的临床疗效及其对宫颈局部免疫微环境的影响。方法 选取2020年6月~2021年11月期间妇科门诊收治的脾肾阳虚型宫颈HR-HPV感染患者,按随机数字表法分为针灸组和对照组,每组各49例,针灸组治疗3个月,对照组观察3个月。观察治疗前后HPV痊愈率、总有效率及阴道灌洗液各细胞因子[分泌型免疫球蛋白A(s Ig A)、白细胞介素-2(IL-2)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]水平。结果 针灸组治疗HR-HPV感染痊愈率明显高于对照组(59.18%vs.22.45%)(P <0.05),总有效率明显高于对照组(83.67%vs.48.98)(P <0.05)。痊愈组阴道灌洗液中IL-2、TNF-α、s Ig A浓度,IL-2/IL-10比值较未痊愈组明显升高(P <0.05),痊愈组IL-10浓度较未痊愈组明显降低(P <0.05)。针灸组患者治疗后较治疗前阴道灌洗液中IL-2、TNF-α、s Ig A浓度,IL-2/IL-10比值明显升高(P <0.05),IL-10浓度明显降低(P <0.05)。对照组治疗前后阴道灌洗液中IL-2、IL-10、TNF-α、s Ig A浓度,IL-2/IL-10比值对比,差异无统计学意义(P> 0.05)。痊愈患者中,两组阴道灌洗液中s Ig A、IL-2、TNF-α浓度,IL-2/IL-10比值对比,差异无统计学意义(P> 0.05)。未痊愈患者中,针灸组及对照组阴道灌洗液中s Ig A、IL-2、TNF-α浓度对比,差异无统计学意义(P> 0.05),针灸组较对照组L-10浓度明显降低,IL-2/IL-10比值明显升高(P <0.05)。结论 针灸治疗HPV感染3个月疗效显著优于自然转归。HPV感染、宫颈局部免疫微环境和辅助性T细胞1(Th1)/Th2失衡之间存在一定的关系,针灸治疗可以明显改善宫颈局部免疫微环境,提高局部IL-2、TNF-α和s Ig A水平,降低宫颈IL-10水平,恢复Th1/Th2平衡和细胞免疫力,并能促进HPV的消除,同时,针灸治疗能维持较高的细胞免疫水平,从而可能有利于预防HPV再次感染。Objective To explore the clinical efficacy of acupuncture and moxibustion in the treatment of high-risk cervical HPV(HRHPV) infection and its impact on the local immune microenvironment of the cervix.Methods From June 2020 to November 2021,cervical HR-HPV infection patients of spleen kidney yang deficiency type admitted to our gynecological clinic were randomly divided into acupuncture and moxibustion group and matched group according to the random number table.There were 49 subjects in each group.The acupuncture and moxibustion group was treated for 3 months,and the matched group was observed for 3 months.The recovery rate and the total effective rate of HPV and various cytokines(s Ig A,IL-2,IL-10,TNF-α) levels in vaginal lavage fluid were observed before and after treatment.Results The cure rate of HR-HPV infection in the acupuncture and moxibustion group was obviously higher than that in the matched group(59.18% vs.22.45%)(P<0.05),and the total effective rate was obviously higher than that in the matched group(83.67% vs.48.98)(P<0.05).IL-2,TNF-α,sIgA concentration and the ratio of IL-2/IL-10 in vaginal lavage fluid of the recovery group were obviously higher than those in the untreated group(P<0.05),the IL-10 concentration in the recovery group was obviously lower than that in the untreated group(P<0.05).After treatment,the concentrations of IL-2,TNF-α and sIgA in vaginal lavage fluid and the ratio of IL-2/IL-10 in the acupuncture group were significantly higher than those before treatment(P<0.05),and the concentration of IL-10 was significantly lower than that before treatment(P<0.05).There were no significant difference in the concentrations of IL-2,IL-10,TNF-α and sIgA in vaginal lavage fluid and the ratio of IL-2/IL-10 in the matched group before and after treatment(P<0.05).In cured patients,there were no statistically significant difference in sIgA,IL-2,TNF-α concentrations and IL-2/IL-10 ratio of vaginal lavage fluid between the two groups(P>0.05).In the uncured patients,there were no significant di

关 键 词：针灸治疗 HR-HPV感染 宫颈局部免疫 

分 类 号：R246.3[医药卫生—针灸推拿学]