加味蜀羊泉散对湿热下注型宫颈鳞状上皮内病变合并高危型人乳头瘤病毒感染术后患者免疫功能及阴道微生态的影响  

Effect of modified Shuyangquan Powder on postoperative immune function and vaginal microecology of patients with cervical squamous intraepithelial lesion and high-risk human papillomavirus of damp-heat type

作　　者：唐艳 周丽 刘海红 张莉 TANG Yan;ZHOU Li;LIU Haihong;ZHANG Li(Department of Gynecology,Nantong Hospital of Traditional Chinese Medicine,Nantong,Jiangsu 226001)

机构地区：[1]江苏省南通市中医院妇科,江苏南通226001

出　　处：《河北中医》2024年第6期901-906,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：南通市科学技术局2020年度市级科技计划(指导性)项目(编号:MSZ20200)。

摘　　要：目的观察加味蜀羊泉散对湿热下注型宫颈鳞状上皮内病变(SIL)合并高危型人乳头瘤病毒(HR-HPV)感染术后患者免疫功能及阴道微生态的影响。方法将112例湿热下注型SIL合并HR-HPV感染宫颈环形电切术(LEEP)患者按照随机数字表法分为2组,对照组56例术后予重组人干扰素α-2b阴道泡腾胶囊治疗,治疗组56例术后在对照组治疗基础上应用加味蜀羊泉散治疗,2组均连续治疗3个月。比较2组术后6个月疗效;比较2组术前、术后6个月中医证候评分、免疫功能、阴道微生态指标变化。结果治疗组中途退出2例,对照组中途退出2例、病例资料缺失2例,最终治疗组54例、对照组52例完成研究。治疗组总有效率92.59%(50/54),对照组总有效率73.08%(38/52),治疗组疗效优于对照组(P<0.05)。2组术后6个月各项中医证候评分及总评分均较本组术前降低(P<0.05);治疗组术后6个月带下量多、色黄或兼绿、质稠或似泡沫、气秽或臭、阴户灼热瘙痒评分及总评分均低于对照组(P<0.05)。2组术后6个月免疫球蛋白(Ig)A、IgM、IgG、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较本组术前升高(P<0.05),CD8^(+)较本组术前降低(P<0.05);治疗组术后6个月IgA、IgM、IgG、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05),CD8^(+)低于对照组(P<0.05)。2组术后6个月菌群密集度(Ⅱ~Ⅲ级)、菌群多样性(Ⅱ~Ⅲ级)、乳酸菌(Ⅰ~Ⅱa级)均较本组术前升高(P<0.05),pH值较本组术前降低(P<0.05);治疗组术后6个月菌群密集度(Ⅱ~Ⅲ级)、菌群多样性(Ⅱ~Ⅲ级)、乳酸菌(Ⅰ~Ⅱa级)均高于对照组(P<0.05),pH值低于对照组(P<0.05)。结论加味蜀羊泉散治疗湿热下注型SIL合并HR-HPV感染术后患者,能改善患者临床症状,提高HR-HPV转阴率及疗效,可能与改善免疫功能、调节阴道微生态等因素有关。Objective To explore the effect of modified Shuyangquan Powder on postoperative immune function and vaginal microecology of patients with cervical squamous intraepithelial lesion(SIL)and high-risk human papillomavirus(HR-HPV)of damp-heat type.Methods A total of 112 patients with SIL and HR-HPV of damp-heat type underwent loop electrosurgical excision procedure(LEEP)were randomized 1∶1 to treatment group(56 patients)or control group(56 patients).All patients were given recombinant human interferon alpha-2b(rhIFNalpha-2b)vaginal effervescent capsules,and those in the treatment group were additionally given modified Shuyangquan Powder.A 3-month consecutive treatment was performed,aiming to compare clinical efficacy,traditional Chinese medicine(TCM)syndrome score,immune function,vaginal microenvironment.Results Finally,there were 54 cases in the treatment group(2 cases of withdrew)and 52 cases in the control group completed the trial(2 cases of withdrew and 2 cases of missing case data),respectively.The total effective rate of the treatment group was better than that of the control group(92.59%[50/54]vs 73.08%[38/52],P<0.05).The 6-month dimension score and total scores of TCM syndrome in both groups were significantly decreased than those before operation(P<0.05),and the 6-month dimension score and total scores of excessive,yellow or green,thick or foamy,and filthy or stinky in leucorrhea,and calor or itch in vulva in the treatment group were decreased than those of the control group(P<0.05).The 6-month levels of serum immunoglobulin(Ig)A,IgG,IgM,CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in both groups were significantly higher than those before operation,but CD8^(+)level was lower(P<0.05).There were significant differences in the above indexes between groups(P<0.05).The 6-month vaginal flora with a density-grade ofⅡ-Ⅲ,flora diversity-grade ofⅡ-Ⅲ,Lactobacillus with a gradeⅠ-Ⅱa in both groups were significantly increased than those before operation(P<0.05),but the pH value was significantly decreased(P<0.05),th

关 键 词：子宫颈 宫颈肿瘤 癌前状态 中药疗法 

分 类 号：R711.74[医药卫生—妇产科学] R737.3[医药卫生—临床医学] R289.6