解毒消瘤汤治疗宫颈HR-HPV感染对病毒载量及宫颈病变组织中IDO、Caspase-1、IL-4的影响  

Effect of Jiedu Xiaoliu tang in treating cervical HR-HPV infection on viral load and IDO,Caspase-1 and IL-4 in cervical lesion tissues

作　　者：郑丽香 毛丽斯 许玲莉 周先富[2] 吴宏华[1] ZHENG Lixiang;MAO Lisi;XU Lingli;ZHOU Xianfu;WU Honghua(Quzhou People's Hospital,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院中药房,浙江衢州324000 [2]衢州市人民医院中医科,浙江衢州324000

出　　处：《中华医院感染学杂志》2025年第3期400-404,共5页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科学研究基金资助项目(2022ZB377)。

摘　　要：目的探讨解毒消瘤汤治疗宫颈高危型人乳头瘤病毒(HR-HPV)感染对病毒载量及宫颈病变组织中吲哚胺-2,3-二氧酶(IDO)、半胱氨酸蛋白酶-1(Caspase-1)、白细胞介素-4(IL-4)水平的影响。方法选取2021年7月—2023年8月衢州市人民医院收治的宫颈HR-HPV感染患者78例作为研究对象,随机分为研究组和对照组各39例,对照组采用重组人干扰素α-2b阴道泡腾片治疗,研究组在对照组基础上采用解毒消瘤汤治疗,均治疗3个月经周期。比较两组临床疗效、HR-HPV转阴情况及阴道微生态环境恢复情况(治疗3个月经周期后),中医症状积分、人乳头瘤病毒(HPV)病毒载量、免疫功能及宫颈病变组织中IDO、Caspase-1、IL-4表达(治疗前、治疗3个月经周期后),安全性(治疗期间)。结果治疗3个月经周期后,研究组HR-HPV转阴率、阴道微生态环境复常率分别为84.62%、84.62%高于对照组(P<0.05),研究组疗效优于对照组(P=0.033)。随着治疗时间的延长,两组中医症状积分、HPV病毒载量、外周血CD_(8)^(+)、辅助性T细胞17(Th17)/调节性T细胞(Treg)水平及宫颈病变组织中IDO、Caspase-1、IL-4阳性表达率呈降低趋势,且相比于对照组,研究组降低幅度更大;两组外周血CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平呈升高趋势,且相比于对照组,研究组升高幅度更大(P<0.05)。治疗期间,两组不良反应发生率比较差异无统计学意义(P=0.428)。结论解毒消瘤汤治疗可有效缓解宫颈HR-HPV感染患者中医症状,减少病毒载量,调节患者宫颈病变组织中IDO、Caspase-1、IL-4表达水平,改善患者阴道微生态环境及免疫功能,减轻患者炎症反应,进而促进疾病康复,提高治疗效果,且安全性良好。OBJECTIVE To explore the effects of Jiedu Xiaoliu tang in treating cervical HR-HPV infection on the viral load and levels of indoleamine 2,3-dioxygenase(IDO),cysteine protease-1(Caspase-1),and interleukin-4(IL-4)in cervical lesion tissues.METHODS Seventy-eight patients with cervical HR-HPV infection admitted to Quzhou People's Hospital from Jul.2021 to Aug.2023 were selected as the study subjects and were randomly divided into the study group and the control group,with 39 cases in each group.The control group was given recombinant human interferonα-2b vaginal effervescent tablets,while the study group was given Jiedu Xiaoliu Tang on the basis of the treatment of the control group,both groups were treated for 3 menstrual cycles.The clinical efficacy,HR-HPV negative conversion and vaginal microenvironment recovery(after 3 menstrual cycles of treatment),the scores of traditional chinese medicine symptom,human papillomavirus(HPV)viral load,immune function,expression of IDO,Caspase-l,and IL-4 in cervical lesion tissues(before and after 3 menstrual cycles of treatment)and the safety(during the treatment period)between two groups were compared.RESULTS After 3 menstrual cycles of treatment,the HR-HPV conversion and vaginal microenvironment normalization of the study group were 84.62%,and 84.62%,respectively,which were higher than the control group(P<0.05).The efficacy of the study group was better than that of the control group(P=0.033).With the prolongation of treatment time,the scores of traditional Chinese medicine symptoms,HPV viral load,levels of peripheral blood CDs+,helper T cell 17(Th17)/regulatory T cell(Treg),and the positive expression rates of IDO,Caspase-1,and IL-4 in cervical lesion tissues showed a decreasing trend in both groups,and the study group showed a significant decrease compared with the control group.The levels of CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)in the peripheral blood of the two groups showed an increasing trend,and the increase in the study group was significant compared with th

关 键 词：人乳头瘤病毒 高危型 解毒消瘤汤 病毒载量 吲哚胺-2 3-二氧酶 半胱氨酸蛋白酶-1 白细胞介素-4 疗效 

分 类 号：R711.32[医药卫生—妇产科学]