易黄汤结合重组人干扰素治疗宫颈高危型HPV感染的效果  

Effect of Yihuang Decoction combined with recombinant human interferon on treatment of high-risk cervical HPV infection

作　　者：康淑芳 周越 张霞 付学美 许娟 KANG Shufang;ZHOU Yue;ZHANG Xia;FU Xuemei;XU Juan(Jinan Second Maternal and Child Health Hospital,Jinan,Shandong 271100,China)

机构地区：[1]济南市第二妇幼保健院妇科,山东济南271100 [2]济南市第二妇幼保健院中医妇科,山东济南271100 [3]济南市第二妇幼保健院检验科,山东济南271100

出　　处：《中华医院感染学杂志》2025年第4期571-576,共6页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金面上基金资助项目(ZR2021MH260)。

摘　　要：目的 探讨易黄汤结合重组人干扰素治疗宫颈高危型人乳头瘤病毒(HR-HPV)感染的效果,并分析HPV转阴率、Toll样受体(TLRs)/核因子(NF)-κB通路和下游基因表达水平。方法 选取2021年3月-2023年10月济南市第二妇幼保健院收治的宫颈高危型HPV感染患者214例为研究对象,随机分为对照组和研究组,各107例。对照组给予重组人干扰素α-2b(rhIFNα-2b)栓治疗,研究组在对照组治疗基础上联合易黄汤加味治疗,2周为1个疗程,治疗3个疗程。比较两组治疗后的临床疗效、HPV转阴率、阴道微环境复常率;比较治疗前后的HR-HPV DNA载量、中医证候积分、T淋巴细胞亚群水平、炎症指标、阴道分泌物pH值、Nugent评分及TLRs/NF-κB通路相关基因的表达。结果 研究组疗效优于对照组(P=0.001)。治疗后,两组患者HR-HPV DNA载量、中医证候积分、CD_(8)^(+)、白细胞介素(IL)-4、IL-1β、肿瘤坏死因子-α(TNF-α)、TLR2、TLR4、NF-κB、B淋巴细胞瘤-2(Bcl-2)、细胞周期蛋白D1(CyclinD1)、阴道分泌物pH值、Nugent评分较治疗前均下降(P<0.05),且研究组低于对照组(P<0.05);治疗后,两组患者CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、宫颈灌洗液γ干扰素(IFN-γ)、IL-12水平均高于治疗前(P<0.05),研究组高于对照组(P<0.05)。治疗后,研究组HPV转阴率、阴道微环境复常率分别为57.94%、88.78%高于对照组(P<0.05)。结论 易黄汤结合rhIFNα-2b治疗可有效调节宫颈高危型HPV感染患者的免疫功能及阴道微环境,通过抑制TLRs/N F-κB通路调控凋亡相关基因表达,降低机体炎症反应,提高HPV转阴率,进而有利于提高临床疗效。OBJECTIVE To investigate the effect of Yihuang decoction combined with recombinant human interferon on cervical high-risk human papillomavirus(HR-HPV)infection,and to analyze the negative conversion rate of HPV,Toll-like receptors(TLRs)/nuclear factor(NF)-kB pathway and downstream genes.METHODS Totally 214 patients with cervical high-risk HPV infection admitted to Jinan Second Maternal and Child Health Care Hos-pital from Mar.2021 to Oct.2023 were selected as the research subjects and were randomly divided into the con-trol group and the study group,with 107 cases in each group.The control group was treated with recombinant hu-man interferonα-2b(rhIFNα-2b),and the study group was treated with Yihuang decoction in addition to rhIFNα-2b.The treatment lasted 3 courses(2 weeks per course).The clinical efficacy,HPV negative conversion rates and vaginal microenvironment normalization rates after treatment were compared between the two groups.The HRHPV DNA loads,TCM syndrome scores,T lymphocyte subsets,inflammatory indicators,vaginal secretion pH value,Nugent score and the expressions of TLRs/NF-kB pathway related genes were compared before and after the treatment.RESULTS The effectiveness of the study group was better than that of the control group(P=0.001).After treatment,HR-HPV DNA loads,TCM syndrome scores,CD_(8)^(+),interleukin(IL)-4,II-1β,tumor necrosis factor-α(TNF-α),TLR2,TLR4,NF-κγB,B-cell lymphoma-2(Bcl-2),CyclinD1,vaginal secretion pH values,Nugent scores decreased in both groups compared with those of the pre-treatment(P<o.05),and was lower in the study group than those in the control group(P<o.05).After treatment,the levels of CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),interferon-(IFN-)and IL-12 in cervical lavage fluid of the two groups were higher than those of pre-treatment(P<0.05),and higher in the study group than those in the control group(P<0.05).After treatment,the HPV negative conversion rate and vaginal microenvironment normalization rate of the study group were 57.94%and 88.78%,respectiv

关 键 词：易黄汤 重组人干扰素 高危型人乳头瘤病毒 人乳头瘤病毒转阴率 Toll样受体/核因子-κB通路 炎症指标 免疫水平 

分 类 号：R711.32[医药卫生—妇产科学]