派特灵与艾拉—光动力治疗不同亚型HPV感染尖锐湿疣的临床疗效观察

发布时间：2018-06-05 01:25

本文选题：尖锐湿疣 + 人乳头瘤病毒　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的1.比较两种治疗方法对不同亚型的HPV病毒感染的尖锐湿疣的治疗效果;2.明确低危型、高危型HPV感染及一重、多重HPV感染是否存在治疗差异;3.统计两种治疗方法治疗期间及治疗结束后的病毒转阴率;4.跟踪随访统计患者半年内的复发率,为临床治疗提供参考。对象与方法利用临床病例对照的方法,将就诊于宁夏医科大学总医院皮肤性病科门诊的尖锐湿疣患者进行HPV分型检测,并根据发病部位及分型结果筛选出符合入选标准的患者,按照就诊顺序随机分成两组,分别采用纯中药制剂派特灵及艾拉-光动力治疗,并对两组临床疗效进行观察。一、对象本研究对象来自于2015年7月-2016年7月就诊于宁夏医科大学总医院门诊的尖锐湿疣患者,诊断标准参照《卫生部尖锐湿疣诊断标准与处理原则(ws235-2003)》。二、方法根据HPV分型结果将符合以下条件的入选患者进行匹配:○1.感染HPV病毒亚型相同(包括低危型、高危型、单一型及混合型HPV感染);○2感染部位相同;○3性别相同。共选取50对匹配成功的患者,并将匹配患者按1:1随机分入派特灵组和艾拉-光动力组。在治疗满一月后及治疗满四月后别再次采用流式荧光杂交法对100例尖锐湿疣患者疣体黏膜交界面脱落细胞或疣体组织进行HPV基因亚型的检测,对比治疗中期及治疗后期病毒转阴率及复发情况,进一步评价两种治疗方法的临床疗效。比较项目包括以下方面:1、一般资料的分析2、两种治疗方法临床疗效的比较3与其他人研究结果的比较统计学方法:所有数据的整理采用EXCEL表格,统计学计算应用SPSS18.0软件,对治疗效果的比较采用卡方检验,以P0.05为差别有统计学意义。结果通过对两组临床疗效比较,得出以下结果:1.50例派特灵组尖锐湿疣患者治疗期间第一次复查HPV病毒阴性检测率为48.0%(24/50,)第二次复查HPV阴性检测率为94.00%(47/50),结合疗效判断标准总有效率为96.00%。50例艾拉-光动力组治疗期间第一次复查HPV病毒阴性检测率为32.0%(16/50,)第二次复查HPV阴性检测率为78.00%(39/50),结合疗效判断标准总有效率为82.0%。比较两组总体疗效得出P0.05,派特灵组的总体治疗效果优于艾拉-光动力组。对艾拉-光动力组和派特灵组男性治疗疗效进行比较得出P0.05,派特灵在治疗男性尖锐湿疣方面疗效优于艾拉-光动力组;对艾拉-光动力组和派特灵组对低危型别HPV感染的治疗上进行比较,得出P0.05,派特灵组在低危型别HPV病毒感染的疗效优于艾拉-光动力组。对艾拉-光动力组和派特灵组对多重HPV感染的治疗上进行比较,P0.05,派特灵组治疗多重HPV感染的疗效优于艾拉-光动力组。2.分别对两组治愈及显效患者进行6个月的跟踪随访,排除再次感染HPV病毒的可能性后,派特灵组复发2例,复发率为4.00%,艾拉-光动力组复发3例,复发率为6.00%。两组患者复发率进行统计学比较,P0.05,两组复发率无统计学差异。3.与他人研究情况比较,派特灵与艾拉-光动力治疗均优于传统的液氮冷冻、激光、电灼等治疗方法。结论1、两种疗法在治疗尖锐湿疣方面都取得了很好的疗效。2、两种疗法都对局部黏膜损害轻微,未破坏器官结构、保持器官功能完整。3、两组患者临床疗效上来看,派特灵组较艾拉-光动力组比具有病毒转阴率高、有效率高的优势,对低危型别及混合型别感染的治疗效果尤佳。4、派特灵治疗时间短,易操作、病人自主性强、花费小等优点,更容易被患者接受。
[Abstract]:Objective 1. to compare the therapeutic effects of two treatments on Condyloma Acuminata with different subtypes of HPV virus infection; 2. clear whether there is a difference in the treatment of low risk, high-risk HPV infection and one heavy, multiple HPV infection; 3. statistics of two treatments during and after the end of treatment; 4. follow up the follow-up statistics for half a year To provide reference for clinical treatment. Objects and methods using the method of clinical case control, the patients with condyloma acuminata in the dermatology department of Ningxia Medical University General Hospital were examined by HPV typing, and the patients were selected according to the location and classification results. The patients were randomly divided into two groups according to the order of medical treatment. Pdling and Ella photodynamic therapy were used to observe the clinical efficacy of two groups. First, the object of the study was from the patients of condyloma acuminata in the outpatient department of Ningxia Medical University General Hospital in July -2016 July 2015. The diagnostic criteria refer to the diagnostic criteria and treatment principles of condyloma acuminata in the Ministry of Health (ws235-2003) Two, the method was matched with the following conditions according to the HPV typing results: 0 1. infection of the HPV virus subtype (including low risk, high risk type, single type and mixed HPV infection); 0 2 infected sites identical; 0 3 sex identical. A total of 50 matched patients were selected and the matched patients were randomly divided into parling group according to 1:1 And Ella photodynamic group. After the treatment of 100 cases of condyloma acuminata patients with condyloma acuminatum after one month of treatment and after April, 100 cases of condyloma acuminata mucosa interface exfoliated cells or verrucous tissues were detected, and two kinds of treatment were compared in the middle and later period of treatment. The comparison project included the following aspects: 1, the analysis of the general data 2, the comparison of the clinical efficacy of the two kinds of treatment methods 3 and the comparison of other people's research results: all the data were collected by the EXCEL table, the statistical calculation was applied to the SPSS18.0 software, the comparison of the therapeutic effect was taken with the chi square test, and the P0.05 was poor. The results were compared with the two groups. The results were as follows: 1.50 cases of condyloma acuminata in putling group were first reexamined HPV virus negative detection rate was 48% (24/50), the second reexamination HPV negative detection rate was 94% (47/50). The total effective rate of the conclusion of the conclusion was 96.00%.50 Ella - photodynamic. The negative detection rate of HPV virus was 32% (16/50) for the first reexamination of the force group (16/50). The negative detection rate of HPV was 78% (39/50). The total effective rate of the therapeutic evaluation standard was 82.0%. compared with the total curative effect of two groups. The overall therapeutic effect of pate group was better than that of the Ella photodynamic group. The Ella photodynamic group and pdling group were better than the PDL group. The curative effect of the male group was compared with that of P0.05. Putling was better than the Ella photodynamic group in the treatment of male condyloma acuminatum. The treatment of the low risk HPV infection in the Ella photodynamic group and the putling group was compared, and the effect of P0.05 and putling group in the low risk type HPV virus infection was better than that of the Ella photodynamic group. The Ella - photodynamic group and pdling group were compared in the treatment of multiple HPV infection. P0.05 and pdling group were better than the Ella - photodynamic group.2. for two groups of cured and effectual patients, respectively. After eliminating the possibility of re infection of the HPV virus, 2 cases were recurred in the pdling group and the recurrence rate was 4 0%, the recurrence rate of the Ella - photodynamic group was 3 cases, the recurrence rate was 6.00%. two, the recurrence rate was statistically compared, P0.05, two groups had no statistical difference,.3. compared with others, pterin and Ella - photodynamic therapy were superior to traditional liquid nitrogen cryotherapy, laser, cauterization and other treatment methods. Conclusion 1, two treatments in the treatment of condyloma acuminata The two treatments were both mild to the local mucosa damage, without destroying the organ structure and maintaining the complete function of the organs.3. The clinical efficacy of the two groups of patients, compared with the Ella photodynamic group, was higher and the effective rate was higher than that of the two groups. In addition,.4 is more easily accepted by patients because of its advantages of short treatment time, easy operation, patient autonomy and low cost.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R752.53

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