内服外用中药对宫颈HR-HPV感染的治疗和对HR-HPV感染宫颈局部免疫环境影响的临床研究

发布时间：2018-04-10 00:36

  本文选题：内服外用中药　切入点：带下病　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:通过观察内服补肝肾清湿毒方及外用清热解毒、化湿止痒方治疗宫颈HR-HPV感染的临床疗效,来寻求能有效治疗宫颈HR-HPV感染的中医辨证思路及理法方药。方法:选取符合本研究要求的肝肾亏虚兼湿热毒邪内蕴型宫颈人乳头瘤病毒感染患者31例,随机将31例患者分为中药组(15例)和干扰素组(16例)。根据导师临床经验,将1个疗程设定为1个月,持续治疗3个月后评判疗效。通过对比两组患者治疗前后临床症状积分、中医证候积分、HC-Ⅱ检测等来评判治疗的成效,并监测宫颈HR-HPV感染伴或不伴宫颈病变(ASC-US、LSIL)患者在药物干预前后宫颈局部细胞因子IL-2、IL-4、IFN-α的变化。结果:1.中药组、干扰素组在治疗后HPV DNA病毒载量较各自治疗前的差异都无统计学意义(P0.05)。中药组在降低HPV DNA病毒载量幅度上优于干扰素组(302.65±448.39→66.46±131.48;410.34±709.01→210.41±478.93)。2.中药组转阴8例(53.33%),干扰素组转阴5例(31.25%),两组转阴率相比无统计学差异(P0.05),但中药组转阴率高于干扰素组。3.中药组、干扰素组治疗后的临床症状积分较各自治疗前都有明显降低,且两组变化都具有显著统计学意义(P0.01;P0.01)。4.中药组、干扰素组治疗后的中医证候积分较各自治疗前都有明显降低,且两组变化都具有显著统计学差异(P0.01;P0.01),中药组在降低中医证候积分明显优于干扰素组(P0.01)。5.中药组与干扰素组总有效率分别为93.33%、81.25%,两组总有效率相比无统计学差异(P0.05),中药组总有效率高于干扰素组。6.治疗前宫颈HR-HPV感染伴或不伴宫颈病变(ASC-US、LSIL)患者阴道冲洗液中IL-4、IL-2、IFN-a浓度均无统计学差异(P0.05)。但IL-4浓度与宫颈局部病变存在正的线性相关。7.在药物干预前后阴道冲洗液中细胞因子IL-2/IL-4比值变化存在统计学差异(P=0.026,P0.05)。结论:1.内服外用中药在治疗肝肾亏虚兼湿热毒邪内蕴型宫颈HR-HPV感染疗效确切,不仅能够显著降低HPVDNA滴度,还能明显改善患者的临床症状及中医证候。因此内服外用中药值得运用于以肝肾亏虚兼湿毒内蕴为证型的宫颈HR-HPV感染。2.IL-4浓度与宫颈病变程度存在正的线性相关,可将IL-4作为检测宫颈病变程度的一个新指标加以研究。3.内服外用中药能够使HPV感染宫颈局部免疫从失衡状态向平衡状态转变。
[Abstract]:Objective: to observe the clinical effect of treating cervical HR-HPV infection by taking the prescription of tonifying liver and kidney clearing dampness and detoxifying external heat and detoxification, so as to seek the TCM dialectical thinking and the prescription of rational method for the effective treatment of HR-HPV infection of cervix.Methods: Thirty-one patients with cervical papillomavirus infection with deficiency of liver and kidney and damp-heat toxin were randomly divided into Chinese medicine group (n = 15) and interferon group (n = 16).According to the tutor's clinical experience, a course of treatment was set as one month, and the curative effect was evaluated after 3 months of continuous treatment.The effectiveness of the treatment was evaluated by comparing the clinical symptom scores, the TCM syndromes score and the HC- 鈪，

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