止带方加减治疗慢性宫颈炎合并HPV感染LEEP术后观察

发布时间：2018-08-22 18:25

【摘要】：目的:探讨止带方加减对慢性宫颈炎合并人类乳头瘤病毒(HPV)感染,高频电波刀宫颈电圈环切术后(LEEP)患者病毒阴转作用,及对重组人γ-干扰素(IFN-γ),白细胞介素-10(IL~(-1)0)和IL-4的影响。方法:将190例符合研究的中、重度患者,按SAS软件生成,随机分为观察组和对照组。两组患者均采用LEEP术。术后对照组89例患者给予治带片口服,5片/次,3次/d;术后观察组91例患者采用止带方加减内服,1剂/d。两组患者均连续治疗4个月经周期。进行治疗前后糜烂面积、糜烂类型、阴道清洁度、带下的量、带下性质、外阴痒痛、接触性出血,下腹或腰痛和湿热下注评分;检测人乳头瘤病毒脱氧核糖核酸(HPV-DNA),记录HPV-DNA阴转情况和HPV病毒载量。检测治疗前后IFN-γ,IL~(-1)0和IL-4水平。结果:经Ridit分析,治疗后观察组慢性宫颈炎疗效优于对照组(P0.05);经Ridit分析,治疗后观察组中医临床证候疗效优于对照组(P0.05);治疗后观察组糜烂面积、糜烂类型、阴道清洁度、带下的量、带下性质等临床症状、体征评分均低于对照组(P0.01);治疗后观察组HPV病毒载量低于对照组(P0.01),湿热下注证评分低于对照组(P0.01);治疗后观察组HPV-DNA阴转率为79.12%,高于对照组的62.92%(P0.05);治疗后两组患者IFN-γ水平均升高,观察组升高更为显著(P0.01),两组患者IL-4和IL~(-1)0水平均下降,观察组下降更为明显(P0.01)。结论:止带方加减治疗慢性宫颈炎合并HPV感染,能显著改善慢性宫颈炎症状、体征,降低HPV-DNA载量,促使HPV阴转,临床疗效明显,其作用机制可能与调节Th1/Th2的失衡有关。
[Abstract]:Objective: to investigate the effect of Zhibanfang on the viral conversion of chronic cervicitis complicated with human papillomavirus (HPV) infection and (LEEP) patients after high frequency electroloop resection of cervix, and the effects on recombinant human interferon- 纬 (IFN- 纬), interleukin-10 (IL-10) and IL-4. Methods: 190 moderate and severe patients were randomly divided into observation group and control group according to SAS software. Both groups were treated with LEEP. 89 patients in the control group were treated with zhibanpian orally for 3 / d, and 91 patients in the postoperative observation group were treated with Zhibanfang plus or minus one dose per day. Patients in both groups were treated continuously for 4 menstrual cycles. Before and after treatment, the area of erosion, the type of erosion, the degree of vaginal cleanliness, the quantity of band, the nature of subband, vulva itching pain, contact hemorrhage, lower abdomen or low back pain and heat and dampness betting score; Human papillomavirus deoxyribonucleic acid (HPV-DNA) was detected to record the HPV-DNA negativity and HPV viral load. The levels of IL ~ (-1) and IL-4 were measured before and after treatment. Results: after Ridit analysis, the curative effect of chronic cervicitis in the observation group was better than that in the control group (P0.05); after Ridit analysis, the curative effect of TCM clinical syndrome in the observation group was better than that in the control group (P0.05); after treatment, the erosion area, erosion type, vaginal cleanliness in the observation group were better than those in the control group. Clinical symptoms such as the quantity of the belt, the nature of the belt, etc. The scores of physical signs were lower than those of the control group (P0.01), the viral load of HPV in the observation group was lower than that of the control group (P0.01), the score of damp-heat betting syndrome was lower than that of the control group (P0.01), the negative conversion rate of HPV-DNA in the observation group was 79.12, which was higher than that in the control group (P 0.05). The levels of IL-4 and IL ~ (-1) in both groups were lower than those in control group (P0.01). Conclusion: the treatment of chronic cervicitis combined with HPV infection with Zhibanfang can significantly improve the symptoms and signs of chronic cervicitis, reduce the load of HPV-DNA, promote the negative conversion of HPV, and the clinical effect is obvious. The mechanism of the treatment may be related to the adjustment of the imbalance of Th1/Th2.
【作者单位】：遵义医学院附属医院;贵州医科大学附属医院;
【基金】：贵州省科学技术基金项目(黔科合J字[2012]2363号)
【分类号】：R271.9

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