發(fā)布時間：2018-08-22 18:25

【摘要】：目的:探討止帶方加減對慢性宮頸炎合并人類乳頭瘤病毒(HPV)感染,高頻電波刀宮頸電圈環(huán)切術后(LEEP)患者病毒陰轉作用,及對重組人γ-干擾素(IFN-γ),白細胞介素-10(IL~(-1)0)和IL-4的影響。方法:將190例符合研究的中、重度患者,按SAS軟件生成,隨機分為觀察組和對照組。兩組患者均采用LEEP術。術后對照組89例患者給予治帶片口服,5片/次,3次/d;術后觀察組91例患者采用止帶方加減內服,1劑/d。兩組患者均連續(xù)治療4個月經周期。進行治療前后糜爛面積、糜爛類型、陰道清潔度、帶下的量、帶下性質、外陰癢痛、接觸性出血,下腹或腰痛和濕熱下注評分;檢測人乳頭瘤病毒脫氧核糖核酸(HPV-DNA),記錄HPV-DNA陰轉情況和HPV病毒載量。檢測治療前后IFN-γ,IL~(-1)0和IL-4水平。結果:經Ridit分析,治療后觀察組慢性宮頸炎療效優(yōu)于對照組(P0.05);經Ridit分析,治療后觀察組中醫(yī)臨床證候療效優(yōu)于對照組(P0.05);治療后觀察組糜爛面積、糜爛類型、陰道清潔度、帶下的量、帶下性質等臨床癥狀、體征評分均低于對照組(P0.01);治療后觀察組HPV病毒載量低于對照組(P0.01),濕熱下注證評分低于對照組(P0.01);治療后觀察組HPV-DNA陰轉率為79.12%,高于對照組的62.92%(P0.05);治療后兩組患者IFN-γ水平均升高,觀察組升高更為顯著(P0.01),兩組患者IL-4和IL~(-1)0水平均下降,觀察組下降更為明顯(P0.01)。結論:止帶方加減治療慢性宮頸炎合并HPV感染,能顯著改善慢性宮頸炎癥狀、體征,降低HPV-DNA載量,促使HPV陰轉,臨床療效明顯,其作用機制可能與調節(jié)Th1/Th2的失衡有關。
[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- 緯 (IFN- 緯), 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.
【作者單位】： 遵義醫(yī)學院附屬醫(yī)院;貴州醫(yī)科大學附屬醫(yī)院;
【基金】：貴州省科學技術基金項目(黔科合J字[2012]2363號)
【分類號】：R271.9

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