本文選題：宮頸上皮內(nèi)瘤變　切入點(diǎn)：人類(lèi)乳頭狀瘤病毒　出處：《中國(guó)實(shí)驗(yàn)方劑學(xué)雜志》2017年16期 　論文類(lèi)型：期刊論文

【摘要】：目的:探討化濕解毒湯對(duì)高級(jí)別CIN高危型HPV感染者LEEP術(shù)后濕熱下注證患者的臨床療效,并從凋亡抑制基因即生存素(Survivin)和增殖細(xì)胞核抗原(Ki67)表達(dá)及HPV病毒載量等方面探討了其對(duì)轉(zhuǎn)歸的影響。方法:將160例CIN高危型HPV感染者,采用SAS軟件生成,隨機(jī)按1∶1比例分為觀察組和對(duì)照組。兩組患者均給予LEEP術(shù)治療。術(shù)后對(duì)照組給予重組人干擾素α-2 b凝膠宮頸外涂,連續(xù)10 d為1個(gè)療程,共使用3個(gè)月經(jīng)周期。觀察組在對(duì)照組治療的基礎(chǔ)上加用化濕解毒湯內(nèi)服,1劑/d。連續(xù)服用3個(gè)月經(jīng)周期,再行3個(gè)月經(jīng)周期隨訪。檢測(cè)術(shù)前和術(shù)后6個(gè)月患者Survivin,Ki67水平陽(yáng)性表達(dá)情況和人乳頭瘤病毒(HPV)DNA基因(HPV-DNA)病毒載量;進(jìn)行術(shù)前和術(shù)后3個(gè)月慢性宮頸炎和濕熱下注證的評(píng)價(jià);檢測(cè)術(shù)前和術(shù)后3個(gè)月宮頸局部灌洗液γ-干擾素(IFN-γ),白細(xì)胞介素-10(IL-10),白細(xì)胞介素-12(IL-12),白細(xì)胞介素-2(IL-2)和白細(xì)胞介素-4(IL-4)水平。結(jié)果:觀察組臨床療效總有效率為94.52%,對(duì)照組為81.69%,觀察組高于對(duì)照組(χ~2=6.691,P0.05);治療后觀察組中醫(yī)證候療效總有效率為95.89%,對(duì)照組為78.87%,觀察組高于對(duì)照組(χ~2=9.529,P0.01);術(shù)后6個(gè)月,觀察組高危型人乳頭瘤病毒(hr-HPV)陰轉(zhuǎn)率為91.78%,對(duì)照組為77.46%,觀察組高于對(duì)照組(χ~2=5.699,P0.05);觀察組患者在術(shù)后6個(gè)月hr-HPV病毒載量低于對(duì)照組(P0.01);術(shù)后6個(gè)月,觀察組Survivin和Ki67陽(yáng)性表達(dá)情況弱于對(duì)照組(P0.05),觀察組Survivin陰轉(zhuǎn)率為73.97%,高于對(duì)照組的56.34%(χ~2=4.938,P0.05),觀察組Ki67陰轉(zhuǎn)率為80.82%,高于對(duì)照組的59.15%(χ~2=8.067,P0.01);術(shù)后3個(gè)月觀察組IFN-γ,IL-2和IL-12水平均高于對(duì)照組,IL-4和IL-10水平均低于對(duì)照組(P0.01)。結(jié)論:采用化濕解毒湯干預(yù)CIN高危型HPV感染LEEP術(shù)后患者,能提高患者的臨床治療效果,能促使hr-HPV陰轉(zhuǎn),降低病毒載量,能降低Survivin和Ki67陽(yáng)性表達(dá),并調(diào)節(jié)Th1/Th2平衡,從而起到控制CIN向?qū)m頸癌轉(zhuǎn)變,改善其預(yù)后。
[Abstract]:Objective: to investigate the clinical effect of Huashi jiedu decoction (Huishjiedu decoction) on the patients with damp and heat betting syndrome after LEEP operation in high grade CIN patients with high risk of HPV infection. The effects of apoptosis suppressor gene (survivin), proliferating cell nuclear antigen (PCNA) Ki67) and HPV viral load on prognosis were discussed. Methods: 160 cases of high risk HPV infected with CIN were generated by SAS software. The patients in the two groups were divided into observation group and control group randomly according to the ratio of 1: 1. The patients in both groups were treated with LEEP. The control group was treated with recombinant human interferon 偽 -2 b gel for 10 days as a course of treatment. Three menstrual cycles were used altogether. The observation group was treated with Huashi jiedu decoction on the basis of the treatment in the control group. The positive expression of survivin Ki67 and the HPV-DNAvirus load of human papillomavirus (HPV-HPV-DNA) gene were detected before and 6 months after the operation, and the evaluation of chronic cervicitis and damp-heat betting syndrome were performed before and 3 months after the operation. The levels of IFN- 緯, IL-10, IL-12, IL-2) and IL-4IL-4 were measured before and 3 months after operation. Results: the total effective rate was 94.52 in the observation group and 94.52 in the control group. 81.69, which was higher in the observation group than in the control group (蠂 ~ (2) 2) 6.691n (P0.05), the total effective rate of TCM syndrome in the observation group was 95.89 and 78.87 in the control group, which was higher than that in the control group (蠂 ~ (2) 2) 9.529 (P0.01); 6 months after operation, the total effective rate of TCM syndromes in the observation group was 95.89 and 78.87, respectively. The negative conversion rate of high-risk human papillomavirus (HPV) was 91.78 in the observation group and 77.46 in the control group, which was higher in the observation group than in the control group (蠂 ~ (2 +) 5.699) P0.05.The hr-HPV viral load in the observation group was lower than that in the control group at 6 months after operation (P 0.01), and at 6 months after operation, the viral load of hr-HPV in the observation group was lower than that in the control group. The positive expression of Survivin and Ki67 in the observation group was weaker than that in the control group (P 0.05). The negative conversion rate of Survivin in the observation group was 73.97, which was higher than that in the control group (56.34%) (蠂 ~ 2 = 4.938, P 0.05), and the negative conversion rate of Ki67 in the observation group was 80.82%, which was higher than that in the control group (59.15%) (蠂 ~ (28.067) P 0.01). The levels of IL-2 and IL-12 in the observation group were higher than those in the control group 3 months after operation. Conclusion: Huashi jiedu decoction is used to treat the patients with CIN high risk HPV infection after LEEP operation, and the level of IL-10 is lower than that of the control group (P 0.01). It can improve the clinical therapeutic effect of patients, promote the negative conversion of hr-HPV, reduce the viral load, decrease the positive expression of Survivin and Ki67, and regulate the balance of Th1/Th2, so as to control the transition of CIN to cervical cancer and improve its prognosis.
【作者單位】： 河南大學(xué)淮河醫(yī)院;
【基金】：河南省高等學(xué)校重點(diǎn)科研計(jì)劃項(xiàng)目(17A320023)
【分類(lèi)號(hào)】：R737.33

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 高慰;;化濕解毒湯治療扁平疣療效觀察——48例報(bào)告及26例對(duì)照[J];天津中醫(yī);1989年01期

2 安福寧;朱連科;何秀文;張洪品;;化濕解毒湯灌腸治療輪狀病毒性腸炎臨床觀察[J];中國(guó)中醫(yī)急癥;2010年12期

3 鄧朝綱;化濕解毒湯治愈陰囊濕疹98例[J];貴陽(yáng)中醫(yī)學(xué)院學(xué)報(bào);1989年04期

4 高慰;自擬化濕解毒湯治療48例扁平疣療效觀察[J];上海中醫(yī)藥雜志;1989年08期

5 郭朝廣;化濕解毒湯加減治療乙型肝炎病毒相關(guān)性腎炎27例小結(jié)[J];中國(guó)鄉(xiāng)村醫(yī)藥;1996年03期

6 鄧朝綱;;化濕解毒湯治療陰囊濕疹[J];天津中醫(yī);1985年04期

7 高慰;自擬化濕解毒湯治療扁平疣48例[J];安徽中醫(yī)臨床雜志;1999年05期

8 史斌;化濕解毒湯治療尖銳濕疣150例[J];實(shí)用中醫(yī)藥雜志;2002年04期

9 鄧朝綱;;化濕解毒湯治愈陰囊濕疹98例[J];新疆中醫(yī)藥;1990年01期

10 方顯明;;清暑化濕解毒湯治療鉤端螺旋體病[J];廣西中醫(yī)藥;1992年01期

，

本文編號(hào)：1611728