發(fā)布時(shí)間：2018-04-10 00:36

  本文選題：內(nèi)服外用中藥　切入點(diǎn)：帶下病　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)觀察內(nèi)服補(bǔ)肝腎清濕毒方及外用清熱解毒、化濕止癢方治療宮頸HR-HPV感染的臨床療效,來(lái)尋求能有效治療宮頸HR-HPV感染的中醫(yī)辨證思路及理法方藥。方法:選取符合本研究要求的肝腎虧虛兼濕熱毒邪內(nèi)蘊(yùn)型宮頸人乳頭瘤病毒感染患者31例,隨機(jī)將31例患者分為中藥組(15例)和干擾素組(16例)。根據(jù)導(dǎo)師臨床經(jīng)驗(yàn),將1個(gè)療程設(shè)定為1個(gè)月,持續(xù)治療3個(gè)月后評(píng)判療效。通過(guò)對(duì)比兩組患者治療前后臨床癥狀積分、中醫(yī)證候積分、HC-Ⅱ檢測(cè)等來(lái)評(píng)判治療的成效,并監(jiān)測(cè)宮頸HR-HPV感染伴或不伴宮頸病變(ASC-US、LSIL)患者在藥物干預(yù)前后宮頸局部細(xì)胞因子IL-2、IL-4、IFN-α的變化。結(jié)果:1.中藥組、干擾素組在治療后HPV DNA病毒載量較各自治療前的差異都無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。中藥組在降低HPV DNA病毒載量幅度上優(yōu)于干擾素組(302.65±448.39→66.46±131.48;410.34±709.01→210.41±478.93)。2.中藥組轉(zhuǎn)陰8例(53.33%),干擾素組轉(zhuǎn)陰5例(31.25%),兩組轉(zhuǎn)陰率相比無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),但中藥組轉(zhuǎn)陰率高于干擾素組。3.中藥組、干擾素組治療后的臨床癥狀積分較各自治療前都有明顯降低,且兩組變化都具有顯著統(tǒng)計(jì)學(xué)意義(P0.01;P0.01)。4.中藥組、干擾素組治療后的中醫(yī)證候積分較各自治療前都有明顯降低,且兩組變化都具有顯著統(tǒng)計(jì)學(xué)差異(P0.01;P0.01),中藥組在降低中醫(yī)證候積分明顯優(yōu)于干擾素組(P0.01)。5.中藥組與干擾素組總有效率分別為93.33%、81.25%,兩組總有效率相比無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),中藥組總有效率高于干擾素組。6.治療前宮頸HR-HPV感染伴或不伴宮頸病變(ASC-US、LSIL)患者陰道沖洗液中IL-4、IL-2、IFN-a濃度均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。但I(xiàn)L-4濃度與宮頸局部病變存在正的線性相關(guān)。7.在藥物干預(yù)前后陰道沖洗液中細(xì)胞因子IL-2/IL-4比值變化存在統(tǒng)計(jì)學(xué)差異(P=0.026,P0.05)。結(jié)論:1.內(nèi)服外用中藥在治療肝腎虧虛兼濕熱毒邪內(nèi)蘊(yùn)型宮頸HR-HPV感染療效確切,不僅能夠顯著降低HPVDNA滴度,還能明顯改善患者的臨床癥狀及中醫(yī)證候。因此內(nèi)服外用中藥值得運(yùn)用于以肝腎虧虛兼濕毒內(nèi)蘊(yùn)為證型的宮頸HR-HPV感染。2.IL-4濃度與宮頸病變程度存在正的線性相關(guān),可將IL-4作為檢測(cè)宮頸病變程度的一個(gè)新指標(biāo)加以研究。3.內(nèi)服外用中藥能夠使HPV感染宮頸局部免疫從失衡狀態(tài)向平衡狀態(tài)轉(zhuǎn)變。
[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，

本文編號(hào)：1728907