五味消毒饮联合西药治疗慢性宫颈炎合并高危型人乳头瘤病毒感染临床研究
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R711.32

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Clinical Study on Wuwei Xiaodu Decoction Combined with Western Medicine for Chronic Cervicitis Complicated with High-risk Human Papillomavirus Infection
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    摘要:

    目的:观察五味消毒饮联合西药治疗慢性宫颈炎合并高危型人乳头瘤病毒(HR-HPV) 感染的疗效及安全性。方法:将86例慢性宫颈炎合并HR-HPV感染(脾虚湿毒蕴结型) 患者作为研究对象,随机分为观察组和对照组各43例。2组均以重组人干扰素α2b凝胶治疗,观察组加用五味消毒饮加减方治疗。2组均连续治疗7 d。治疗前后评定中医证候积分,检测T淋巴细胞亚群、免疫球蛋白及炎症因子[肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)] 水平,对比2组治疗后的临床疗效、HR-HPV转阴率和随访6、12个月的感染复发率。结果:治疗后,观察组总有效率95.35%,对照组总有效率72.09%,2组比较,差异有统计学意义(P<0.05)。2组带下情况、外阴瘙痒或痛、小腹胀痛、舌红苔黄腻及脉滑数评分均较治疗前下降,观察组5项评分均低于对照组,差异均有统计学意义(P<0.05)。2组T淋巴细胞亚群指标均较治疗前有所改善,观察组CD3+、CD4+、CD8+、CD4+/CD8+值均高于对照组,差异均有统计学意义(P<0.05)。2组IgG、IgM、IgA水平均较治疗前上升,观察组3项指标值均高于对照组,差异均有统计学意义(P<0.05)。2组炎症因子TNF-α、IL-6、hs-CRP水平均较治疗前下降,观察组3项指标值均低于对照组,差异均有统计学意义(P<0.05)。观察组HR-HPV 转阴率高于对照组(P<0.01),随访6 个月和12 个月的感染复发率均低于对照组,差异均有统计学意义(P<0.05)。结论:五味消毒饮加减联合重组人干扰素α2b凝胶治疗慢性宫颈炎合并HR-HPV 感染患者,可有效改善临床症状,提高免疫功能,增强抗感染力,减轻炎症反应,有利于预后。

    Abstract:

    Abstract: Objective: To observe the clinical effect and safety of Wuwei Xiaodu decoction combined with western medicine for chronic cervicitis complicated with high- risk human papillomavirus(HR- HPV) infection. Methods:Selected 86 cases of patients with chronic cervicitis complicated with HR- HPV infection(dampness- toxin accumulation due to spleen deficiency type) as study objects,and divided them into the observation group and the control group randomly,43 cases in each group. Both groups received recombinant human interferonα2b gel, while the observation group additionally received modified Wuwei Xiaodu. The course of treatment lasted continuously for 7 days. Before and after treatment, evaluated Chinese medicine syndrome scores,and detected the levels of T- lymphocyte subsets,immunoglobulin and inflammatory factors[tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)];compared the clinical effect and the negative conversion rate of HR-HPV after treatment,and the recurrence rate of infection after 6 and 12 months of follow- ups in the two groups. Results:After treatment,the total effective rate was 95.35% in the observation group and 72.09% in the control group, difference being significant(P<0.05). The scores of leukorrhea, pruritus vulvae or vulvodynia, abdominal distending pain, red tongue with yellowish greasy fur and slippery pulse in both groups were respectively lower than those before treatment,and the five scores above in the observation group were respectively lower than those in the control group,differences being significant(P<0.05). The indexes of T-lymphocyte subsets in both groups were improved when compared with those before treatment,and the values of CD3+,CD4+,CD8+ and CD4+/CD8+ in the observation group were respectively higher than those in the control group,differences being significant(P<0.05). The levels of IgG,IgM,and IgA in both groups were increased when compared with those before treatment,and the three indexes above in the observation group were respectively higher than those in the control group, differences being significant(P<0.05). The levels of inflammatory factors including TNF- α, IL- 6, and hs- CRP in both groups were decreased when compared with those before treatment,and the three indexes in the observation group were respectively lower than those in the control group,differences being significant(P<0.05). The negative conversion rate of HR-HPV in the observation group was higher than that in the control group(P<0.01),and the recurrence rates of infection after 6 and 12 months of follow-ups were lower than those in the control group,differences being significant(P<0.05). Conclusion:The application of modified Wuwei Xiaodu decoction combined with recombinant human interferon α2b gel has good effect in treating patients with chronic cervicitis complicated with HR- HPV infection,which can effectively improve clinical symptoms,enhance immune funcsstion and anti-infective ability,and alleviate inflammatory response,thus being beneficial for prognosis.

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王亚萍,陈珍.五味消毒饮联合西药治疗慢性宫颈炎合并高危型人乳头瘤病毒感染临床研究[J].新中医,2020,52(12):20-24

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  • 在线发布日期: 2020-06-15
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