含砷复方中药对慢性官颈炎的治疗作用及其对HPV负荷量的影响

Therapeutic Effect of Herbal Compound Including Arsenic and Its Effect on Human Papilloma Virus Load in Patients with Chronic cervicitis

目的:观察含砷复方中药二黄散对慢性宫颈炎的临床疗效及对HPV负荷量的影响。方法:将161例患者按感染hrHPV的情况分为hrHPV阴性组133例,hrHPV阳性组28例,分别接受二黄散(由雄黄、黄连、白矾、冰片、铅粉组成)药物治疗,观察疗效并比较治疗前后HPV-DNA的变化。结果:停药后第3次月经中期检查,总有效105例(65.21%);第6次月经中期复查,总有效129例(80.12%),其中,Ⅰ、Ⅱ、Ⅲ度宫颈糜烂患者总有效率分别为91.07%、85.42%、64.91%,各程度比较,差异有非常显著性意义(P<0.01);而Ⅰ、Ⅱ、Ⅲ度治愈率分别为32.14%、27.08%、17.54%,各程度比较,差异有显著性意义(P<0.05)。28例感染hrHPV病毒的患者治疗后病毒负荷量明显下降,共11例转阴,治疗前后比较,差异有显著性意义(P<0.05)。治疗停药后第3次月经中期复查,有5例出现hrHPv DNA转阴(转阴率为17.86%);第6次月经中期复查,hrHPV DNA转阴6例,转阴率为26.09%,累积转阴11例,累积转阴率为39.29%。29例CINⅠ级患者停药后于第6次月经中期阴道镜下活检,结果转化为细胞化生7例、细胞增生5例、炎性病变7例,总缓解率为65.52%。结论:二黄散对慢性宫颈炎有治疗作用,且随用药后时间的延长作用更明显,其中病变程度越轻疗效越显著。二黄散对HPV感染有一定的清除能力,且能逆转CINⅠ级病变。

Objective:To observe the therapeutic effect of herbal compound including arsenic and its effect on human papilloma virus(HPV)load in patients with chronic cer- vicitis.Methods:One hundred and sixty-one patients with chronic cervicitis with hrHPV negative(n=133)or positive(n=28)received Erhuang Powder(mainly composed of Realgar,Rhizoma Coptidis,Alumen,Borneolum Syntheticum,etc.).The therapeutic ef- fect was evaluated after treatment,and the changes of HPV DNA content were compared before and after treatment.Results:One hundred and five patients(65.21%)were effec- tive at menstrual midterm of the third menstrual circle after suspension,and 129 (80.12%)were effective at menstrual midterm of the sixth menstrual circle after suspen- sion,The total effective rate was 92.85%,85.42% and 64.91% for patients with cervi- cal erosion at degreeⅠ,ⅡandⅢ(P<0.01)respectively,and the cure rate was 32.14%,27.08% and 17.54%(P<0.05)respectively.In 28 patients with hrHPV positive,hrHPV content was decreased,and hrHPV turned negative in 11(39.29%)pa- tients after treatment(P<0.05 compared with that before treatment),among which 5 (17.86%)turned negative at menstrual midterm of the third menstrual circle after suspen- sion and 6(26.09%)at menstrual midterm of the sixth menstrual circle after suspension. The results of biopsy under colposcope in 29 cases with cervical intraepithelial neoplasia (CIN)at menstrual midterm of the sixth menstrual circle after suspension showed:cell metaplasia was found in 7 patients,cell proliferation in 5,inflammatory lesion in 7,and the total relief rate was 65.52%.Conclusion:Erhuang Powder is effective for chronic cervicitis and the effect is in a time-dependant manner.Erhuang Powder has an effect on clearing HPV and counteracting grade I CIN.