自制补清方方剂“熏洗Ⅰ号”对Ⅰa～Ⅱb期子宫颈癌合并HR-HPV感染放疗后的临床干预研究

The Study of Intervention by "Xun Xi No.1" for Cervical Cancer of Ⅰa～Ⅱb Stage Infected by High-Risk HPV

目的探讨分析应用补清方中药干预和治疗HR-HPV感染在子宫颈癌放射治疗中的临床价值。方法应用木贼草、制秀附、薏苡仁、蛇舌草、虎杖和金钱草等研制了局部应用的补清方剂"薰洗Ⅰ号",对首次放疗的80例Ⅰa～Ⅱb子宫颈癌患者随机均分至试验组和对照组。试验组常规放疗加用中药"薰洗Ⅰ号"局部治疗干预,对照组单纯常规放疗。运用原位杂交技术检测两组患者治疗前后HPV16/18型的表达水平,并观察两组患者肿瘤无病生存率和盆腔淋巴结转移率变化。结果试验组HPV阳性率由67.5%降低到37.5%,P<0.05;对照组由72.5%降低到65.0%,P>0.05。3年无瘤生存率单纯例数显示试验组优于对照组6例,但无统计学差异。5年无瘤生存率试验组65.0%,对照组42.5%;盆腔淋巴结转移率试验组为7.5%,对照组为25.0%,P<0.05,二者均有显著性差异。结论在早期子宫颈癌放疗中配合使用补清方中药"薰洗Ⅰ号"HPV阳性率明显降低,肿瘤5年无瘤生存率优于单纯放疗组,且盆腔淋巴结转移率较低。另外,中药"薰洗Ⅰ号"具备"廉、简、便、验",无明显毒副作用的优点。若放疗加中药二者协同使用对早期子宫颈癌的治疗,具有较高的临床使用价值和推广前景。

Objective To detect the cervical high-risk HPV（16/18 type） by in situ hybridization. And to explore the clinical value of traditional Chinese medicine for HPV infection in radiation treatment of cervical cancer. Method Group 80 cases of the patients with cervical cancer of Ⅰa～Ⅱb stage into trail group and control group. Give radiation treatment and ＂Xun Xi No.1＂ to trail group, and just radiation treatment to control group. Detect the HPV expression by ISH and observe the disease-free survival rate and pelvic lymph node metastasis. Results In trail group the positive rate of HPV changed from 67.5% to 37.5%, and the difference was statistically significant. In control group the rate changed from 72.5% to 65.0%, and the difference was not statistically significant The cases of three-year disease-free of trail group more than control group, but the difference was not significant. Five-year disease-free survival rate and pelvic lymph node metastasis in trail group was 65.0%, and the control group was 42.5%,and pelvic lymph node metastasis in trail group was 7.5%, and 25.0% in control group. There was a significant difference in two groups. Conclusion In early radiation treatment of cervical cancer, giving ＂Xun Xi No. 1＂ can reduce the HPV positive rate obviously, improve the five-year disease-free survival rate, and lower pelvic lymph node metastasis. ＂Xun Xi No.1＂ was cheaply-priced, simple, convenient, objective and without toxic side effect. It showed a high clinical value in improving radiation treatment and traditional Chinese medicine to use them synergistically.