疣毒净制剂治疗宫颈HR-HPV感染患者的疗效观察

Therapeutic Efficacy of Youdujing Preparation in Treating Cervical High-risk Human Papilloma Virus Infection Patients

目的探讨疣毒净制剂治疗宫颈高危型人乳头瘤病毒(high-risk human papilloma virus,HR-HPV)感染的疗效及作用机制。方法采用随机单盲法将70例HR-HPV感染患者分为治疗组与对照组,每组35例。治疗组予疣毒净外洗液及点涂霜外用,对照组以生理盐水冲洗,治疗3个月经周期后第1次月经结束后行HR-HPVDNA检测,治疗前后作阴道镜引导活检+颈管搔刮,取宫颈病变部位新鲜组织检测人端粒酶逆转录酶(human telomerase reverse transcriptase,hTERT)mRNA表达。结果治疗组HR-HPV逆转总有效率(96.6%)高于对照组(70%,P<0.01)。两组治疗前宫颈病检结果及hTERTmRNA表达比较,差异无统计学意义(P>0.05);两组治疗后hTERTmRNA表达均降低,差异均有统计学意义(P<0.01),治疗组治疗后宫颈活检结果、hTERTmRNA表达优于对照组(P<0.05)。结论疣毒净制剂可能通过下调hTERTmRNA表达、降低端粒酶活性,从而达到清除HR-HPV感染、逆转宫颈癌前病变的作用。

Objective To study the clinical efficacy and mechanisms of Youdujing （YDJ） preparation in treating the cervical high-risk human papilloma virus （HR-HPV） infection. Methods Totally HR-HPV infection 70 patients were assigned to the treatment group and the control group using random single blind method, 35 cases in each group. YDJ external lotion and YDJ cream were applied to patients in the treatment group, while normal saline was applied for those in the control group. HR-HPV DNA detection was performed by the end of the 1st menstruation after 3 menstrual cycles. The cervical biopsy and cervical smear were performed using vaginoscope before and after treatment. The mRNA expression of human telomerase reverse transcriptase （hTERT） was de- tected from fresh tissues of the cervical lesion. Results The total effective rate was 96.6% in the treatment group, higher than that of the control group （70. 00%, P 〈0.01 ）. Before treatment there was no statistical differ- ence in the pathological results of the cervix and the mRNA expression of hTERT between the two groups （ P 〉 0.05）. The mRNA expression of hTERT decreased in the two groups after treatment, showing statistical differ- ence （P〈0.01）. Better effects on the pathological results of the cervix and the mRNA expression of hTERT were obtained in the treatment group after treatment （, P 〈0, 05）. Conclusion YDJ played a role in clearing HR- HPV infection and reversing the cervical precancerous changes possibly through down-regulating the mRNA ex- pression of hTERT and lowering the telomerase activation.