中药二黄散对伴有HPV感染的CINⅠ患者宫颈局部微环境的影响

Study on the Improvement of cervical microenvironment and Curative of Er Huang San Therapy on CINⅠ accompanied by human papilloma virurus infection

目的研究中药二黄散对伴有HPV感染的CINⅠ患者对宫颈局部免疫状态的影响及治疗效果。方法选取伴有HPV感染的CINⅠ患者100例,将其随机分为二黄治疗组(50例)和对照组1(不作任何治疗,50例),同期50例正常妇女为对照组2。观察不同时间宫颈病变及HPV转归情况,并应用酶联免疫吸附试验测定不同时间的阴道灌洗液辅助性T淋巴细胞(Th细胞)1、2细胞因子水平,其中Thl细胞因子以白细胞介素(IL)2、IFN-γ表示,Th2细胞因子以IL-4、10表示,并结合临床资料进行分析。结果治疗组CINⅠ及HPV不同时间转归率明显高于与对照组1,比较差异均有统计学意义(P<0.05,P<0.01),治疗组患者治疗后IL-2水平均有不同程度升高,与治疗前及对照组1比较,差异均无统计学意义(P>0.05);治疗组患者治疗后IL-4、IL-10水平均无明显变化,与治疗前及对照组1比较,差异也均无统计学意义(P>0.05)。治疗组患者治疗后IFN-γ水平均明显升高,与治疗前及对照组1比较,差异有统计学意义(P<0.01)。结论中药二黄散对伴有HPV感染的CINⅠ患者有较好的治疗作用,其治疗机制可能为:通过调节Th1/Th2的免疫平衡清除HPV病毒,且通过调节Th1细胞因子IFN-γ在宫颈病变发展过程中的作用较IL-2可能更为重要。

Objective To investigate the improvement of cervical microen vironment and Curative of Er HuangSan Therapy on CINⅠ accompanied by human papillomavirurus（HPV） infection. Methods A total of 100 cases with CINⅠ accompanied by HPV infection were entered in the randomized group study, Er HuangSan therapy group and observed group （ no any therapy, control group 1 ）, healthy women as control group 2. Each group included 50 cases. Evaluate the outcome of them. Vaginal lavage was col- lected from healthy women and patients of two groups. The level of intedeukin （IL）2,4,10 and interferon -3,（ IFN -γ）were detec- ted by enzyme linked immunosorbent assay（ELISA）. Results The total effective rate of CINⅠ and HPV were 85.4% ,60.4% and 40.0% ,20.0%, at 3 m ,6 m and 9 m in therapy group that higher than those in control group with significant difference（ P 〈0.05, P 〈 0.01 ）. The level of IL - 2, IL - 4, IL - 10 between post - treatment, pre - treatment and control groupl had no significant difference （ P 〉 0.05 ）. the IFN -γ level of patients after therapy were significantly higher than that of pre - treatment and control groupl （P 〈 0.05）. Conclusion Er HuangSan can be used for treatment of CINⅠ accompanied by HPV infection effectively. It may regulate Thl/Th2 immune balance to clean up HPV. IFN - γ plays an important role in the defence of cervical epithelial cell. Th1 may be more important than Th2 in lower genital tract infections.