妇科排毒汤联合西药治疗慢性宫颈炎合并HPV感染的疗效及对病毒载量的影响

Efficacy of Fuke Paidu Decoction Combined With Western Medicine in the Treatment of Chronic Cervicitis Complicated With HPV Infection and Influence on Viral Load

目的探讨妇科排毒汤联合常规西药治疗慢性宫颈炎合并人乳头瘤病毒(Human papillomavirus,HPV)感染的疗效,及对病毒载量、复阳率的影响。方法将104例慢性宫颈炎合并HPV感染患者,按随机数字表法分为观察组和对照组,每组52例。对照组给予重组人干扰素α2b栓治疗,隔日1次,观察组在对照组基础上给予妇科排毒汤治疗,每日1剂。连续治疗3个月经周期。观察两组患者临床疗效。比较治疗前后两组患者临床体征评分、血清炎性因子及宫颈免疫细胞水平、HPV转变情况,并统计两组患者治疗期间不良反应情况。结果治疗后,观察组总有效率高于对照组,差异有统计学意义(P<0.05);两组患者阴道分泌物异常、宫颈炎症面积、宫颈炎症深度及总分评分均低于治疗前,且观察组均低与对照组,差异有统计学意义(P<0.05);两组患者血清白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平均低于治疗前,白细胞介素-10(Interleukin-10,IL-10)水平高于治疗前,且观察组血清IL-6、TNF-α水平均低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05);两组患者宫颈分泌物CD4+、CD4+/CD8+水平均高于治疗前,CD8+水平低于治疗前,且观察组CD4+、CD4+/CD8+水平高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者HPV病毒载量均低于治疗前,且观察组低于对照组,观察组转阴率高于对照组,差异有统计学意义(P<0.05)。9个月后复查,观察组复阳率低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应情况比较,差异无统计学意义(P>0.05)。结论妇科排毒汤可显著提高对慢性宫颈炎合并HPV感染的临床疗效,改善患者症状体征,减轻炎症反应,降低病毒载量,促进转阴,并可通过提高免疫能力减少复发。

Objective To explore the effect of Fuke Paidu Decoction combined with conventional western medicine in the treatment of chronic cervicitis combined with human papillomavirus(HPV)infection,and its influence on viral load and recovery rate.Methods A total of 104 patients with chronic cervicitis and HPV infection who were divided into observation group and control group according to the random number table method,with 52 cases in each group.The control group was treated with recombinant human interferonα2b suppository,once every other day,and the observation group was treated with Fuke Paidu Decoction on the basis of the control group,once a day.Treatment is continued for 3 menstrual cycles.After treatment,the clinical efficacy of the two groups of patients was compared.Before and after treatment,the clinical signs scores,serum inflammatory factors and immune cell levels,and HPV conversion of the two groups of patients were compared.Adverse reactions during treatment are counted.Results After treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05);after treatment,the abnormal vaginal discharge,cervical inflammation area,cervical inflammation depth and total score of the two groups were lower than those before treatment.Both groups were lower than those of the control group(P<0.05);after treatment,the levels of serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were lower than those before treatment.Interleukin-10(IL-10)level was higher than before treatment,and the serum IL-6 and TNF-αlevels of the observation group were lower than those of the control group,and the IL-10 level was higher than that of the control group(P<0.05);after treatment,the two groups the cervical secretion CD4+and CD4+/CD8+levels of the patients were higher than before treatment,and the CD8+level was lower than before treatment,and the CD4+and CD4+/CD8+levels in the observation group were higher than those in the control group(P<0.05).After treatment,the HPV viral load of the two groups of patients was lower than before treatment,and the observation group was lower than the control group,and the negative conversion rate of the observation group was higher than that of the control group(P<0.05).After 9 months,the re-yang rate of observation group was lower than that of control group(P<0.05).During the treatment period,there was no significant difference in adverse reactions between the two groups of patients(P>0.05).Conclusion Fuke Paidu Decoction can significantly improve the clinical efficacy of chronic cervicitis combined with HPV infection,improve the symptoms and signs of patients,reduce inflammation,reduce viral load,promote negative conversion,and reduce recurrence by improving immunity,and has high safety,which is worthy of clinical promotion.