三花解毒饮联合尤靖安治疗湿热下注型轻中度宫颈上皮内瘤变合并高危型人乳头瘤病毒持续感染临床研究

Clinical Study on Sanhua Jiedu Yin Combined with Youjing’an for Mild to Moderate Cervical Intraepithelial Neoplasia of Lower Energizer Dampness-Heat Type Complicated with Persistent Infection of High-Risk Human Papilloma Virus

目的:观察三花解毒饮联合尤靖安治疗轻中度宫颈上皮内瘤变(CINⅠ-Ⅱ)合并高危型人乳头瘤病毒(HR-HPV)持续感染湿热下注型患者的效果及对宫颈病理改变的影响。方法:选取84例CINⅠ-Ⅱ合并HR-HPV持续感染湿热下注型患者为研究对象,按随机数字表法分为对照组与观察组,各42例。对照组给予尤靖安治疗,观察组在对照组基础上用三花解毒饮治疗,对比2组临床疗效、HPV转阴率、宫颈组织病理改变、P16^(INK4a)阳性表达率及治疗前后中医证候积分、HPV病毒载量。结果:与同组治疗前比较,治疗后2组各项中医证候积分、HPV病毒载量均降低(P<0.05);与对照组治疗后比较,观察组各项中医证候积分、HPV病毒载量均较低(P<0.05)。治疗后,观察组清除HPV总有效率、宫颈组织病理总有效率及HPV转阴率均高于对照组(P<0.05),P16^(INK4a)阳性表达率低于对照组(P<0.05)。结论:三花解毒饮联合尤靖安能显著抑制HR-HPV生长,减轻HR-HPV持续感染,降低HPV病毒载量,提高HPV清除效果及转阴效果,逆转CIN进展,改善宫颈组织病理结果,利于患者预后。

Objective:To observe the curative effect of Sanhua Jiedu yin combined with Youjing’an on patients of lower energizer dampness-heat type with mild to moderate cervical intraepithelial neoplasia(CINⅠ-Ⅱ)complicated with persistent infection of high-risk human papilloma virus(HR-HPV),and its effect on pathological changes of cervix.Methods:A total of84 cases of patients who had CINⅠ-Ⅱ complicated with persistent HR-HPV infection of lower energizer dampness-heat type were selected as the study subjects,and divided into the control group and the observation group according to the random number table method,42 cases in each group.The control group was treated with Youjing’an,and the observation group was treated with Sanhua Jiedu yin and Youjing’an.The clinical effect,the negative rate of HPV,pathological changes of cervix and the positive expression rate of P16^(INK4) awere compared between the two groups.Before and after treatment,Chinese medicine syndrome score and HPV viral load were compared between the two groups.Results:When compared with those before treatment in the same group,Chinese medicine syndrome scores and HPV viral load after treatment in the two groups were decreased(P<0.05).When compared with those after treatment in the control group,Chinese medicine syndrome scores and HPV viral load in the observation group were lower(P<0.05).After treatment,the total effective rate of HPV clearance,the total effective rate of pathological changes of cervix,and the negative rate of HPV in the observation group were higher than those in the control group(P<0.05),and the positive expression rate of P16^(INK4) awas lower(P<0.05).Conclusion:The therapy of Sanhua Jiedu yin combined with Youjing’an can significantly inhibit HR-HPV growth,relieve persistent HR-HPV infection,lighten HPV viral load,enhance the clearance effect and negative rate of HPV,revert the development of CIN,improve pathological changes of cervix,and conduce to prognosis.