疏肝健脾解毒汤联合穴位贴敷治疗慢性宫颈炎合并HPV感染的疗效及对免疫功能的影响

Efficacy of Shugan Jianpi Jiedu Decoction Combined with Acupoint Application onChronic Cervicitis Complicated with HPV Infection and Its Influence on Immune Function

目的探讨疏肝健脾解毒汤联合穴位贴敷治疗慢性宫颈炎合并人乳头瘤病毒(Human papillomavirus,HPV)感染的疗效及对免疫功能的影响。方法选取2020年5月—2021年12月期间江苏省中医院妇科诊治的慢性宫颈炎合并HPV感染者80例,按随机数字表法分为观察组与对照组,每组各40例。两组均给予重组人干扰素α2b栓治疗,观察组在此基础上给予疏肝健脾解毒汤联合穴位贴敷治疗。治疗后观察比较两组患者临床疗效、HPV转阴率、不良反应及复发情况,治疗前后中医临床证候、西医体征评分及差值,检测HPV-DNA病毒载量、免疫球蛋白(IgA、IgG、IgM)、肿瘤坏死因子α(TNF-α)、白介素(IL-1β、IL-2和IL-10)水平。结果治疗1疗程后两组患者HPV-DNA病毒载量均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组HPV-DNA病毒载量较对照组明显降低,HPV转阴率较对照组明显升高,差异有统计学意义(P<0.05)。治疗后观察组总有效率97.50%(39/40)明显高于对照组82.50%(33/40),差异有统计学意义(χ^(2)=10.889,P=0.001)。治疗1疗程后两组患者中医证候、西医临床体征评分均较治疗前明显降低,差值均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组中医证候、西医临床体征评分均较对照组明显降低,差值较对照组明显升高,差异有统计学意义(P<0.05)。治疗1疗程后观察组患者IgA、IgG及IgM指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05)。治疗1疗程后两组患者血清TNF-α、IL-1β、IL-2及IL-10水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组血清各项水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者均无不良反应发生。随访期间观察组宫颈炎复发率2.63%明显低于对照组16.13%,差异有统计学意义(P<0.05)。结论疏肝健脾解毒汤联合穴位贴敷治疗慢性宫颈炎合并HPV感染具有良好疗效,能够明显改善临床症状及体征,保护免疫功能,抑制炎症反应,降低复发率。

Objective To investigate the efficacy of Shugan Jianpi Jiedu Decoction combined with acupoint application on chronic cervicitis with human papillomavirus(HPV)infection and the influence on immune function.Methods A total of 80 cases of chronic cervicitis with HPV infection who were treated in Department of Gynecology,Jiangsu Province Hospital of Chinese Medicine from May 2020 to December 2021 were enrolled and randomized into the observation group(n=40)and control group(n=40)with the random number table method.The control group received recombinant human interferonα-2b suppository,and the observation group Shugan Jianpi Jiedu Decoction,acupoint application,and recombinant human interferonα-2b suppository.The clinical efficacy,test result of HPV,occurrence of adverse reactions,and recurrence rate were compared between the two groups.The traditional Chinese medicine(TCM)syndrome score,and western medicine sign score and the difference,HPV-DNA load,and the levels of immunoglobulins(IgA,IgG,IgM),tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-2,and IL-10 were detected before and after treatment.Results After one course of treatment,the HPV-DNA load was lower than that before treatment in both groups(P<0.05).In addition the load was lower in the observation group than in the control group and the proportion of HPV-negative cases was larger in the observation group than in the control group(P<0.05).The total effective rate was 97.50%(39/40)in the observation,as compared with the 82.50%(33/40)in the control group(χ^(2)=10.889,P=0.001).After treatment,the TCM syndrome score and western medicine sign score were decreased and the difference was increased in the two groups as compared with those before treatment(P<0.05).The TCM syndrome score and western medicine sign score were lower and the difference was higher in the observation group than in the control group(P<0.05).After treatment,the levels of IgA,IgG,and IgM in the observation group were higher than those before treatment(P<0.05)and those in the control group(P<0.05),and the serum levels of TNF-α,IL-1β,IL-2,and IL-10 were lower than those before treatment in the two groups(P<0.05),and lower in the observation group than in the control group(P<0.05).No adverse reaction occurred in either group.During the follow-up,the recurrence rate of cervicitis in the observation group was lower than that in the control group(2.63%vs.16.13%,P<0.05).Conclusion The combination of Shugan Jianpi Jiedu Decoctionand acupoint application is effective for the treatment of chronic cervicitis complicated with HPV infection.It can significantly alleviate clinical symptoms and signs,protect immune function,inhibit inflammation,and reduce recurrence rate.