宫糜散联合LEEP治疗宫颈癌前病变的临床研究及其对高危型HPV的影响

Clinical Study of Gongmi San Combined with LEEP in the Treatment of Cervical Precancerous Lesions and its Effect on High-risk HPV

目的:观察宫糜散联合宫颈环形电切术(LEEP)对宫颈癌前病变(CINⅡ~Ⅲ)的临床效果及其对高危型人乳头状瘤病毒(HPV)的影响。方法:前瞻性选取泉州市中医院2019年8月至2022年3月期间收治的90例CINⅡ~Ⅲ患者,采用电脑随机数字表法分为3组,各30例。A组患者采用LEEP,B组患者采用LEEP+重组人干扰素α-2b,C组患者采用LEEP+宫糜散。比较各组患者治疗总有效率、HPV病毒载量、Ⅰ~Ⅳ级阴道清洁度。结果:C组患者治疗总有效率为93.33%,高于B组的80.00%和A组的66.67%,差异具有统计学意义(P <0.05)。治疗后C组患者的HPV病毒载量低于A组、B组,且治疗后B组患者的HPV病毒载量低于A组,差异具有统计学意义(P <0.05)。治疗后C组患者的Ⅰ~Ⅱ级阴道清洁度比例高于A组、B组,且治疗后B组患者的Ⅰ~Ⅱ级阴道清洁度比例高于A组,差异具有统计学意义(P <0.05)。治疗期间各组患者的不良反应发生率比较,差异无统计学意义(P> 0.05)。结论:宫糜散联合LEEP治疗CIN效果显著,可提高高危型HPV病毒清除率,改善阴道内环境,减轻临床症状。

Objective To observe the clinical effect of Gongmi San combined with loop electrosurgical excision procedure(LEEP) on cervical precancerous lesions(CIN Ⅱ ~ Ⅲ) and the effect of high-risk human papillomavirus(HPV). Methods A total of 90 patients with CIN Ⅱ ~ Ⅲ admitted to Quanzhou Hospital of Traditional Chinese Medicine from August 2019 to March 2022were prospectively selected and divided into three groups by computer random number table method, with 30 cases in each group.Patients in group A received LEEP, patients in group B received LEEP plus recombinant human interferon α-2b, and patients in group C received LEEP plus Gongmi San. The total effective rate, HPV viral load and grade I-Ⅳ vaginal cleanliness were compared in each group. Results The total effective rate of group C was 93.33%, higher than 80.00% of group B and 66.67% of group A, and the differences were statistically significant(P < 0.05). After treatment, the HPV viral load of the group C was lower than that of the group A and group B, and the HPV viral load of the group B was lower than that of the group A, and the differences were statistically significant(P < 0.05). After treatment, the proportion of grade Ⅰ-Ⅱ vaginal cleanliness in the group C was higher than that in the groups A and B, and the proportion of grade Ⅰ-Ⅱ vaginal cleanliness in the group B was higher than that in the group A, and the differences were statistically significant(P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups during treatment(P > 0.05). Conclusion Gongmi San combined with LEEP has a significant effect on CIN,which can improve the clearance rate of high-risk HPV virus, improve the vaginal environment and reduce clinical symptoms.