加味蜀羊泉散治疗高危型人乳头瘤病毒持续感染合并低级别宫颈上皮内瘤变疗效及对TLR4、NF-κB表达的影响

Efficacy of Modified Shuyangquan Powder in the treatment of persistent infection of HR-HPV complicated with CIN I and its infuence on TLR4 and NF-κB expression

目的:观察加味蜀羊泉散治疗高危型人乳头瘤病毒(HR-HPV)持续感染合并低级别宫颈上皮内瘤变(CINⅠ)的疗效,并探讨对TLR4、NF-κB的表达影响。方法:将120例患者随机分为对照组和治疗组,每组60例。对照组予重组人干扰素α2b阴道泡腾胶囊阴道给药,治疗组在对照组基础上予加味蜀羊泉散内服,比较两组的中医证候积分、HR-HPV转阴率、CINⅠ逆转率、总有效率、HR-HPV复发率及宫颈组织中TLR4、NF-κB的表达。结果:两组治疗后中医证候积分及TLR4、NF-κB阳性率均较治疗前显著降低(P<0.05),且治疗组显著低于对照组(P<0.05)。治疗组HR-HPV转阴率、CINⅠ逆转率显著高于对照组(P<0.05),HR-HPV感染复发率显著低于对照组(P<0.05)。治疗组总有效率为73.33%(44/60),显著高于对照组的50.00%(30/60,P<0.05)。结论:加味蜀羊泉散可有效改善患者临床症状,清除HR-HPV持续感染并降低其复发率,有效阻断宫颈病变的进展,其机制可能与下调TLR4、NF-κB表达,调节免疫功能有关。

Objective:To observe the therapeutic effect of Modified Shuyangquan Powder on persistent infection of high-risk human papilloma virus(HR-HPV)complicated with low level of cervical intraepithelial neoplasia(CIN I),and to explore the regulatory mechanism of Toll-like receptor-4(TLR4)and nuclear factor-xB(NF-kB).Methods:A total of 120 patients were randomly divided into control group(60 cases)and treatment group(60 cases),the control group was given interferon vaginally,and the treatment group was given Modified Shuyangquan Powder orally on the basis of the control group,the traditional Chinese medicine(TCM)syndrome score,HR-HPV negative conversion rate,CIN I reversal rate,total effective rate,HR-HPV recurrence rate,and the expression of TLR4 and NF-κB in cervical tissue of the two groups were analyzed.Results:The TCM syndrome score and the positive rates of TLR4 and NF-κB were significantly decreased in both groups after treatment than before treatment(P<0.05).The HR-HPV negative conversion rate and the CIN I reversal rate in the treatment group were significantly higher than those in the control group(P<0.05),the recurrence rate of HR-HPV infection was significantly lower than that of control group(P<0.05).The total effective rate of the treatment group was 73.33%(44/60),which was significantly better than that of the control group 50.00%(30/60)(P<0.05).Conclusion:Modified Shuyangquan Powder can effectively improve the clinical symptoms of persistent HR-HPV infection with CIN I,eliminate persistent HR-HPV infection and reduce its recurrence rate,and effectively block the progress of cervical lesions.Its mechanism may be related to down-regulating the expression of TLR4 and NF-κB and regulating immune function.