外用红色诺卡氏菌细胞壁骨架治疗子宫颈锥切术后高危型HPV持续感染的临床疗效分析

Clinical Efficacy Analysis of Red Nocardia Rubra Cell Wall Skeleton in the Treatment of Persistent High-Risk HPV Infection after Cervical Conization

目的:探讨外用红色诺卡氏菌细胞壁骨架(Nr-CWS)治疗子宫颈锥切术后高危型人乳头瘤病毒(HR-HPV)持续感染的临床疗效。方法:选择2019年1月至2021年1月因HR-HPV感染引起子宫颈高级别上皮内病变(HSIL),于青岛大学附属青岛妇女儿童医院行子宫颈冷刀锥切术,术后6个月复查HR-HPV持续感染的69例患者为研究对象,并随机分为治疗组(Nr-CWS治疗1个疗程,36例)和对照组(仅观察,33例)。统计患者治疗有效率、阴道微生态变化及副反应发生的情况。结果:①69例患者中,治疗组治疗有效率(80.56%)明显高于对照组(39.39%),差异有统计学意义(P<0.05)。②治疗组乳杆菌患者的比率较对照组增加明显(77.78%vs.45.45%,P<0.05);治疗组pH值≥4.6、白细胞酯酶(LE)阳性患者的比率较对照组及治疗前均有明显降低,差异有统计学意义(P<0.05)。③治疗组36例患者中发热5例,下腹坠胀感5例,腹泻1例,皮疹1例。结论:Nr-CWS治疗子宫颈锥切术后持续HR-HPV感染疗效较好,阴道微生态环境指标(乳杆菌、LE、pH值≥4.6)改善明显,且无严重副反应发生,但仍需从卫生经济学角度出发,根据患者情况综合考虑。

Objective:To investigate the clinical efficacy of external application of red nocardia rubra cell wall skeleton(Nr-CWS)in the treatment of persistent infection of high-risk human papilloma virus(HR-HPV)after cervical conization.Methods:The patients with high-grade cervical intraepithelial lesion(HSIL)caused by HR-HPV infection who underwent cervical cold knife conization at the Qingdao Women′s and Children′s Hospital Affiliated to Qingdao University between January 2019 and January 2021 were selected.69 patients with persistent HR-HPV infection were randomly divided into treatment group(n=36)and control group(n=33).The effective rate of treatment,the change of vaginal microecology and the occurrence of adverse reactions were analyzed.Results:①Among the 69 patients,the effective rate of treatment in the treatment group(80.56%)was significantly higher than that in the control group(39.39%)(P<0.05).②The rate of Lactobacillus in the treatment group was significantly higher than that in the control group(77.78%vs.45.45%,P<0.05).The percentage of patients with pH≥4.6 and positive leukocyte esterase(LE)in the treatment group was significantly lower than that in the control group and before treatment(P<0.05).③In the treatment group,there were 5 cases of fever,5 cases of abdominal heaving,1 case of diarrhea and 1 case of skin rash.Conclusions:Nr-CWS has a better therapeutic effect on persistent HR-HPV infection after cervical conization,significant improvement in vaginal microenvironment indicators(lactobacillus,LE,pH≥4.6),and no serious adverse reactions.However,it still needs to be considered comprehensively from the perspective of health economics and based on the patient′s basic situation.