加味二妙颗粒治疗宫颈人乳头瘤病毒感染效果的影响因素研究

Study on the factors influencing the effectiveness of Jiawei Ermiao granules in the treatment of cervical human papilloma virus infection

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摘要目的:探究加味二妙颗粒治疗宫颈人乳头瘤病毒(HPV)感染效果的影响因素。方法:采用回顾性研究的方法,收集使用加味二妙颗粒治疗宫颈HPV感染患者的临床资料,根据用药后HPV转阴情况分为转阴组及未转阴组,比较两组的临床资料,采用Logistic回归分析确定影响宫颈HPV感染患者加味二妙颗粒疗效的影响因素,采用COX回归分析影响HPV转阴时间的影响因素。结果:共纳入研究病例316例,其中转阴222例,未转阴94例,加味二妙颗粒治疗总转阴率为70.25%;对HPV单一分型转阴率进行分析发现加味二妙颗粒HPV对13种高危型HPV均有较高的转阴率,其中HPV68、HPV51、HPV39、HPV18转阴率分别高达90.48%、91.67%、89.29%、89.66%;多因素Logistic回归分析显示用药疗程分级(P=0.04)、是否感染高危型HPV(P=0.02,95%CI:0.04~0.74)可影响最终临床疗效。多因素COX回归显示是否合并其余治疗(HR=0.59,95%CI:0.43~0.80)可影响6个月转阴时间。在排除混杂因素后,Kaplan-Meier生存曲线分析显示合并其余治疗的6个月HPV转阴率低于非合并治疗组,根据Log Rank比较两者差异具有统计学意义(P<0.001)。结论:加味二妙颗粒对子宫颈人乳头瘤病毒感染的HPV转阴效果显著,在处方治疗剂量下安全性良好,病程、感染型别是否为高危型是加味二妙颗粒疗效的影响因素,是否合并其余治疗可影响6个月转阴时间。 Objective:To investigate the influencing factors of the therapeutic effect of Jiawei Ermiao granules on cervical human papillomavirus(HPV)infection.Methods:A retrospective study was conducted to collect the clinical data from patients with cervical HPV infection who fulfilled the criteria for acceptance and discharge standards,and the patients were classified into two groups based on HPV conversion status:A conversion group and a non-conversion group according to the HPV conversion status after the administration of the drug,and the clinical data of these two groups were compared,and the factors that influenced the efficacy of Jiawei Ermiao granules in patients with cervical HPV infection were determined by logistic regression analysis.Logistic regression analysis was used to determine the factors affecting the efficacy of Jiawei Ermiao granules in patients with cervical HPV infection,and COX regression analysis was used to analyse the factors affecting the time of HPV conversion.Results:A total of 316 cases were included in the study,with 222 cases showing conversion and 94 cases were not showing conversion,and the total conversion rate of Jiawei Ermiao granules treatment was 70.25%.Analysis of the conversion rate of HPV single subtypes found that Jiawei Ermiao granules had a high conversion rate of 13 kinds of high-risk types of HPV,with HPV68,HPV51,HPV39,and HPV18 showing conversion rates as high as90.48%,91.67%,89.29%,and 89.66%,respectively.Multifactoriate logistic regression analysis showed that the grading of the medication course(P=0.04)and whether infected with high-risk types of HPV(P=0.02,95%CI:0.04~0.74)could affect the final clinical efficacy.Multifactoriate COX regression analysis showed that the combination with other treatments(HR=0.59,95%CI:0.43~0.80)could influence the time to 6-month conversion.After excluding confounding factors,Kaplan-Meier survival curve analysis showed that the 6-month HPV conversion rate was lower in the combined with the rest of treatment than in the non-combined group,and the difference between the two was statistically significant according to Log Rank comparison(P<0.001).Conclusion:Jiawei Ermiao granules are significantly effective in promoting HPV conversion in cervical human papilloma virus infection,with a good safety profile at the prescribed therapeutic dose.The duration of the disease and whether the type of infection is high-risk or not are factors influencing the efficacy of Jiawei Ermiao granules,and whether or not to combine with the rest of the treatments can affect the time to conversion at 6 months.

作者洪丹丹王汝钥李秀马桦韩月郭红玉胡杨嘉怡徐雯雯马蔚蓉孙睿范欢欢陈婕谈静张凯莉张娜娜刘歆玥司雨任青玲 HONG Dandan;WANG Ruyue;LI Xiu;MA Hua;HAN Yue;GUO Hongyu;HU Yangjiayi;XU Wenwen;MA Weirong;SUN Rui;FAN Huanhuan;CHEN Jie;TAN Jing;ZHANG Kaili;ZHANG Nana;LIU Xinyue;SI Yu;REN Qingling(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China;Maternity and Reproductive Clinical Medicine Innovation Centre of Jiangsu Provincial Hospital of Chinese Medicine,Nanjing 210029,China;Beijing Du Heng Zhi Dao Medicine Technology Co.Ltd,Beijing 100024,China;Jiangsu Rongyu Pharmaceutical Co.Ltd.,Nanjing 210033,China)

机构地区南京中医药大学附属医院江苏省中医妇产生殖临床医学创新中心北京度衡之道医药科技有限公司南京融昱医药产业有限公司

出处《陕西中医》 2025年第9期1178-1183,共6页 Shaanxi Journal of Traditional Chinese Medicine

基金国家自然科学基金资助项目(82074478) 国家中医药管理局中医药循证能力提升项目(K2023BZ01) 江苏省中医药管理局中医临床医学创新中心研究项目(ZX202102) 江苏省中医药领军人才培养项目(SLJ0307) 江苏省中医院院级课题(2024QB010)。

关键词人乳头瘤病毒病程感染型别加味二妙颗粒宫颈癌高危型转阴率 Human papillomavirus Course of illness Infection type Jiawei Ermiao granules Cervical cancer High-risk type Negative conversion rate

分类号 R711.31 [医药卫生—妇产科学]