摘要
目的:观察儿黄栓治疗高危型人乳头瘤病毒(HR-HPV)感染的疗效,并探讨其对阴道微生态和相关因子表达的影响。方法:将92例患者随机分为观察组和对照组,每组46例。对照组予重组人干扰素α-2b凝胶阴道给药,观察组予儿黄栓阴道给药,比较两组患者的中医证候积分、HR-HPV疗效、HR-HPV DNA平均病毒载量、液基薄层细胞学检查(TCT)情况、阴道微生态改善情况及相关因子水平。结果:与本组治疗前比较,治疗后观察组2种高危型HR-HPV DNA病毒载量、菌群多样性异常、优势菌异常、过氧化氢异常、白细胞酯酶异常、pH异常、阴道微环境异常及肿瘤坏死因子-α(TNF-α)和核转录因子-κB(NF-κB)水平均明显下降,白细胞介素(IL)-12水平明显上升(P<0.05);治疗后对照组β-葡萄糖醛酸酶异常发生率明显减少(P<0.05);治疗后观察组及对照组中医证候总积分、12种高危型HR-HPV DNA平均病毒载量、2+12种高危型HR-HPV DNA平均病毒载量、IL-6、Toll样受体4(TLR4)、髓样分化因子88(MyD88)水平均明显下降(P<0.05)。与对照组治疗后比较,观察组中医证候总积分、2种高危型HR-HPV DNA平均病毒载量、TNF-α、IL-6、TLR4、MyD88、NF-κB水平明显降低(P<0.05),IL-12水平明显升高(P<0.05),治疗后观察组优势菌异常、过氧化氢异常、白细胞酯酶异常、pH异常及阴道微环境异常的改善情况均明显优于对照组(P<0.05)。与本组治疗前比较,观察组HR-HPV感染的总有效率为83.3%(35/42),对照组总有效率为74.4%(32/43);观察组TCT的总有效率为88.1%(37/42),对照组总有效率为88.3%(38/43),差异均无统计学意义。结论:儿黄栓在治疗HR-HPV感染和TCT方面和重组人干扰素α-2b凝胶具有相当的疗效,且在改善阴道微生态多项指标、减轻HR-HPV患者临床症状、降低2种高危型HR-HPV DNA平均病毒载量方面优于重组人干扰素α-2b凝胶,其机制可能与降低TNF-α、IL-6、TLR4、MyD88、NF-κB水平,升高IL-12水平有关。
Objective:To observe the efficacy of Erhuang suppository in treating high-risk human papillomavirus(HR-HPV)infection and investigate its effects on vaginal microecology and related factor expression.Methods:Ninety-two patients were randomly assigned into an observation group and a control group,with 46 patients in each group.The control group was treated with recombinant human interferonα-2b gel,while the observation group was treated with Erhuang suppository.The two groups were compared in terms of their changes in traditional Chinese medicine(TCM)symptom scores,efficacy for HRHPV,average HR-HPV DNA load,thinprep cytologic test(TCT)results,improvement of vaginal microecology,and expression of related factors.Results:After treatment,the observation group showed decreases in the average DNA load of 2 HR-HPV types,abnormalities in microbial diversity,dominant bacteria,hydrogen peroxide,leukocyte esterase,pH value,vaginal microenvironment,and levels of tumor necrosis factor-α(TNF-α)and nuclear factor kappa-B(NF-κB),and an increase in the interleukin-12(IL-12)level(P<0.05).The control group showed a decrease in the incidenceβ-glucuronylase abnormalities after treatment(P<0.05).Compared with the baseline before treatment,the observation group and the control group showed decreases in the total score of TCM symptoms,the average DNA load of 12 HR-HPV types,average DNA load of 2+12 HR-HPV types,interleukin-6(IL-6),Toll-like receptor 4(TLR4),and myeloid differentiation factor 88(MyD88)after treatment(P<0.05).After treatment,the observation group had lower total TCM symptom score,average DNA load of two HR-HPV types,and levels of TNF-α,IL-6,TLR4,MyD88,and NF-κB,and higher IL-12 level than the control group(P<0.05).Moroever,the observation group outperformed the control group in reducing the abnormalities in dominant bacteria,hydrogen peroxide,leukocyte esterase,pH value,and vaginal microenvironment(P<0.05).The total response rate of HR-HPV infection was 83.3%(35/42)in observation group and 74.4%(32/43)in control group.The total response rate of TCT was 88.1%(37/42)in observation group and 88.3%(38/43)in control group,with no statistical significance.Conclusion:In the treatment of HR-HPV infection and TCT,Erhuang Suppository has comparable efficacy with recombinant human interferonα-2b gel and is superior to recombinant human interferonα-2b gel in improving multiple indicators of vaginal microecology,alleviating clinical symptoms of HR-HPV patients,and reducing the average DNA load of two HR-HPV types.The mechanism may be related to the decreases in TNF-α,IL-6,TLR4.MyD88,and NF-κB levels and the increase in the IL-12 level.
作者
李佳
解娅娅
徐佳越
陈翘楚
赵禹昕
刘芳媛
韩凤娟
LI Jia;XIE Yaya;XU Jiayue;CHEN Qiaochu;ZHAO Yuxin;LIU Fangyuan;HAN Fengjuan(First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China;Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710000,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第23期154-163,共10页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金面上项目(81473717)
黑龙江省博士后资助项目(LBH-Z22039)
黑龙江省青年中医药科研课题(ZHY2024-252)。
关键词
高危型人乳头瘤病毒
儿黄栓
阴道微生态
疗效
病毒载量
high-risk human papillomavirus
Erhuang suppository
vaginal microecology
therapeutic effect
viral load
