| 引用本文： |
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林艳,王福菊,胡佳贞,等.蜚蠊提取液改善阴道微生态及治疗宫颈持续性高危型人乳头瘤病毒感染的研究[J].同济大学学报（医学版）,2022,43(5):696-702. [点击复制]
- LIN Yan,WANG Fuju,HU Jiazhen,et al.Treatment of persistent HR-HPV infection by intravaginal administration of cockroach extract combined with interferon[J].同济大学学报（医学版）,2022,43(5):696-702. [点击复制]
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| 摘要: |
| 目的观察蜚蠊提取液联合干扰素对宫颈持续性高危型人乳头瘤病毒（high-risk human papillomavirus， HR-HPV）感染的治疗效果，并比较治疗前后阴道微生态及宫颈局部细胞免疫功能变化。方法按病例纳入和排除标准纳入宫颈持续性HR-HPV感染患者80例随机分为2组，每组40例，对照组使用干扰素阴道纳入治疗，研究组在对照组的基础上加用蜚蠊提取液进行阴道冲洗，两组均治疗3个疗程。在治疗前后分别进行宫颈HR-HPV检测、阴道微生态评价及宫颈细胞免疫功能检测。结果治疗后研究组宫颈持续性HR-HPV感染转为阴性24例（61.54%），对照组转为阴性13例（33.33%），研究组治疗宫颈持续性HR-HPV感染的效果明显优于对照组（χ2=6.221，P=0.013）；研究组治疗后阴道微生态失衡（χ2=6.642，P=0.010）、乳杆菌分级异常（Ⅱb或Ⅲ级，χ2=6.271，P=0.012）、革兰阴性短杆菌（χ2=7.508，P=0.006）、革兰阳性球菌（χ2=8.419，P=0.004）、pH值异常（χ2=4.198，P=0.040）、H2O2阳性（χ2=5.769，P=0.016）及AV检出（χ2=4.255，P=0.039）等指标较治疗前得到明显改善（P＜0.05）；对照组治疗后仅在pH值异常改善方面与治疗前差异有统计学意义（χ2=7.429，P=0.006）；两组间治疗后比较，研究组对阴道微生态失衡的治疗效果较对照组更明显，具有显著性差异（χ2=4.446，P=0.035）；治疗后研究组宫颈细胞免疫功能改善比对照组更明显，CD4（t=-4.741，P＜0.001）、CD8（t=-4.725，P＜0.001）、CD4/CD8（Z=-5.022，P＜0.001）、TNF-α（t=-4.912，P＜0.001）、IL-4（t=-2.162，P=0.034）差异均具有统计学意义（P＜0.05）。结论蜚蠊提取液清利湿热、活血解毒等功效，与干扰素合用可显著提高宫颈持续性HR-HPV感染的治疗效果，其作用可能与通过纠正阴道微生态失衡及改善宫颈局部细胞免疫功能相关。 |
| 关键词: 高危型人乳头瘤病毒 蜚蠊提取液 阴道微生态 宫颈免疫 |
| DOI：10.12289/j.issn.1008-0392.22185 |
| 投稿时间：2022-05-04 |
| 基金项目:上海市普陀区科委卫生科技创新重点项目（ptkwws201906） |
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| Treatment of persistent HR-HPV infection by intravaginal administration of cockroach extract combined with interferon |
| LIN Yan,WANG Fuju,HU Jiazhen,XU Lan,ZHANG Xing,ZHANG Xinpei,ZHAO Yunzhi,FAN Bozhen |
| (Department of Gynecology and Obstetrics， Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai 200062， China;Center of Reproductive Medicine， Second Affiliated Hospital of Naval Medical University， Shanghai 200003， China) |
| Abstract: |
| ObjectiveTo evaluate the efficacy of cockroach extract combined with interferon in treatment of cervical persistent HR-HPV infection and its mechanism. MethodsEighty patients with persistent cervical HR-HPV infection were randomly assigned into two groups with 40 cases in each group. The control group received intravaginal administration of interferon, and the study group received intraoperative interferon and vaginal douching of cockroach extract, with a total of 3 courses. Cervical HR-HPV test, vaginal microecological evaluation and cervical immune cell detection were performed before and after treatment, and the results were compared between two groups. ResultsBy the end of treatment 39 cases in each group completed the study, there was negative conversion of HR-HPV infection in 24 cases of study group(61.5%) and 13 cases of control group(33.3%)(χ2=6.221, P=0.013). In study group the indicators of vaginal microecology were significantly improved after treatment: imbalance of vaginal microecology(χ2=6.642, P=0.010), abnormal LBG(χ2=6.271, P=0.012), Gram-negative brevibacillus(χ2=7.508, P=0.006), Gram-positive cocci(χ2=8.419, P=0.004), abnormal pH value(χ2=4.198, P=0.040), positive H2O2(χ2=5.769, P=0.016) and AV detection(χ2=4.255, P=0.039); while only abnormal pH value in the control group was improved(χ2=7.429, P=0.006). After treatment, the vaginal microecological imbalance(χ2=4.446, P=0.035), and the immunological indicators[CD4(t=-4.725, P<0.001), CD8(t=-4.725, P<0.001), CD4/CD8(Z=-5.022, P<0.001),TNF-α(t=-4.912, P<0.001) and IL-4(t=-2.162, P=0.034)] in study group were significantly better than those in control group(P<0.05). ConclusionThe intravaginal douching of cockroach extract can significantly improve the therapeutic efficacy of interferon for patients with persistent cervical HR-HPV infection, which is associated with the improvement of vaginal microecology and local cellular immune function. |
| Key words: high-risk human papillomavirus cockroach extract vaginal microecology cer-vical immune |
