摘要
目的 观察疏肝健脾解毒方辅助光动力疗法对女性尖锐湿疣患者人乳头瘤病毒(HPV)病毒载量、免疫调节的作用.方法 选取2022 年3 月—2022 年10 月收治的 108 例女性尖锐湿疣,随机数字表法分为 2 组,每组 54例.2 组均采取常规基础治疗,对照组配合光动力疗法,观察组配合疏肝健脾解毒方辅助光动力疗法,疗程 3 个月.观察2 组临床疗效、HPV病毒载量、转阴率、干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、IL-10、T淋巴细胞亚群、MyD88 信号通路蛋白表达[白细胞介素-1 受体相关激酶-1(IRAK1)、IRAK4、肿瘤坏死因子受体相关因子 6(TRAF6)]、女性性功能指数(FSFI)、尖锐湿疣生活质量评定量表(CECA10)评分及随访 3 个月复发情况.结果 观察组总有效率96.30%(52/54)高于对照组81.48%(44/54)(P＜0.05).治疗1、3 个月后,观察组HPV病毒载量、血清IL-10 水平以及IRAK1、TRAF6、IRAK4 表达量低于对照组,转阴率、CD3+、CD4+、CD4+/CD8+、血清 IFN-γ 和 IL-2 水平以及FSFI、CECA10 评分高于对照组(P＜0.05).观察组复发率 9.26%(5/54)低于对照组 27.78%(15/54)(P＜0.05).结论 疏肝健脾解毒方辅助光动力疗法对女性尖锐湿疣疗效显著,能降低HPV病毒载量,提高转阴率,抑制炎症反应及MyD88 信号通路蛋白表达,调控机体免疫功能,阻断病情进展及复发.
Abstract
Objective To observe the effects of Shugan Jianpi Jiedu prescription assisted photodynamic therapy on human papillomavirus(HPV)viral load and immune regulation in female patients with condyloma acuminatum(CA).Meth-ods A total of 108 female patients with CA treated from March 2022 to October 2022 were selected and divided into two groups,with 54 cases in each group,by random number table method.Both groups received conventional basic treatment,control group was supplemented with photodynamic therapy,and observation group was supplemented with Shugan Jianpi Jiedu prescription combined with photodynamic therapy.The course of treatment was 3 months.Clinical efficacy,HPV viral load,positive to negative negative conversion rate,interferon-γ(IFN-γ),interleukin-2(IL-2),interleukin-10(IL-10),T lym-phocyte subsets,protein expression of MyD88 signaling pathway[interleukin-1 receptor-associated kinase-1(IRAK1),interleukin-1 receptor-associated kinase-4(IRAK4),tumor necrosis factor receptor-associated factor 6(TRAF6)],female sexual function index(FSFI),quality of life evaluation of condyloma acuminata(CECA10)score and recurrence at 3 months after follow-up were observed in the two groups.Results The total effective rate of observation group was 96.30%(52/54),which was higher than that of control group[81.48%(44/54)](P＜0.05).At 1 and 3 months after treatment,HPV viral load,serum IL-10 level and IRAK1,TRAF6 and IRAK4 expression levels in the observation group were lower than those in the control group,while the positive to negative conversion rate,CD3+,CD4+,CD4+/CD8+,serum IFN-γ and IL-2 lev-els,FSFI and CECA10 scores were higher than those of control group(P＜0.05).The recurrence rate of observation group was 9.26%(5/54),which was lower than that of control group[27.78%(15/54)](P＜0.05).Conclusion Shugan Jianpi Jiedu prescription assisted photodynamic therapy has significant efficacy in the treatment of condyloma acuminatum,which can reduce HPV viral load,increase positive to negative conversion rate,inhibit inflammatory response and protein ex-pression of MyD88 signaling pathway,regulate immune function,and block disease progression and recurrence.
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