目的 探讨CO2激光联合中医药在宫颈低级别鳞状上皮内病变(LSIL)合并高危人乳头瘤病毒(HR-HPV)感染治疗中的应用效果.方法 选取2020年1月至2022年12月河池市人民医院收治的宫颈LSIL合并HR-HPV感染患者150例,依据随机数表法将其分为药物组、激光组和联合组,每组各50例.三组治疗结束后随访3个月,随访结束后返院复查,比较三组治疗前、随访结束时的HR-HPV病毒载量、P16和Ki-67阳性率;比较三组宫颈刮片细胞学检查(TCT)结果、HPV转阴率、不良反应发生情况.结果 随访结束时,三组HR-HPV病毒载量低于治疗前,且联合组低于激光组和药物组,激光组低于药物组,差异有统计学意义(P＜0.05).联合组宫颈TCT转为正常或炎症占比、HR-HPV转阴率均高于激光组和药物组,差异有统计学意义(P＜0.05)o随访结束时,三组P16和Ki-67阳性率低于治疗前,且联合组低于激光组和药物组,差异有统计学意义(P＜0.05).三组不良反应总发生率比较,差异无统计学意义(P＞0.05).结论 在宫颈LSIL合并HR-HPV感染治愈率、HR-HPV及P16、Ki-67转阴率方面,联合治疗效果更好.
Objective To explore the application effect of CO2 laser combined with traditional Chinese medicine in the treatment of low-grade squamous intraepithelial lesion(LSIL)of the cervix combined with high-risk human papillomavirus(HR-HPV)infection.Methods A total of 150 patients with cervical LSIL combined with HR-HPV infection admitted to Hechi People's Hospital from January 2020 to December 2022 were included as subjects.According to the random number table method,they were divided into a drug group,a laser group,and a combination therapy group,with 50 cases in each group.Follow-up for 3 months after the completion of treatment in three groups was conducted,and the subjects returned to the hospital for re-examination.The HR-HPV viral load,P16,and Ki-67 positivity rate before treatment and at the end of follow-up in the three groups were compared.The results of cervical thinprep cytology test(TCT),HPV seroconversion rate,and incidence of adverse reactions among three groups were compared.Results At the end of follow-up,the HR-HPV viral loads of the three groups were lower than those before treatment,and the combination therapy group was lower than the laser and drug groups,and the laser group was lower than the drug group,with statistically significant differences(P＜0.05).The proportion of cervical TCT conversion to normal or inflammation and the rate of HR-HPV conversion to negative in the combination therapy group were higher than those in the laser group and drug group,with statistically significant differences(P＜0.05).At the end of follow-up,the P16 and Ki-67 positivity rate was lower than that before treatment in the three groups,and lower in the combination therap group than in the laser and drug groups,with statistically significant differences(P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups(P＞0.05).Conclusion In terms of the cure rate of cervical LSIL combined with HR-HPV infection,the seroconversion rates of HR-HPV,P16,and Ki-67,the combination therapy group showed better results.
黄艳丽;潘琦文;李建湘;覃小妮;黄红莲
右江民族医学院附属河池医院 广西壮族自治区河池市人民医院妇科,广西河池 547000
临床医学
低级别鳞状上皮内病变;高危人乳头瘤病毒;CO2激光;中医药外治
Low-grade squamous intraepithelial lesion;High-risk human papillomavirus;CO2 laser;External treatment of traditional Chinese medicine
《中国医药科学》 2024 (012)
63-66 / 4
广西壮族自治区中医药管理局科研课题(GXZYZ20210271).
10.20116/j.issn2095-0616.2024.12.15
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