膦甲酸钠氯化钠联合女性抗毒洁阴复合剂治疗宫颈高危型HPV感染的效果

doi:10.3760/cma.j.cn441417-20240729-14020

摘要/Abstract

摘要：

目的　分析膦甲酸钠氯化钠联合女性抗毒洁阴复合剂治疗宫颈高危型人乳头瘤病毒（HPV）感染的效果。方法　采用回顾性分析，选取2022年3月至2024年1月西安交通大学第一附属医院榆林医院收治的89例宫颈高危型HPV感染患者的临床资料，以治疗方法不同分为对照组（43例）与观察组（46例）。对照组年龄（40.45±6.97）岁，接受膦甲酸钠氯化钠治疗；观察组年龄（41.52±6.38）岁，在对照组的基础上联合女性抗毒洁阴复合剂治疗。对比两组临床疗效、免疫功能、炎症反应、阴道清洁情况、细胞因子及不良反应。统计学方法采用t检验、χ²检验。结果　观察组总有效率高于对照组［93.48%（43/46）比72.42%（32/43）］（P<0.05）。治疗后，观察组CD3+、CD4+水平高于对照组［（65.41±6.85）%比（60.57±5.74）%、（44.22±6.94）%比（36.38±5.67）%］，CD8+水平［（20.06±3.24）%］低于对照组［（24.11±4.30）%］（均P<0.05）；观察组血清白细胞介素-4（IL-4）、转化生长因子β1（TGF-β1）水平［（6.05±1.32）ng/L、（15.13±3.10）ng/L］低于对照组［（12.73±2.48）ng/L、（22.48±4.36）ng/L］，血清γ干扰素（IFN-γ）水平［（197.42±22.58）ng/L］高于对照组［（181.36±19.45）ng/L］（均P<0.05）；观察组Nugent评分、阴道分泌物清洁度、辅助性T细胞2（Th2）水平均低于对照组［（2.18±0.42）分比（2.67±0.64）分、（1.12±0.21）分比（1.68±0.26）分、（4.79±0.65）%比（6.20±0.74）%］，Th1水平高于对照组［（14.85±2.94）%比（11.53±2.40）%］（均P<0.05）。两组不良反应发生率对比差异无统计学意义（P>0.05）。结论　膦甲酸钠氯化钠联合女性抗毒洁阴复合剂治疗宫颈高危型HPV感染效果确切，可减轻患者炎症反应，改善免疫功能与阴道清洁度，调节细胞因子，且安全可靠。

关键词: 高危型人乳头瘤病毒, 膦甲酸钠氯化钠, 女性抗毒洁阴复合剂, 临床疗效

Abstract:

Objective　To analyze the effect of foscarnet sodium and sodium chloride combined with female Kangdu Jieyin compound for patients with cervical high-risk human papillomavirus (HPV) infection. Methods　Eighty-nine patients with cervical high-risk HPV infection treated at Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University from March 2022 to January 2024 were selected as the study objects. According to the treatment methods, they were divided into a control group (43 cases) and an observation group (46 cases). The control group were (40.45±6.97) years old, while the observation group 41.52±6.38. The control group took foscarnet sodium and sodium chloride; in addition, the observation group took female Kangdu Jieyin compound adjuvant treatment. The clinical efficacies, immune function, inflammatory response, vaginal cleanliness, cytokines, and adverse reactions were compared between the two groups. t test and χ² test were used as the statistical methods. Results　The total effective rate of the observation group was higher than that of the control group [93.48% (43/46) vs. 72.42% (32/43); P<0.05]. After the treatment, the levels of CD3+ and CD4+ in the observation group were higher than those in the control group [(65.41±6.85)% vs. (60.57±5.74)% and (44.22±6.94)% vs. (36.38±5.67)%], and the level of CD8+ was lower [(20.06±3.24)% vs. (24.11±4.30)%] (all P<0.05). After the treatment, the serum levels of interleukin-4 (IL-4) and transforming growth factor β1 (TGF-β1) in the observation group were lower than those in the control group [(6.05±1.32) ng/L vs. (12.73±2.48) ng/L and (15.13±3.10) ng/L vs. (22.48±4.36) ng/L], and the serum level of interferon gamma (IFN-γ) was higher [(197.42±22.58) ng/L vs. (181.36±19.45) ng/L] (all P<0.05). After the treatment, the Nugent score, cleanliness of vaginal secretions, and level of helper T cell 2 (Th2) in the observation group were lower than those in the control group [(2.18±0.42 vs. 2.67±0.64, 1.12±0.21 vs. 1.68±0.26, and (4.79±0.65)% vs. (6.20±0.74)%], and the level of Th1 was higher [(14.85±2.94)% vs. (11.53±2.40)%] (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Foscarnet sodium and sodium chloride combined with female Kangdu Jieyin compound for patients with cervical high-risk HPV infection is effective, safe, and reliable, and can reduce their inflammation, improve their immune function and vaginal cleanliness, and regulate cytokines.

Key words: High-risk human papillomavirus, , Foscarnet sodium and sodium chloride, , FemaleKangdu Jieyin , compound, , Clinical effect

中图分类号:

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马耀芳朱静李海香.

膦甲酸钠氯化钠联合女性抗毒洁阴复合剂治疗宫颈高危型HPV感染的效果 [J]. 国际医药卫生导报, 2025, 31(14): 2388-2392.

Ma Yaofang, Zhu Jing, Li Haixiang.

Effect of foscarnet sodium and sodium chloride combined with female Kangdu Jieyin compound for patients with cervical high-risk HPV infection [J]. International Medicine and Health Guidance News, 2025, 31(14): 2388-2392.

参考文献

[1]Abu-Rustum NR, Yashar CM, Arend R, et al. NCCN guidelines(R) insights: cervical cancer, version 1.2024[J]. J Natl Compr Canc Netw, 2023, 21(12): 1224-1233. DOI: 10.6004/jnccn.2023.0062.

[2]Kusakabe M, Taguchi A, Sone K, et al. Carcinogenesis and management of human papillomavirus-associated cervical cancer[J]. Int J Clin Oncol, 2023, 28(8): 965-974. DOI: 10.1007/s10147-023-02337-7.

[3]Ramkumar SP, Simpson MC, Adjei BE, et al. High-risk human papillomavirus 16/18 associated with improved survival in sinonasal squamous cell carcinoma[J]. Cancer, 2023, 129(9): 1372-1383. DOI: 10.1002/cncr.34690.

[4]徐美玉.膦甲酸钠氯化钠联合保妇康栓治疗高危型HPV感染宫颈炎的临床研究[J].实用临床医药杂志, 2015, 19(21): 174-175. DOI:10.7619/jcmp.201521065.

[5]王福媛,王朝霞,赵乐,等.生物钟节律相关因素对女性HPV转阴影响的前瞻性队列研究[J].中国癌症防治杂志,2022,14(5):552-557. DOI:10.3969/j.issn.1674-5671.2022.05.13.

[6]樊尚荣,刘丹. 2015年美国疾病控制中心性传播疾病的诊断和治疗指南(续)--人乳头瘤病毒感染的诊断和治疗指南[J].中国全科医学, 2015(29): 3513-3515. DOI:10.3969/j.issn.1007-9572.2015.26.002.

[7]李维国,王向东.新版«临床疾病诊断依据治愈好转标准»简介[J].解放军医院管理杂志, 1998, 5(3): 299.

[8]Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol, 1991,29(2):297-301. DOI: 10.1128/jcm.29.2.297-301.1991.

[9]Tang Y, Tong Q, Dai N, et al. Evaluation of the clinical efficacy of vaginal treatment options for persistent high-risk human papillomavirus infection after excisional treatment of cervical high-grade squamous intraepithelial lesions: a systematic review and Bayesian network meta-analysis[J]. Virol J, 2023, 20(1): 47. DOI: 10.1186/s12985-023-02001-6.

[10]Kakkar A, Satapathy S, Sikka K, et al. Evaluation of high-risk human papillomavirus in sinonasal papillomas and squamous cell carcinomas[J]. Virchows Arch, 2023, 483(3): 381-392. DOI: 10.1007/s00428-023-03601-x.

[11]Ittiamornlert P, Jareemit N, Phianpiset R, et al. High-risk human papillomavirus genotyping in women with atypical squamous cells of undetermined significance[J]. Sci Rep, 2023, 13(1): 12134. DOI: 10.1038/s41598-023-39206-2.

[12]Gorur L, Dolanbay M, Ozturk F, et al. High-risk human papillomavirus in Turkish patients with clinically suspicious cervical lesions analyzed by multiplex-PCR[J]. Indian J Med Res, 2022, 156(6): 786-791. DOI: 10.4103/ijmr.IJMR_2335_20.

[13]Kucukyildiz I, Karaca M, Akgor U, et al. Endocervical polyps in high risk human papillomavirus infections[J]. Ginekol Pol, 2022, 93(1): 7-10. DOI: 10.5603/GP.a2021.0207.

[14]Leiendecker L, Neumann T, Jung PS, et al. Human papillomavirus 42 drives digital papillary adenocarcinoma and elicits a germ cell-like program conserved in HPV-positive cancers[J]. Cancer Discov, 2023, 13(1): 70-84. DOI: 10.1158/2159-8290.CD-22-0489.

[15]杨彩虹,孟焕然,万颖,等.膦甲酸钠氯化钠联合重组人干扰素α-2b栓治疗宫颈癌前病变合并HPV高危型感染的临床疗效[J].癌症进展, 2016, 14(12): 1249-1251,1274. DOI:10.11877/j.issn.1672-1535.2016.14.12.23.

[16]郑玉.治疗HPV感染阴道用药后对阴道微生态影响的临床分析[D].长春:吉林大学, 2022.DOI:10.27162/d.cnki.gjlin.2022.005000.

[17]支雄莉,赵娜,田霞,等.保妇康栓联合瑞贝生对宫颈高危型HPV感染患者细胞免疫功能的影响[J].河北医药,2022, 44(15): 2357-2360. DOI:10.3969/j.issn.1002-7386.2022.15.030.

[18]马欢,张贤雨,张飞,等.瑞贝生联合同步放化疗治疗高危型人乳头瘤病毒感染宫颈癌患者疗效观察[J].临床军医杂志, 2020, 48(11): 1321-1322. DOI:10.16680/j.1671-3826.2020.11.20.

[19]胡利娟,鲁小龙,熊永红,等.不同类型人乳头状瘤病毒感染者CD4+T细胞、CD8+T细胞、Th1/Th2因子水平分析[J].中国计划生育学杂志,2023,31(5):1164-1167. DOI:10.3969/j.issn.1004-8189.2023.05.034.

[20]丁洁,文丽芳,王全义,等. HR-HPV宫颈癌患者外周血Th1/Th2细胞因子变化及其意义[J].中国艾滋病性病, 2023, 29(4): 443-447. DOI:10.13419/j.cnki.aids.2023.04.16.

[21]宋晓红,白文佩.保妇康栓辅助治疗高危型HPV感染疗效及对HPV病毒载量和宫颈炎症的影响[J].中国计划生育学杂志, 2024, 32(5): 1052-1056. DOI:10.3969/j.issn.1004-8189.2024.05.014.

[22]支雄莉,赵娜,田霞,等.保妇康栓联合瑞贝生对宫颈高危型HPV感染患者TLRs/NF-κB通路及下游基因表达的影响[J].河北医药, 2023, 45(1): 64-67. DOI:10.3969/j.issn.1002-7386.2023.01.014.

[23]谢虹,赵芳,马新,等.膦甲酸钠氯化钠治疗人乳头状瘤病毒感染宫颈炎的临床疗效[J].中华医院感染学杂志, 2014(12): 2943-2945. DOI:10.11816/cn.ni.2014-141300.

[24]支雄莉,赵娜,田霞,等.保妇康栓联合瑞贝生对宫颈高危型HPV感染的疗效观察[J].河北医药, 2022, 44(9): 1399-1401. DOI:10.3969/j.issn.1002-7386.2022.09.029.