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刊于《欧洲炎症杂志》8月14日 第16卷
European Journal of Inflammation
Volume 16© The Author(s)
研究背景
宫颈 HPV 感染人群中，随着 CIN 检出率逐年增加，因 CIN 行全子宫切除术的患者也相应增加，子宫切除术后患者需要长期随访，术后推荐阴道断端细胞学及 HPV 检测，但是对于术后 HR-HPV 的 “ 再次 ” 或 “ 持续 ” 感染，加重了很多患者的心理负担，患者希望能尽快的摆脱 HPV 感染的困扰。对于HR-HPV 的持续感染，目前尚无统一的治疗方案，中药因疗效确切、安全、副作用小、经济便捷等引起了医学界的广泛关注。
As the detection rate of cervical intraepithelial neoplasia (CIN) increases year by year, the number of patients undergoing panhysterectomy due to CIN also increases. After hysterectomy, patients need long term follow-ups, Vaginal stump cytology and HPV detection are recommended after panhysterectomy. However, a “second” or “continuous” infection of HR-HPV after surgery aggravates the burden of many patients. Patients want to get rid of HPV infection as soon as possible. There is no unifified treatment option for the persistent infection of HR-HPV，Traditional Chinese medicine has attracted extensive attention in the medical field of HPV due to its exact curative effect, safety, less side effectand economic convenience.
研究目的
研究派特灵阴道断端上药对因 CIN 行全子宫切除术术后持续性 HR-HPV 感染转阴结果的疗效。
This study aims to determine the effect of paiteling by placing a vaginal stump on the outcome of persistent high-risk human papillomavirus (HR-HPV) infection after hysterectomy for cervical intraepithelial neoplasia (CIN).
研究方法
本次研究的 125 例患者均来自山西医科大学第一医院就诊登记的患者，其中实验组派特灵组共 55 例，对照组共 70 例，待用药结束后第 3、9 月复查 TCT 及 HPV 分型，了解其 HR-HPV 变化情况及其有无不良反应，观察两组的转阴率。对照组患者仅观察随访不做治疗处理。
From January to December , 125 patients were enrolled in the study. These patients were divided into groups, according topatient’s preference. There were 55 patients in the paiteling group, while there were 70 patients in the control group.At the end of the third and ninth month, Thinprep cytology test (TCT) and human papillomavirus (HPV) typing werereviewed to determine the changes in HR-HPV and its complications. The negative conversion rates of these two groupswere observed. Patients in the control group were observed and followed up without treatment.
研究结果
治疗后第 3 个月时，派特灵组 HPV 转阴率分别为 83.64%，对照组转阴率为 34.29%，差异有统计学意义（χ2=30.444，P<0.01）；第9 个月时，派特灵组 HPV 转阴率分别为 90.91%，对照组转阴率为 48.57%，差异有统计学意义（χ2=25.047，P<0.01）。两组患者均无不良反应。如表格 1
HPV: 人乳头瘤病毒
At the third monthafter treatment, HPV negative rates were83.64% and 34.29% in the paiteling group and control group, respectively(χ2 = 30.444, P < 0.01). In the ninth month, the rate of HPV negative conversion was 90.91% in the paiteling group and48.57% in the control group (χ2 = 25.047, P < 0.01).The difference between the two groups was statistically significant,and patients in both groups had no obvious adverse reactions.
结论和讨论
派特灵阴道断端上药可以加快全子宫切除术后 HR-HPV 感染的转阴。
本 研 究 表 明 派 特 灵 治 疗 阴 道 断 端 HR-HPV 的 持 续 感 染， 第 3 个 月 及第 9 个 月 HPV 转 阴 率 分 别 为 83.64% 及90.91%。说明派特灵能够有效清除 HR-HPV 的感染。对于研究中 HPV16 或 / 和 HPV18 感染的患者，派特灵的转阴率达到了 100％。
Paiteling irrigation at the vaginal stump can accelerate the positive to negative conversion of HR HPV infection after panhysterectomy。
This study revealed that for persistent HR-HPV infection in the vaginal stump, after paiteling treatment, the HPV positive-to-negative conversion rate at 3 and 9 months was 83.64% and 90.91%, respectively. This suggests that paiteling can effectively eliminate HR-HPV infection. In the patients with HPV16 or/and HPV18 infection in this study, the positive-to-negative conversion rate in the paiteling group reached 100%.
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