二黄栓治疗高危型HPV持续阳性宫颈病变的临床疗效观察及机制探讨

摘要

目的 评价二黄栓治疗高危型人乳头瘤病毒(HPV )持续阳性宫颈病变的临床疗效,并探讨其作用机制.方法 将高危型 HPV持续感染且病理学诊断为慢性宫颈炎或子宫颈上皮内瘤变(CIN)Ⅰ级并自愿选择药物保守治疗的患者40例,随机分为二黄栓组及保妇康栓组,每组慢性宫颈炎和CINⅠ级各10例.另选空白对照组20例,均为高危型HPV持续感染,其中慢性宫颈炎和CINⅠ级各10例,仅观察不做治疗.比较药物治疗后随访期间的疗效及 HPV转阴率,同时应用Western blot检测二黄栓用药前后宫颈组织PI3K 、p-Akt蛋白的表达变化.结果 药物治疗3个月后,二黄栓组病变治愈率75%(15/20) ,保妇康栓组病变治愈率55%(11/20) ,治疗宫颈病变的有效性两组相比差异无统计学意义(P＞0.05) .应用二黄栓治疗后,有17例(85%)高危型转阴,而在保妇康栓组中8例(40%)高危型转阴,两组相比差异具有统计学意义(P＜0.01).用二黄栓治疗后,宫颈组织中PI3K 、p-Akt蛋白表达明显下降(均 P＜0.01).结论 二黄栓治疗高危型 HPV持续感染的宫颈病变是安全有效的,二黄栓促 HPV转阴可能与其抑制 PI3K ,p-Akt的表达有关.%Objective To evaluate the effect of Erhuang suppository treatment in cervical lesions with persistent high-risk human papilloma virus infection and to explore its action mechanism.Methods Using case control study ,we classified patients who got high-risk HPV persistent infection and pathologically diagnosed with CIN Ⅰ or chronic cervicitis into 3 groups random-ly :experimental group ,using Erhuang suppository or Baofukang suppository;the control group ,without any treatment. The cur-ative effect of drug therapy after the treatment was compared and expression changes of PI 3K and p-Akt protein were detected by Western blotting before and after use of Erhuang suppository. Results After treatment for 3 months ,in the Erhuang sup-pository experimental group ,cervical lesions in 15 (75%)cases turned to normal;in the Baofukang suppository experimental group ,cervical lesions in 11(55%)cases returned to normal ,with no statistically significant difference between the two groups (P＞0.05). After the treatment ,high-risk HPV was negative in 17(75%)cases of Erhuang suppository group and in 8(40%) cases of the Baofukang suppository group ,with statistically significant difference between the two groups (P＜0.01). After the treatment by Erhuang suppository ,in the cervical tissue ,PI3K and p-Akt protein expression decreased significantly (P＜0.01). Conclusion Erhuang suppository is effective and safe on treating high-risk HPV persistent infection CIN Ⅰ and chronic cervici-tis ,Erhuang suppository prompting high-risk HPV to become negative may be related to the expression of inhibitory PI 3K ,p-Akt.