阴道镜下宫颈病变特征与宫颈上皮内瘤变中医证型的相关性研究

Study on the Correlation between the Characteristics of Cervical Lesions under Colposcopy and Traditional Chinese Medicine Syndrome Types of Cervical Intraepithelial Neoplasia (CIN)

摘要: 目的：系统探讨阴道镜下宫颈病变特征与宫颈上皮内瘤变(CIN)中医证型的关联性，为CIN中医辨证的客观化、标准化提供量化依据，助力中医药防治CIN的临床实践。方法：选取2024年3月至2025年9月浦江县中医院妇科确诊的80例CIN患者，由专业人员参照《中医妇科学》标准进行辨证分型，并完成阴道镜检查、获取阴道镜下的证候望诊信息。采用SPSS23.0软件分析数据，计数资料以“例(%)”描述，分类资料采用卡方检验(或Fisher确切概率法)进行分析。结果80例CIN患者中，中医证型以湿热下注型为主(61例，76.2%)，脾虚型次之(16例，20%)，阴虚夹湿型最少(3例，3.8%)；CIN不同证型的阴道镜下宫颈分泌物的颜色、质地有显著差异(P < 0.001)。结论：CIN中医证型与阴道镜下宫颈病变特征存在显著相关性，可用于宫颈上皮内瘤变宫颈局部望诊，湿热下注型多表现为黄色/淡黄色粘稠分泌物、轻度/中度糜烂；脾虚型多为白色、稀薄分泌物、轻度糜烂，该关联可为CIN中医辨证提供客观参考，推动中医药精准防治CIN。

Abstract: Objective: To systematically explore the correlation between the characteristics of cervical lesions under colposcopy and traditional Chinese medicine (TCM) syndrome types of cervical intraepithelial neoplasia (CIN), providing quantitative basis for the objective and standardized TCM syndrome differentiation of CIN, and assisting in the clinical practice of TCM prevention and treatment of CIN. Method: 69 patients with CIN diagnosed in the gynecology department of Pujiang County Traditional Chinese Medicine Hospital from March 2024 to September 2025 were selected. Professional personnel followed the standards of “Traditional Chinese Medicine Gynecology” for syndrome differentiation and classification, and completed vaginal colposcopy examination to obtain diagnostic information on the syndrome under the colposcopy. SPSS23.0 software was used to analyze the data, with count data described as “%” and categorical data analyzed using chi square test (or Fisher’s exact probability method). Among the 80 patients with CIN, the traditional Chinese medicine (TCM) syndrome type was mainly damp heat type (61 cases, 76.2%), followed by spleen deficiency type (16 cases, 20%), and yin deficiency with dampness type was the least (3 cases, 3.8%); there are significant differences in the color and texture of cervical secretions under colposcopy for different types of CIN (P < 0.05). Conclusion: There is a significant correlation between the traditional Chinese medicine syndrome types of CIN and the characteristics of cervical lesions under colposcopy, which can be used for local observation of cervical intraepithelial neoplasia. The damp heat descending type is often characterized by yellow/light yellow viscous secretions and mild/moderate erosion; the spleen deficiency type is mostly characterized by white, thin secretions, and mild erosion. This association can provide objective reference for the traditional Chinese medicine diagnosis and treatment of CIN, and promote the precise prevention and treatment of CIN with traditional Chinese medicine.