心理干预联合药物治疗宫颈低级别鳞状上皮内病变的研究进展

Research Progress on Psychological Intervention Combined with Pharmacotherapy for Low-Grade Squamous Intraepithelial Lesion

摘要: 宫颈低级别鳞状上皮内病变(LSIL)是与高危型人乳头瘤病毒(HR-HPV)感染密切相关的宫颈癌前病变，其临床管理长期面临“被动随访”与“主动干预时机难以把握”的两难选择。心理神经免疫学研究表明，心理应激可通过神经–内分泌–免疫网络调控宿主抗病毒免疫应答，进而影响HR-HPV清除及病变转归，这为心理干预应用于LSIL管理提供了理论依据。在药物干预方面，保妇康栓与干扰素联合应用在增强宫颈局部免疫、抑制病毒复制方面疗效确切。基于“生物–心理–社会”医学模式，将结构化心理干预与药物治疗有机整合，可望产生多靶点协同效应，是优化LSIL管理策略的重要方向。本文在综述这一整合策略的理论基础、应用现状及未来方向的同时，也客观讨论了其潜在的局限性，如经济与时间成本、药物不良反应及患者依从性等，以期为临床提供更为全面的参考。

Abstract: Low-grade squamous intraepithelial lesion (LSIL) is a precancerous condition of the cervix. It is closely tied to high-risk human papillomavirus (HR-HPV) infection. Managing LSIL is hard. Guidelines usually recommend regular follow-up. But this watchful waiting often causes a lot of mental stress for patients. At the same time, the best time to start active treatment is hard to find. Psychoneuroimmunology gives us some clues. It shows that mental stress can change the body’s antiviral immune response. It does this through the neuro-endocrine-immune network. This process can affect HR-HPV clearance and lesion regression. This link gives us a reason to include mental support in LSIL care. On the drug side, doctors often use Baofukang Suppository with interferon. This mix can boost local cervical immunity and stop the virus from making copies. More and more clinical data support this treatment. From the biopsychosocial view, a structured mix of mental help and drug therapy looks hopeful. It may bring synergistic effects on several targets. It may also open a practical way to make LSIL management better. This article not only reviews the theoretical foundations, clinical applications, and future directions of this integrated strategy, but also objectively discusses its potential limitations, including economic and time costs, adverse drug reactions, and patient adherence challenges, to provide a more balanced reference for clinical practice.