紫术消瘤散对P16/Ki67在子宫颈低级别鳞状上皮内瘤变表达的影响

Effects of Zizhu Xiaoliu San on the Expression of P16/Ki67 in Cervical Low-Grade Squamous Intraepithelial Neoplasia

摘要: 目的：观察紫术消瘤散治疗湿热瘀结型子宫颈低级别鳞状上皮内瘤变(LSIL)患者的疗效，为临床运用中医药治疗LSIL提供参考。方法：选取2020年08月至2022年1月就诊我院妇科门诊，经组织病理学证实为LSIL合并HR-HPV感染，P16/Ki67双染阳性，中医辨证符合湿热瘀结证的患者共120例。中药治疗组将紫术消瘤散涂抹于宫颈及宫颈管治疗3个疗程，西药治疗组将重组人干扰素α-2b阴道泡腾胶囊(辛复宁®)置于阴道的穹窿处治疗3个疗程，空白对照组不采取治疗措施，比较治疗前后高危型HPV病毒转阴及P16/Ki67表达情况。结果：中药治疗组治疗后HR-HPV转阴率高于西药治疗组、空白组，差异具有统计学意义(P < 0.05)。西药组治疗后HR-HPV转阴率高于空白组，但差异无统计学意义(P < 0.0167)。中药治疗组治疗后P16/Ki67双染表达转阴率高于西药治疗组、空白组，差异具有统计学意义(P < 0.05)。西药治疗组治疗后P16/Ki67双染表达转阴率高于空白组，但差异无统计学意义(P < 0.0167)。结论：紫术消瘤散、干扰素均能够在一定程度上逆转HR-HPV感染，但紫术消瘤散在抗HPV感染、逆转LSIL进展更具优势，值得临床推广。

Abstract: Objective: To observe the curative effect of Zizhu Xiaoliu Powder in the treatment of patients with cervical low-grade squamous intraepithelial neoplasia (LSIL) of damp-heat stasis type, and to provide a reference for clinical application of traditional Chinese medicine in the treatment of LSIL. Methods: Selected from August 2020 to January 2022 in our hospital's gynecological outpatient clinic, confirmed by histopathology that LSIL complicated with HR-HPV infection, P16/Ki67 double staining was positive, and a total of 120 patients with TCM syndrome matching with damp-heat stasis syndrome were selected. The traditional Chinese medicine treatment group applied Zizhu Xiaoliu Powder to the cervix and cervical canal for 3 courses of treatment, while the western medicine treatment group applied recombinant human interferon α-2b vaginal effervescent capsules (Xinfuning®) to the fornix of the vagina for 3 courses of treatment. In the blank control group, no treatment was taken, and the negative conversion of high-risk HPV virus and the expression of P16/Ki67 were compared before and after treatment. Results: The HR-HPV negative conversion rate in the traditional Chinese medicine treatment group was higher than that in the western medicine treatment group and the blank group, and the difference was statistically significant (P < 0.05). The HR-HPV negative conversion rate in the western medicine group was higher than that in the blank group, but the difference was not statistically significant (P < 0.0167). After treatment, the negative rate of P16/Ki67 double staining in the traditional Chinese medicine treatment group was higher than that in the western medicine treatment group and the blank group, and the difference was statistically significant (P < 0.05). The negative rate of P16/Ki67 double staining in the western medicine treatment group was higher than that in the blank group, but the difference was not statistically significant (P < 0.0167). Conclusion: Zizhu Xiaoliu San and interferon can reverse HR-HPV infection to a certain extent, but Zizhu Xiaoliu San has more advantages in resisting HPV infection and reversing the progress of LSIL, and it is worthy of clinical promotion.