目的 探讨苦参凝胶联合重组人干扰素α-2b凝胶治疗宫颈高危型人乳头瘤病毒感染的临床疗效。方法 收集无锡市妇幼保健院2023年1月—2024年1月收治的108例宫颈高危型人乳头瘤病毒感染女性患者的病历资料，根据临床治疗方案不同将患者分为对照组和治疗组，各54例。对照组于月经干净3 d后使用重组人干扰素α-2b凝胶，1枚/次，1次/2 d。治疗组在对照组基础上于月经干净3 d后使用苦参凝胶，1枚/次，1次/d。两组患者持续用药3个月。比较两组的临床疗效、人乳头瘤病毒的病毒载量、高危型人乳头瘤病毒感染转阴率、阴道微生态情况、免疫功能指标、血清免疫失衡因子。结果 对照组的总有效率为77.78%，治疗组的总有效率为92.59%，组间比较差异显著（P＜0.05）。治疗后，治疗组的人乳头瘤病毒感染转阴率为90.74%，高于对照组的人乳头瘤病毒感染转阴率75.93%，差异有统计学意义（P＜0.05）。两组治疗后人乳头瘤病毒的病毒载量均显著降低（P＜0.05），且治疗组的人乳头瘤病毒的病毒载量低于对照组（P＜0.05）。两组治疗后阴道分泌物pH值、Nugent评分均显著降低（P＜0.05），且治疗组阴道分泌物pH值、Nugent评分低于对照组（P＜0.05）。两组治疗后CD3⁺、CD4⁺均显著升高，CD8⁺显著降低（P＜0.05），且治疗组CD3⁺、CD4⁺高于对照组，CD8⁺低于对照组（P＜0.05）。两组治疗后血清白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平均显著降低（P＜0.05），且治疗组血清IL-2、IL-6、TNF-α水平低于对照组（P＜0.05）。结论 苦参凝胶联合重组人干扰素α-2b凝胶治疗宫颈高危型人乳头瘤病毒感染的效果显著，可促进患者人乳头瘤病毒感染转阴，调节患者免疫功能和阴道微生态平衡。

Objective To explore the therapeutic effect of Kushen Gel combined with Recombinant Human Interferon α-2b Gel in treatment of high-risk cervical human papillomavirus infection. Methods The medical records of 108 female patients with high-risk cervical human papillomavirus infection admitted to Wuxi Maternal and Child Health Hospital from January 2023 to January 2024 were collected. According to different clinical treatment plans, the patients were divided into control group and treatment group, with 54 cases in each group. The control group used Recombinant Human Interferon α-2b Gel 3 d after menstruation, 1 piece/time, once every 2 d. The treatment group used Kushen Gel on the basis of the control group 3 d after menstruation, 1 piece/time, once daily. The patients in two groups were treated for 3 months. The clinical efficacy, viral load of human papillomavirus, seroconversion rate of high-risk human papillomavirus infection, vaginal microbiota, immune function indicators, and serum immune imbalance factors were compared between two groups. Results The total effective rate of the control group was 77.78%, while the total effective rate of the treatment group was 92.59%, and the difference was significant between two groups (P < 0.05). After treatment, the conversion rate of human papillomavirus infection in the treatment group was 90.74%, which was higher than 75.93% in the control group, and the difference was statistically significant (P < 0.05). The viral load of human papillomavirus in two groups was significantly decreased (P < 0.05), and the viral load of human papillomavirus in the treatment group was lower than that in the control group (P < 0.05). After treatment, the pH value and Nugent score of vaginal secretions in two groups significantly decreased (P < 0.05), and the pH value and Nugent score of vaginal secretions in the treatment group were lower than those in the control group (P < 0.05). After treatment, CD3⁺ and CD4⁺ in two groups significantly increased, while CD8⁺ significantly decreased (P < 0.05). CD3⁺ and CD4⁺ in the treatment group were higher than those in the control group, while CD8⁺ was lower than those in the control group (P < 0.05). After treatment, the serum levels of interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were significantly reduced in two groups (P < 0.05), and the serum levels of IL-2, IL-6, and TNF-α in the treatment group were lower than those in the control group (P < 0.05). Conclusion Kushen Gel combined with Recombinant Human Interferon α-2b Gel has a significant effect in treatment of high-risk cervical human papillomavirus infection, which can promote the negative transformation of human papillomavirus infection in patients, and regulate the immune function and vaginal microecological balance of patients.

R984

白求恩·医学科学研究基金项目