高危型人乳頭瘤病毒感染宮頸病變患者體質特點探析

劉君　薛曉鷗　馬秀麗　李艷華

摘要：目的 ?探究高危型人乳頭瘤病毒（HR-HPV）感染的宮頸病變患者中醫體質分布特點，分析其臨床特征與體質類型的關系，為中醫藥防治HR-HPV感染導致的宮頸病變提供依據。方法 ?采用流行病學研究方法，以問卷調查的方式收集135例HR-HPV感染的宮頸病變患者相關信息，進行體質判定，分析其體質分布特點及主要體質類型與宮頸病變程度、HR-HPV感染特點、年齡及p16抑癌蛋白表達強度的關系。結果 ?HR-HPV感染的宮頸病變患者體質類型所占比例由高到低依次為濕熱質、陽虛質、平和質、氣虛質、氣郁質、陰虛質、痰濕質、血瘀質、特稟質，差異有統計學意義（P<0.05）。不同體質類型患者的宮頸病變程度、HR-HPV感染特點、年齡、p16抑癌蛋白表達強度比較，差異有統計學意義（P<0.05）。結論 ?HR-HPV感染的宮頸病變患者體質類型以濕熱質、陽虛質為主，其體質類型與宮頸病變程度、HR-HPV感染特點、年齡、p16抑癌蛋白表達強度有關。

關鍵詞：高危型人乳頭瘤病毒;宮頸病變;中醫體質;年齡;p16抑癌蛋白;表達強度

中圖分類號：R271.913 ???文獻標識碼：A??? 文章編號：1005-5304（2020）01-0014-05

DOI：10.3969/j.issn.1005-5304.201908251

Discussion on Physical Characteristics of Cervical Lesions Patients with High-riskHuman Papillomavirus Infection

LIU Jun， XUE Xiaoou， MA Xiuli， LI Yanhua

Dongzhimen Hospital， Beijing University of Chinese Medicine， Beijing 100700， China

Abstract： Objective To explore the characteristics of TCM constitution distribution in cervical lesions patients with high-risk human papillomavirus （HR-HPV） infection; To analyze the relationship between clinical characteristics and constitutional types; To provide evidence for the prevention and treatment of cervical lesions caused by HR-HPV infection in TCM. Methods Epidemiological methods was used; 135 cases of cervical lesions with HR-HPV infection were collected by questionnaire survey; their constitution distribution characteristics and the relationship between the main constitution types and the grade of cervical lesions， the characteristics of HR-HPV infection， age and the expression intensity of p16 anti-cancer protein were analyzed. Results The constitutional types of cervical lesions patients infected with HR-HPV were damp-heat， yang-deficiency， peace， qi-deficiency， qi-depression， yin-deficiency， phlegm-dampness， blood stasis and specific endowment in order from high to low， with statistical significance （P<0.05）. The degree of cervical lesions， the characteristics of HR-HPV infection， age and the expression of p16 anti-cancer protein of patients with different constitution were different， with statistical significance （P<0.05）. Conclusion The constitutional types of cervical lesions infected by HR-HPV are mainly damp-heat and yang deficiency， which are related to the degree of cervical lesions， HR-HPV infection characteristics， age， and p16 anti-cancer protein expression intensity.

Keywords： high-risk human papillomavirus; cervical lesions; TCM constitution; age; p16 anti-cancer protein; expression intensity

宮頸癌（cervical carcinoma）是目前全球范圍內導致女性死亡的第四大癌癥相關性疾病^[1]。流行病學研究顯示，2015年我國宮頸癌新發病例近10萬，約3萬例死于該病^[2]。高危型人乳頭瘤病毒（high-risk human papillomavirus，HR-HPV）感染是引發宮頸上皮內瘤變（cervical intraepithelial neoplasia，CIN）從而進展為宮頸癌的主要原因^[3]，因此，防止HR-HPV感染是預防CIN及宮頸癌的關鍵。根據中醫治未病理論，可在未發病時通過體質調理，改善體質狀況，從而提高患者防御病邪的能力。遵循辨證論治原則，祛邪扶正，可改善已病患者的體質狀況，增強其對已入侵病邪的抵御清除能力并固本防止復發。本研究通過對宮頸HR-HPV感染的宮頸病變患者體質類型及其臨床特征進行研究，分析患者臨床特征與體質類型的關系，為中醫藥防治HR-HPV感染所導致的宮頸病變提供依據。……