高危型HPV感染患者Th1/Th2平衡与中医体质相关性研究
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摘要
[目的]通过观察宫颈高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染患者与健康女性中医体质分布、阴道灌洗液细胞因子水平,以及Th1/Th2平衡情况,探讨宫颈HR-HPV感染患者Th1/Th2平衡与中医体质的相关性。[方法]选择HR-HPV感染患者(感染组)与健康女性(对照组)各60例,应用《KY3H中医体质辨识表》进行体质辨识,采用酶联免疫吸附(enzyme linked immunosorbent assay,ELISA)法检测各组患者阴道灌洗液中白细胞介素-2(interleukin-2,IL-2)、γ-干扰素(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)、白细胞介素-10(interleukin-10,IL-10)的水平。比较两组中医体质分布情况、阴道灌洗液细胞因子水平,并比较两组中偏颇体质人群的阴道灌洗液细胞因子水平以及Th1/Th2细胞因子平衡情况。[结果]感染组中偏颇体质占主导(63.33%),且与对照组比较明显增高(P<0.05);感染组IL-2、IFN-γ水平明显低于对照组,IL-4、IL-10明显高于对照组,差异均有统计学意义(P<0.01);偏颇体质人群中,感染组IL-2、IFN-γ水平低于对照组,其中IL-2差异无统计学意义(P>0.05),IFN-γ差异有统计学意义(P<0.01);IL-4、IL-10水平高于对照组,差异均有统计学意义(P<0.05,P<0.01)。偏颇体质Th1/Th2细胞因子比较,感染组IL-2/IL-4、IL-2/IL-10、IFN-γ/IL-4、IFN-γ/IL-10比值均低于对照组,差异有统计学意义(P<0.05)。[结论]偏颇体质女性更易感染HR-HPV,且阴道灌洗液细胞因子Th1/Th2平衡向Th2漂移。
[Objective] To explore the correlation between Th1/Th2 balance and TCM constitution in by observing the distribution of TCM constitution, the level of cytokine in the vaginal lavage fluid and the balance of Th1/Th2 in women with cervical high-risk human papillomavirus(HR-HPV) infection and healthy women. [Methods] Sixty patients with cervical HR-HPV infection(infection group) and sixty healthy women(control group) were selected. TCM constitution identification through the"KY3H Chinese Medicine Constitution Identification Table". The levels of interleukin-2(IL-2), interferon-γ(IFN-γ), interleukin-4(IL-4) and interleukin-10(IL-10) in vaginal lavage fluid were detected by enzyme linked immunosorbent assay(ELISA). TCM constitution,the level of cytokine in vaginal lavage fluid, and the balance of Th1/Th2 cytokine was compared in the two groups and in people with biased constitution.[Results] Biased constitution was dominant in infection group(63.33%), and it was significantly higher than that in control group(P<0.05). The level of IL-2 and IFN-γ were significantly lower in infection group than control group, IL-4 and IL-10 were significantly higher than control group(P<0.01). In the biased constitution, the level of IL-2 and IFN-γ in infection group was lower than that of control group, and there was no significant difference in IL-2(P>0.05), and the difference of IFN-γ was statistically significant(P<0.01). The levels of IL-4 and IL-10 were higher than those in control group(P<0.05,P<0.01). Comparison of Th1/Th2 cytokine in biased constitution, the ratios of IL-2/IL-4, IL-2/IL-10, IFN-γ/IL-4 and IFN-γ/IL-10 in infection group were lower than control group(P<0.05). [Conclusion] Women with biased constitution are more susceptible to HR-HPV, and the balance of cytokine Th1/Th2 in vagina lavage fluid is drifting towards to Th2.
[Objective] To explore the correlation between Th1/Th2 balance and TCM constitution in by observing the distribution of TCM constitution, the level of cytokine in the vaginal lavage fluid and the balance of Th1/Th2 in women with cervical high-risk human papillomavirus(HR-HPV) infection and healthy women. [Methods] Sixty patients with cervical HR-HPV infection(infection group) and sixty healthy women(control group) were selected. TCM constitution identification through the"KY3H Chinese Medicine Constitution Identification Table". The levels of interleukin-2(IL-2), interferon-γ(IFN-γ), interleukin-4(IL-4) and interleukin-10(IL-10) in vaginal lavage fluid were detected by enzyme linked immunosorbent assay(ELISA). TCM constitution,the level of cytokine in vaginal lavage fluid, and the balance of Th1/Th2 cytokine was compared in the two groups and in people with biased constitution.[Results] Biased constitution was dominant in infection group(63.33%), and it was significantly higher than that in control group(P<0.05). The level of IL-2 and IFN-γ were significantly lower in infection group than control group, IL-4 and IL-10 were significantly higher than control group(P<0.01). In the biased constitution, the level of IL-2 and IFN-γ in infection group was lower than that of control group, and there was no significant difference in IL-2(P>0.05), and the difference of IFN-γ was statistically significant(P<0.01). The levels of IL-4 and IL-10 were higher than those in control group(P<0.05,P<0.01). Comparison of Th1/Th2 cytokine in biased constitution, the ratios of IL-2/IL-4, IL-2/IL-10, IFN-γ/IL-4 and IFN-γ/IL-10 in infection group were lower than control group(P<0.05). [Conclusion] Women with biased constitution are more susceptible to HR-HPV, and the balance of cytokine Th1/Th2 in vagina lavage fluid is drifting towards to Th2.
引文
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[10]时扬,米淑玲,辛乐,等.宫颈感染人乳头瘤病毒-16患者血清锌、白细胞介素-2,-10的相关性分析[J].中华妇幼临床医学杂志(电子版),2011,7(2):109-112.
[11]陈晋广,杨志波,朱明芳.中药黄白液对复发性生殖器疱疹患者外周血Th1/Th2细胞因子的影响[J].中国中西医结合皮肤性病学杂志,2009,8(5):294-295.
[12]胡雅君,何啸兰,贺漪,等.宫颈鳞癌患者外周血单个核细胞Th1/Th2平衡状态的研究[J].实用预防医学,2010,17(12):2350-2351.
[13]Feng Q,Wei H,Morihara J,et al.Th2 type inflammation promotes the gradual progression of HPV-infected cervical cells to cervical carcinoma[J].Gynecol Oncol,2012,127(2):412-419.
[14]孙红,刘晓莹.“治未病”思想在防治宫颈癌前病变(CIN)中的应用[J].新疆中医药,2011,29(6):73-74.
[2]周少林,戴小丽.中医体质学说在“治未病”中的应用探讨[J].辽宁中医杂志,2012,39(3):448-451.
[3]郭春香,宋静慧.宫颈病变与阴道局部细胞免疫研究新进展[J].中国妇产科临床杂志,2013,14(5):472-474.
[4]中华中医药学会.中医体质分类与判定[M].北京:中国中医药出版社,2009:1-4.
[5]刘静.宫颈HR-HPV感染与中医体质及阴道免疫微环境的关系[D].北京:北京中医药大学,2012:31.
[6]何紫常,范保维,石少连,等.HR-HPV感染临床自然转归、影响因素探究[J].数理医药学杂志,2018,31(6):859-860.
[7]夏楠,任青玲.基于中医体质学说论述宫颈HPV感染的成因及防治[J].江苏中医药,2017,49(7):5-7.
[8]王琦.中医体质学[M].北京:人民卫生出版社,2009:1.
[9]董勇佔,王香.宫颈癌及宫颈上皮瘤变患者Th1/Th2水平变化及其相关炎性因子的检测与临床意义[J].中国临床新医学,2015,8(10):943-946.
[10]时扬,米淑玲,辛乐,等.宫颈感染人乳头瘤病毒-16患者血清锌、白细胞介素-2,-10的相关性分析[J].中华妇幼临床医学杂志(电子版),2011,7(2):109-112.
[11]陈晋广,杨志波,朱明芳.中药黄白液对复发性生殖器疱疹患者外周血Th1/Th2细胞因子的影响[J].中国中西医结合皮肤性病学杂志,2009,8(5):294-295.
[12]胡雅君,何啸兰,贺漪,等.宫颈鳞癌患者外周血单个核细胞Th1/Th2平衡状态的研究[J].实用预防医学,2010,17(12):2350-2351.
[13]Feng Q,Wei H,Morihara J,et al.Th2 type inflammation promotes the gradual progression of HPV-infected cervical cells to cervical carcinoma[J].Gynecol Oncol,2012,127(2):412-419.
[14]孙红,刘晓莹.“治未病”思想在防治宫颈癌前病变(CIN)中的应用[J].新疆中医药,2011,29(6):73-74.