摘要
目的:探讨清热益气方防治复发性生殖器疱疹(Recurrent genitalherpes,RGH)的临床意义和作用机理;探讨RGH患者包皮和宫颈上皮人β防御素-2(humanβdefensin 2,hBD-2)的表达情况及清热益气方对其影响。
方法:临床89例RGH患者完全随机分为泛昔洛韦组29例,清热益气方组30例和清热益气方加泛昔洛韦组30例,分别观察治疗前后临床症状积分、临床有效率、3个月和6个月内复发率,检测患者治疗前后外周血T淋巴细胞亚群的变化,并与20例健康者进行比较。实验部分13例男性患者、14例女性患者各分别随机分为清热益气方组和泛昔洛韦组,于治疗前后检测hBD-2的表达情况,并各与5例健康者进行比较。
结果:1.三组治疗后临床症状积分均明显改善,三组近期临床有效率无显著性差异,3个月和6个月内复发情况比较,清热益气方加泛昔洛韦组明显优于其它两组。2.清热益气方组和清热益气方加泛昔洛韦组均能提高患者外周血CD_3~+、CD_4~+T淋巴细胞百分比和CD_4~+/CD_8~+比值,但泛昔洛韦组治疗前后无明显变化。3.正常人和RGH患者包皮和宫颈上皮中均可检测到hBD-2表达,但RGH患者表达比正常人明显增多,治疗后检测hBD-2表达情况,清热益气方组表达高于泛昔洛韦组。
结论:清热益气方适用于RGH治疗,可以改善患者的免疫功能,与泛昔洛韦合用防止GH复发有协同作用,并可保持患者局部hBD-2的较高浓度表达。
Objective:To investigate the clinical significance and mechanism of Qi-Tonifying Heat-Clearing Decoction in preventing and curing the Recurrent genital herpes(RGH). To investigate the expressive situation of prepuce and neck of uterus humanβ-Defension-2(hBD-2) and influence of Qi-Tonifying Heat-Clearing Decoction.
Method:The 89 patients were randomly divided into 3 groups completely. 29 were treated with Famciclovir. 30 were with Qi-Tonifying Heat-Clearing Decoction. 30 were with Qi-Tonifying Heat-Clearing Decoction combined Famciclovir. Observed the integral of clinical symptoms, clinical efficient rate, and the recurring rate respectively before and after the treatment, also checked the change of T-Lymphocyte subsets, and compared with 20 normal person. In the part of experiment, 13 male patients and 14 female patients were randomly devided into the group treated with Qi-Tonifying Heat-Clearing Decoction, the group with Famciclovir. The expressive situation of hBD-2 were observed before and after the treatment comparing with 5 normal person respectively.
Results:
1. The integral of clinical symptoms were improved obviously after theatment for three groups. There was no significant difference in clinical rate for another three groups. The group treated with Qi-Tonifying Heat-Clearing Decoction combined Famciclovir showed a lower recurring rate than other two groups.
2. The group treated with Qi-Tonifying Heat-Clearing Decoction and Qi-Tonifying Heat-Clearing Decoction combined Famciclovir can improve the percentage of CD_3~+,CD_4~+ T-Lymphocyte and the rate of CD_4~+ and CD_8~+ in periphery blood for patients.
3. hBD-2 can be found in prepuce and neck of uterus for normal person and the patients with RGH, but the patients with RGH got more. The group treated with Qi-Tonifying Heat-Clearing Decoction showed higher efficient rate than Famciclovir by checking the situation of expression after treatment.
Conclusion: Qi-Tonifying Heat-Clearing Decoction is effective for patient with RGH. It can improve the function of immunity, also prevent the recurring of RGH combining with Famciclovir, and keep a higher density of hBD-2 in local parts of body.
引文
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