【作者】 陈剑云；

【导师】 池凤好；

【作者基本信息】 广州中医药大学 ， 中医外科学， 2010， 硕士

【摘要】 研究目的：尖锐湿疣是临床常见的性传播疾病,且有逐渐增长的趋势,近代研究表明HPV感染或尖锐湿疣可导致或继发生殖器恶性肿瘤如宫颈癌,外阴、肛门癌等,从而引起人类的高度重视。尖锐湿疣易于反复发作,目前中成药外用治疗尖锐湿疣的方法报道不少,但是令人满意的不多,因此寻找理想的外用中成药亦成为中医界一直关注的问题。本课题通过观察山楂核提取物为主要成份制成的消毒液-优可洛外用治疗尖锐湿疣与C02激光治疗尖锐湿疣的临床疗效比较及实验室指标比较,来探讨中成药外治尖锐湿疣的疗效,以寻找一种理想的、安全方便的尖锐湿疣外用中成药。方法：采用前瞻性随机对照研究方法,本课题将符合纳入标准的132例尖锐湿疣病例,按随机对照原则,分为优可洛治疗组65例,激光对照组67例,分别按照研究方案进行治疗。收集两组治疗前后的指标和数据进行观察：一般资料；临床疗效；治疗后创面愈合天数；病毒转阴率；复发率；不良反应。应用SPSS17.0软件统计分析,对治疗结果采用卡方检验分析。结果1.一般资料：两组在年龄、受教育程度、病程、疣体数量及积分等一般资料比较差异均无统计学意义(P>0.05)。复查时治疗组脱失6例,对照组脱失4例。2.两组疗效比较：治疗疗程结束时优可洛治疗组65例疣体去除率为100%,无效0例。激光对照组67例,疣体去除率亦为100%。两组疗效比较差异无统计学意义(P>0.05)。3.两组治疗后HPV-DNA-PCR比较：(1)治疗后1个月HPV-DNA-PCR检测：优可洛治疗组59例,阴性32例,阳性27例,阴性率为54.24%；激光组63例,阴性21例,阳性42例,阴性率为33.33%。治疗后1个月两组病毒清除率比较差异有统计学意义(P<0.05)。(2)治疗后3个月HPV-DNA-PCR检测：优可洛治疗组59例,阴性41例,阳性18例,阴性率为69.49%；激光组63例,阴性25例,阳性38例,阴性率为39.68%。治疗后3个月两组病毒清除率比较差异有统计学意义(P<0.05)。(3)6个月HPV-DNA-PCR检测：优可洛治疗组59例,阴性46例,阳性13例,阴性率为77.97%；激光组63例,阴性28例,阳性35例,阴性率为44.44%。治疗后6个月两组病毒清除率比较差异有统计学意义(P<0.05)。4.两组复发率比较：(1)治疗疗程结束后1个月内复发率比较：治疗组复发4例,复发率为6.78%,对照组复发14例,复发率为22.22%,两组治疗疗程结束后1月内复发率比较差异有统计学意义(P<0.05)。(2)治疗疗程结束后3个月内复发率比较：治疗组复发4例,复发率为6.78%,对照组复发18例,复发率为28.57%,两组治疗疗程结束后3个月内复发率比较差异有统计学意义(P<0.05)。(3)治疗疗程结束后6个月内复发率比较：治疗组复发4例,复发率为6.78%,对照组复发20例,复发率为31.75%,两组治疗疗程结束后6月内复发率比较差异有统计学意义(P<0.05)。结论优可洛祛除尖锐湿疣,与激光治疗疗效相当；在HPV转阴率、复发率等方面优于激光治疗；优可洛无明显的毒副作用及不良反应,临床疗效确切。观察证实优可洛是一种很有发展前景的中药提取物外用药。更多还原

【Abstract】 Objective:Condyloma acuminatum(CA) is the common sexually transmitted disease in clinical, and there is a gradual upward trend, recent studies have shown that HPV infection.or genital condyloma may cause or secondary malignancies such as cervical, vulvar, anal cancer, and so on, which led to a high degree of human attention。It is very easy for CA to recurrent attacke, The method of Chinese medicine topical treatment of condyloma have been reported for many times which make little effect, it is becoming an isue to find an ideal method of chinese herbal for CA. in the professin of TCM. This research is to study the efficiency of YOUKELUO which is an chinese hebal medicine,according to observe the efficiency and laboratory indicators for comparison of youkeluo and C02 laser for CA, the aim of the study is to find an ideal, safe and convenient chinese patent medicinefor CA.Method:A prospective randomized controlled study is used in the research,132 cases of condyloma cases which meet the inclusion criteria will be divided into treatment group 65 cases of Youke Luo and laser control group,67 cases, respectively in accordance with research program for treatment. two sets of indicators and data before and after the treatment will be Collectted which including general informations, clinical effects, the days of the the surface of wound healing, the rate of the clearance of the virus, the rate of the recurrence, the safety, the untoward effect and so on。The softwareof spssl7 is used to analysis the date, Chi-square test is used to analysis the results of treatmentResults: 1.general informations:there is no statistical significance in the comparision of the age, the degree of education, the course of disease and the number of the warts.2. Comparison of the efficacy of the two groups:in treatment group, there were 65 cases of traditional chinese medicine "Youkeluo", All the warts of which were removed, The rate of elimination was 100%; laser-control group,67 cases, the virus removal rate is also 100%. There is no significant difference between the two groups (P>0.05).3. Comparison of HPV-DNA-PCR results of the two groups:(1) HPV-DNA-PCR results of the inspection:excellent Luo treated 59 cases can be negative in 32 cases,27 cases were positive and negative rate was 54.24%; laser group 63 cases, negative 21 cases,42 cases of positive and negative rate was 33.33%. Using chi-square test P=0.020, difference between two groups of viral clearance rate was statistically significant (P<0.05).(2)HPV-DNA-PCR results of the inspection:treatment groups:41 cases were negative,18 cases were positive and negative rate was 77.97%;laser group:negative 25 cases,38 cases of positive and negative rate was 39.68%. difference between two groups of viral clearance rate was statistically significant (P<0.05).(3)HPV-DNA-PCR results of the inspection:excellent Luo treated 59 cases can be negative in 46cases,13 cases of positive and negative rate was 69.49%; laser group:negative 28 cases, positive in 35 cases, negative rate was 44.44%. Difference between two groups of viral clearance rate was statistically significant (P<0.05).4. Comparison of relapse rate of the two groups:(1)1 month after treatment,4 cases recurrenced in the treatment, the recurrence rate was 6.78%. in control group 1 month after treatment 14 cases of recurrence, the recurrence rate was 22.22%,,1 month after treatment two groups compared the recurrence rate, the difference was statistically significant (P<0.05).(2) 3 months after treatment, in the treatment group 4 case recurrenced, the recurrence rate was 6.78%, in the control group18 cases recurrenced 3 months after treatment, the recurrence rate was28.57%, in the two groups 3 months after treatment, difference in recurrence rate statistically significant (P<0.05). (3)6 months after treatment,4 cases recurrenced in the treatment group, the recurrence rate was6.78%.20 cases recurrenced 6 months after treatment in the control group, the recurrence rate was 31.75%, in the two groups 6 months after treatment, difference in recurrence rate statistically significant (P<0.05). Conclusiongs:Youkeluo can remove the lesion of CA, which can be compared with the efficiency of the C02 laser, however the rate of the repelling the HPV, the rate of the recurrence are better than the C02 laser. The clinical efficacy of YOUKELUO is lclear, the side effect and untoward effect are slight. YOUKELUO is confirmed to be a great prospect for the development of Chinese medicine for external use.更多还原