中西医结合治疗外阴上皮内非瘤样病变临床观察

目的观察中西医结合治疗外阴上皮内非瘤样病变的疗效。方法将100例门诊病理确诊为外阴上皮内非瘤样病变女性患者,分为中西医结合组(治疗组)和西药组(对照组),每组50例,治疗组口服滋补肝肾、养血祛风中药,同时每晚睡前将该方药渣煎水500mL,坐浴5～10min;每天用金甘油(本院自制皮肤外用药,主要成分:金霉素、甘油等)涂抹外阴病变处2次。对照组每天用温水坐浴5～10min,金甘油涂抹外阴病变处2次。均以治疗2个月为1个疗程,治疗1个疗程并随访2个月后进行疗效评定,观察治疗前后局部皮肤病损程度、阴部痒痛程度及局部病变组织中雌、孕激素受体水平。结果治疗组临床总有效率为94%(47/50),对照组为66%(33/50)。两组治疗结束2月后阴部局部皮肤病损程度、阴部痒痛程度症状积分比较差异均有统计学意义(P<0.01),治疗组优于对照组。而两组局部病变组织中雌、孕激素受体阳性率比较差异无统计学意义。结论中西医结合治疗方法能有效治疗外阴上皮内非瘤样病变,并明显改善相关临床症状。

英文摘要:

Objective To assess the clinical effect of integrative Chinese and Western medicine in treating nontumorous vulval intraepithelial lesion(NIEL).Methods One hundred patients of NIEL,with their diagnosis confirmed by pathologic examination,were equally assigned to two groups randomly,the treatment group and the control group.The treatment group was treated by Chinese recipe consisting of herbs for nourishing Gan-Shen,it was decocted for 3 times,the foregoing two decoctions for oral intake,and the latter one(500 mL)for hip bathing 5-10 min every night before sleep.Besides,the self-formulated preparation Jingan oil(composed of aureomycin and glycerine,etc.),was locally applied twice every day.The control group was treated only by local applying of Jingan oil and a 5-10 min hip bathing with warm water every night.The course for both groups was 2 months.Efficacy of the treatment was assessed at the end of the therapeutic course and after a 2-month follow-up,depending on the changes of local lesion degree,vulval symptoms as pain and itching,estrogen and progestin receptors in the lesion,and the scores of symptoms.Results The total clinical effective rate was 94%(47/50)in the treatment group and 66%(33/50)in the control group.The severity of local lesion degree,symptoms of pain and itching and the scores of symptoms were significantly improved in both groups,as compared with those before treatment(all P<0.01).However,comparison between groups showed that the improvement was better in the treatment group.The positive rates of estrogen and progestin receptors in the local lesions of the two groups showed insignificantly statistical difference.Conclusion The integrative medical treatment can effectively alleviate the NIEL and improve the relevant clinical symptoms.

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