| Objective:1. The use of Meta-analysis method to evaluate the clinical efficacy of traditional Chinese medicine cervical human papillomavirus (HPV) infections, by understanding the current treatment, analysis of Chinese medicine treatment of cervical HPV infection in the role and efficacy characteristics, so the future of cervical HPV infection in clinical research and reference applications.2. The impact of clinical studies of the clinical efficacy of drugs tied to poisoning caused by blood stasis type of cervical HPV infection for blood detoxification dampness Treatment of cervical HPV infection in the clinical efficacy and safety of more reference.Method:Research ideas and experimental design of this paper is divided into three parts, the first part of the literature review of cervical HPV infection, respectively, according to modern medicine and traditional medicine research progress of the disease to be summarized; the second part is the traditional Chinese medicine Meta-analysis of HPV infection, and the third part is the clinical application of blood detoxification dampness treatment of cervical HPV infection efficacy.Meta-analysis:According to the International Center Evidence-Based Medicine/ Cochrane Collaboration Handbook standards, a computer search of Wanfang database (WF, 1998-2016), Chinese Biomedical Literature Database (CBM,1979-2016), Chinese full-text periodical database HowNet (CNKI,1979-2016), VIP Chinese scientific and technical journals database (VIP,1989-2016), building a database to retrieve the number of years from January 2016 to include the relevant Chinese medicine treatment of cervical HPV infection in randomized controlled trials (randomized controlled trial, RCT) or quasi-randomized controlled trials (Quasi Randomised controlled trial, Quasi-RCT) literature will be screened literature according to Cochrane Review Handbook 5.0 quality evaluation criteria, included literature research randomization, blinding the use, allocation concealment implementation, sample size, relatively balanced between the two groups, treatment methods, statistical methods, follow-up and lost other content data extraction and quality assessment. Using the Cochrane Collaboration Review Manager 5.3 software developed by Meta-analysis, evaluation of the effectiveness of Chinese medicine in HPV negative rates of cervical erosion and improve the area.Clinical Research:Clinical included patients with cervical HPV infection in line with Western diagnostic criteria and poisoning caused by blood stasis syndrome TCM diagnostic criteria for blood detoxification dampness the method of treatment, usually menstrual regularity of poison will be tied (by the Curcuma, honeysuckle, forsythia, cork, comfrey etc.) and placed deep in the vaginal vault,1/night,20 days for a continuous treatment medication cycle interval 5-10 days until the start of the next menstrual clean after two cycles 3 treatment cycles as a course; postmenopausal patients enrolled after the beginning of treatment,20 days for a treatment cycle, every 10 days, and continue to the first two cycles, three cycles for a course of treatment, after treatment review of cervical HPV infection Happening.By observing with local treatment of drug suppository clinical efficacy in patients with cervical HPV infection, HPV negative situation observed after treatment, and the main symptoms (such as vaginal discharge quantity, color, quality anomalies, genital itching, contact bleeding, degree of cervical erosion, dry mouth, mouth pain, lower abdomen or lumbosacral pain, abnormal urine, etc.) score, calculated using the method of nimodipine, efficacy index=(points before treatment-after treatment points)/points before treatment X 100%, based on the total clinical efficacy integral change, TCM symptom improvement as the indexes assess treatment efficacy and safety observations.Result:1.Meta AnalysisDatabases were developed for different search strategies were retrieved Chinese literature 1641, re-check to exclude 582 documents. By reading the title, abstract, exclude obviously does not meet the requirements of the document 977, the remaining 82 documents download Read the full screening and exclusion are not marked with "randomized controlled" or non-compliance evaluate the diagnostic system, inclusion and exclusion criteria documents 69 eventually included 13 Chinese medicine treatment of cervical HPV infection in randomized controlled trials (RCT) or quasi-randomized controlled trials (Quasi-RCT), this 13 literature literature data extraction and quality assessment. Risk of bias assessment results show that the present study included literature of methodological quality and reporting quality is generally low, with high risk of bias.13 Document CCP provides 1198 cases of cervical HPV infection were randomly divided into test group and the control group 612 cases 586 cases, through the included studies Meta-analysis results are as follows:(1) Based on comparison of the efficacy of HPV negative rate:13 Document test for heterogeneity 12= 77%, P<0.00001, significant heterogeneity, the random effects model, RR=1.33,95% CI [1.10,1.62], P=0.003<0.01, treatment group and control HPV negative group had statistically significant efficacy rate, indicating that medicine in the treatment of cervical HPV infection HPV negative rate effective than Western medicine group; comparison of cervical erosion:6 Document test for heterogeneity 12=76%, P=0.0009, significant heterogeneity, the random effects model, RR=1.15,95% CI [0.99,1.33], P=0.06> 0.05, the treatment group and the control group, no significant difference between cervical erosion, indicating that medicine in the treatment of cervical HPV infection Clinical aspects of cervical erosion is almost equivalent to the WM group. (2) according to the different routes of administration subgroup analysis, the treatment group with oral joint topical application of traditional Chinese manner, after treatment, HPV negative rates than western medicine control group (RR=1.46,95% CI [1.22,1.73], significantly experiment Z=4.20, P<0.0001), the difference was statistically significant. Treated with simple topical application of traditional Chinese manner, after treatment, HPV negative rates than western medicine control group (RR= 1.15,95% CI [0.94,1.40], significant experimental Z=1.39, P=0.17> 0.05), show the difference was not statistically significant. The treatment group whether it is oral or topical separate joint topical application of traditional Chinese manner, no significant difference (RR =1.75,95% CI [0.76,4.02] the degree of improvement after treatment of cervical erosion and western medicine group, significant experimental Z=1.32, P=0.19> 0.05; RR=1.07,95% CI [0.93,1.25], significant experimental Z=0.96, P=0.34> 0.05). (3) different subgroup analysis according to drug treatment, regardless of treatment for two months or three months after the application of traditional Chinese medicine treatment of HPV negative rate of the control group (RR=1.67,95% CI [1.27,2.18], significant test Z-3.70, P=0.0002<0.01; RR = 1.20,95% CI [1.09,1.32], significant experimental Z=3.74, P=0.0002<0.01), the difference was statistically significant. After 2 months of treatment group after treatment of cervical erosion degree of improvement than the comparison group of poor efficacy (RR= 0.64,95% CI [0.44,0.93], significant experimental Z=2.36, P=0.02<0.05), the difference was statistically significance. Chinese medicine treatment after 3 months after cervical erosion degree of improvement than comparison group (RR=1.21,95% CI [1.06,1.37], significant experimental Z=2.93, P=0.003<0.01). (4) The sensitivity analysis showed that larger studies exclude the weights, HPV negative cervical erosion rates and evaluation results did not change, indicating that research results are stable. (5) substantially symmetrical funnel plot, indicating publication bias is unlikely.2. Clinical ResearchAfter total symptom scores before and after treatment by t test; clinical collected 36 cases of cervical HR-HPV infection to blood detoxification dampness for the law, after a bolt of drug treatment, HPV negative rate of 50%, the total effective rate was 58.3%, P<0.01, the difference was statistically significant; aspects of TCM syndrome effect, determined by calculating the integral effect, cured 10 cases, effective in 16 cases,10 cases, total effective rate was 72.22%; change in three main symptoms before and after treatment, vaginal discharge volume, color, odor, texture, lumbar pain, abnormal urine situation improved to varying degrees, of which the most significant improvement in the case of vaginal discharge.Conclusion:1.Meta analysis results suggest that Chinese medicine can effectively clear the HPV infection and for HPV negative rate effective than Western medicine, although there is a certain effect, but no significant difference for cervical erosion and western medicine alone. Because included a small number of documents, lower quality, the lack of standardization, this Meta analysis results may be affected, clinical reference The evaluation results should be combined with analysis of specific situations.2. In recent years, Chinese medicine clinical study of the treatment of cervical HPV infection in the implementation, application blinded randomization method has not been given sufficient attention, clinical research norms implementation to be improved.3. The results of clinical studies confirmed that blood detoxification dampness Treatment of cervical HPV infection is safe and effective antiviral can prevent the occurrence of cervical cancer, is of great value for clinical application. |
PDF Full Text Request