Meta Analysis Of Traditional Chinese Medicine Combined With Interferon In The Treatment Of Cervical High-risk Human Papilloma Virus Infection

Objective:To evaluate the clinical efficacy of traditional Chinese medicine combined with interferon(IFN)in the treatment of cervical high-risk human papillomavirus(HR-HPV)infection by using the statistical method of meta-analysis,in order to provide real and reliable evidence-based medicine.Method:According to the purpose of the research,the key words were defined and the retrieval type were constructed.Objective to search CNKI,CBM,VIP,WANFANG and PubMed for relevant literature on the treatment of HR-HPV infection with TCM combined with interferon from the date of establishment to August 3 1,2020.All the literatures were screened according to the inclusion and exclusion criteria,and then the data of the included literatures were extracted.The risk of literatures was evaluated by Revaman5.4.Meta-analysis was performed on the outcome indicators,and the results were analyzed by heterogeneity test,sensitivity analysis,subgroup analysis and publication bias evaluation under revamn5.4.Results:1 A total of 35 articles were included in this study,all of which were in Chinese.There were 3 83 9 patients in all incorporated in this study,including 2004 in the experimental group and 193 4 in the control group.The results of bias risk assessment showed that all literature had different degrees of bias and low quality.2 Meta-analysis results:Chinese medicine combined with interferon in the treatment of HR-HPV infection in HPV related outcome indicators such as HPV negative conversion rate[RR=1.3 6,9 5%CI(1.27,1.4 5),Z=9.15,P<0.00 001],total effective rate of HPV treatment[RR=1.2 5,9 5%CI(1.1 7,1.3 4),Z=6.66,P<0.0000 1],HPV viral load[SMD=-1.99,95%CI(-2.77,-1.21),Z=5.02,P<0.00001];cervical disease related outcome indicators such as CIN I reversal rate[RR=1.26,95%CI(1.08,1.47),Z=2.99,P=0.003],total effective rate of cervicitis treatment[RR=1.17,95%CI(1.09,1.26),Z=4.3 0,P<0.0001],TCM syndrome outcome indicators such as total effective rate of TCM syndrome treatment[RR=1.28,95%CI(1.13,1.45),Z=3.93,P<0.0001],TCM syndrome score[SMD=-1.66,95%CI(-2.0 8,-1.24),Z=7.72,P<0.00001];total effective rate of clinical comprehensive outcome indicators such as total effective rate of clinical comprehensive effect[RR=1.20,95%CI(1.1 4,1.26),Z=7.3 1,P<0.0000 1];immune function related outcome indicators such as CD4+cell level[MD=4.78,9 5%CI(3.11,6.4 5),Z=5.62,P<0.00001],CD4+/CD8+ratio[MD=0.24,95%CI(0.10,0.3 7),Z=3.44,P=0.0006];and so on are likely better than interferon,the difference is statistically significant.There is no significant difference in CD8+cell level[MD=-0.17,95%CI(-2.23,2.58),Z=0.14,P=0.89]and incidence of adverse reactions[(RR=0.67,95%CI(0.41,1.08),Z=1.64,P=0.10]between TCM combined with interferon and interferon alone in the treatment of HR-HPV infection.3 The sensitivity analysis indicated that the meta-analysis of CD8+cell level was not stable.The results of publication bias showed there might be bias in HPV negative conversion rate and total effective rate,HPV viral load,total effective rate of TCM syndrome,TCM syndrome score and total effective rate of clinical comprehensive efficacy.The publication bias of adverse reactions was small.Conclusion:1 Traditional Chinese medicine combined with interferon in the treatment of cervical HR-HPV infection may be better than interferon in terms of HPV curative effect,cervical disease curative effect,TCM syndrome curative effect,clinical comprehensive curative effect and immune function curative effect.2 Traditional Chinese medicine combined with interferon in the treatment of cervical HR-HPV infection has no obvious advantage in incidence of adverse reactions.