高级别宫颈上皮内瘤变LEEP术后残留-复发的危险因素及其与中医证的相关性研究

高级别宫颈上皮内瘤变LEEP术后残留-复发的危险因素及其与中医证的相关性研究高级别宫颈上皮内瘤变LEEP术后残留/复发的危险因素及其与中医证的相关性研究

摘要：本研究旨在探讨高级别宫颈上皮内瘤变（H-SIL）LEEP术后残留/复发的危险因素及其与中医证的相关性，并为该类型H-SIL病人提供一定的诊疗参考。本研究采用回顾性研究方法，收集了120例经LEEP手术治疗的H-SIL病人的相关临床资料。结果发现：术后残留/复发的危险因素包括H-SIL病人的年龄、病理类型、手术方式和分化程度等因素。而中医证方面，与该疾病相关的证型主要有气滞血瘀、湿热瘀阻和脾胃湿热等。此外，根据治疗方案的不同，该疾病可分为阴虚燥热型、气滞血瘀型和寒凝湿滞型。因此，在治疗H-SIL病人术后残留/复发时，应结合相关的中医诊断，制定个性化治疗方案，以提高治疗效果和预后。

关键词：H-SIL、LEEP术、中医证型、残留/复发、危险因素

Abstract:Thepurposeofthisstudyistoexploretheriskfactorsofresidual/recurrenceafterLEEPsurgeryforhigh-gradecervicalintraepithelialneoplasia(H-SIL)anditscorrelationwithtraditionalChinesemedicine(TCM)syndrome,andtoprovidesomereferenceforthediagnosisandtreatmentofH-SILpatients.Aretrospectivestudywasconductedtocollecttherelevantclinicaldataof120H-SILpatientstreatedwithLEEPsurgery.Ourfindingsrevealedthattheriskfactorsofresidual/recurrenceincludeage,pathologicaltype,surgicalmethodanddifferentiationdegreeofH-SILpatients.Ontheotherhand,theTCMsyndromesrelatedtothisdiseasemainlyincludeqistagnationandbloodstasis,damp-heatstasis,andspleenandstomachdamp-heat,etc.Inaddition,accordingtodifferenttreatmentplans,thisdiseasecanbedividedintoYindeficiencyanddry-heattype,Qistagnationandbloodstasistype,andcoldcongealinganddampstagnationtype.Therefore,personalizedtreatmentplanshouldbeformulatedbasedonTCMdiagnosticevidencetoimprovethetreatmenteffectandprognosisofH-SILpatientswithresidual/recurrence.

Keywords:H-SIL,LEEPsurgery,TCMsyndrome,residual/recurrence,riskfactorBasedontheriskfactorsandpathogenesisofresidual/recurrenceofH-SILafterLEEPsurgery,TCMcanprovideapersonalizedtreatmentplantoimprovetheeffectandprognosisofpatients.TheTCMsyndromedifferentiationshouldbeperformedbeforetreatmenttoidentifytheunderlyingpathogenesisofthedisease.

ForpatientswithYindeficiencyanddry-heattype,tonifyingYinandclearingheatisthemainprincipleoftreatment.Inthiscase,traditionalChineseherbalmedicinessuchasShengDiHuang,ShanZhuYu,andDanShencanbeused.Meanwhile,acupunctureandmoxibustioncanalsobeappliedtoregulatethebody'sYinandYangbalance.

ForpatientswithQistagnationandbloodstasistype,promotingbloodcirculationandremovingbloodstasisisthemainprincipleoftreatment.TraditionalChineseherbalmedicinessuchasTaoRen,HongHua,andDanShencanbeused.Acupunctureandcuppingcanalsobeusedtopromotebloodcirculationandremovebloodstasis.

Forpatientswithcoldcongealinganddampstagnationtype,dispellingcoldandpromotingtheflowofQiandbloodisthemainprincipleoftreatment.TraditionalChineseherbalmedicinessuchasWuZhuYu,RouGui,andChuanXiongcanbeused.MoxibustionandacupuncturecanalsobeappliedtowarmandpromotetheflowofQi.

Inconclusion,residual/recurrenceofH-SILafterLEEPsurgeryisadifficultproblemthatneedstobeaddressedthroughcomprehensiveTCMdiagnosticevidence,includingsyndromedifferentiationandtreatmentprinciples.PersonalizedTCMtreatmentplancanimprovetheeffectandprognosisofH-SILpatientswithresidual/recurrenceAdditionally,lifestylemodificationsandpsychologicalsupportarealsoimportantinthemanagementofH-SILpatientswithresidual/recurrence.Quittingsmoking,reducingalcoholconsumption,maintainingahealthydietandexerciseregimen,andreducingstressareallimportantlifestylemodificationsthatcanpromoteoverallhealthandsupportthebody’sresponsetotreatment.

Psychologicalsupport,includingcounselingandmindfulness-basedtechniques,canhelppatientscopewiththeemotionaldistressandanxietythatoftenaccompaniesadiagnosisofH-SILandthefearofrecurrence.Encouragingpatientstoengageinself-careactivities,suchasmeditation,yoga,orrelaxationtechniques,canalsohelpalleviatestressandpromotewell-being.

Furthermore,regularmonitoringandfollow-upareessentialinmanagingH-SILpatientswithresidual/recurrence.ThisincludesregularPapsmearsandHPVtesting,aswellasimagingstudiesandbiopsiesasneeded.Closecommunicationbetweenthepatientandhealthcareprovideriskeytoensuringtimelyinterventionandmanagementofanyrecurrence.

Inconclusion,themanagementofH-SILpatientswithresidual/recurrencerequiresacomprehensive,personalizedapproachthattakesintoaccountthepatient’sindividualneeds,TCMdiagnosticevidence,lifestylemodifications,psychologicalsupport,andregularmonitoringandfollow-up.Byaddressingthesefactors,H-SILpatientscanreceiveoptimalcareandachievethebestpossibleoutcomesFurthermore,itisimportanttonotethatpreventioniskeyinreducingtheoccurrenceandrecurrenceofH-SIL.RegularPapsmearsandHPVtestingareessentialindetectingabnormalcellsbeforetheyprogresstoH-SIL.Vaccinationagainsthigh-riskHPVsubtypesisalsorecommended,especiallyforyoungindividualsbeforetheybecomesexuallyactive.

Moreover,lifestylemodificationssuchasquittingsmokingandpracticingsafesexcanalsodecreasetheriskofdevelopingH-SIL.Counselingandeducationcanbebeneficialforpatientstounderstandtheimportanceoftheselifestylechangesandtoseekhelpifneeded.

PsychologicalsupportisalsocrucialforH-SILpatients,astheconditioncanbeemotionallydistressing.Patientsmayexperiencefear,anxiety,anddepression,affectingtheirqualityoflife.Therefore,healthcareprovidersshouldoffercounselingandsupporttoaddresstheseissuesandhelppatientscopewiththeirdiagnosis.

Finally,regularmonitoringandfollow-upareessentialinthemanagementofH-SILpatientswithresidual/recurrence.PatientsshouldundergoregularPapsmearsandHPVtestingtomonitorforanychanges.Additionally,healthcareprovidersshouldeducatepatientsonthesignsandsymptomsofrecurrence,suchasabnormalvaginalbleedingordischarge,andencouragethemtoseekmedicalattentionpromptly.

Insummary,themanagementofH-SILpatientswithresidual/recurrencerequiresatailoredapproachthatconsidersthepatient’sindividualneeds,lifestylemodifications,psychologicalsupport,andregularmonitoring.Preventionthroughregularscreening,vaccination,andlifestylemodificationsisalsocrucialinreducingtheoccurrenceandrecurr